Mei Yangyang, Chen Yiming, Zhang Bo, Xia Wei, Shao Naiyuan, Feng Xingliang
Department of Urology, Jiangyin People's Hospital, the Jiangyin Clinical College of Xuzhou Medical University, Jiangyin, Jiangsu, China.
Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Front Endocrinol (Lausanne). 2024 Nov 20;15:1492836. doi: 10.3389/fendo.2024.1492836. eCollection 2024.
Erectile dysfunction (ED) is one of the most common male sexual disorders, closely associated with both inflammation and lipid dysregulation. Recently, a novel inflammation-lipid composite marker, CRP/HDL, has been proposed to integrate the impact of both pathways on health, yet its relationship with ED remains unexplored. Therefore, our study aimed to investigate the potential association between the CRP/HDL ratio and ED.
We utilized data from the NHANES database, known for its comprehensive and high-quality information. A total of 3,633 eligible participants from the 2001-2004 cycles were included. ED was assessed using a single-item questionnaire, while CRP and HDL were measured from blood samples. Multivariable regression analyses were performed to evaluate the association between CRP/HDL and ED after adjusting for potential confounders. Additionally, subgroup and sensitivity analyses were conducted to test the robustness of the results, and the linear trend between CRP/HDL and ED was visualized through smooth curve fitting.
Among the 3,633 participants, 1,027 had a history of ED. The CRP/HDL ratio was significantly higher in participants with ED compared to those without (10.53 ± 0.69 vs. 7.43 ± 0.35, P<0.001). In the regression analysis, a higher continuous CRP/HDL ratio was significantly associated with increased ED risk even after full adjustment (OR: 1.17, 95% CI: 1.05, 1.30; P = 0.01). Compared to Q1 of the CRP/HDL ratio, participants in Q2, Q3, and Q4 had progressively higher ED risks: Q2 (OR: 1.40, 95% CI: 1.01, 1.95; P = 0.05), Q3 (OR: 1.58, 95% CI: 1.10, 2.27; P = 0.02), and Q4 (OR: 1.85, 95% CI: 1.31, 2.60; P = 0.005), showing a clear linear trend. Subgroup analyses indicated consistent results across various populations with no significant interactions, and sensitivity analysis revealed that the CRP/HDL ratio also increased the risk of severe ED (OR: 1.14, 95% CI: 1.03, 1.26; P = 0.02).
This is the first study to establish a significant positive association between an elevated CRP/HDL ratio and ED risk, suggesting its potential role in screening for ED risk and guiding timely interventions. However, further large-scale studies are needed to confirm our findings and explore the underlying mechanisms.
勃起功能障碍（ED）是最常见的男性性功能障碍之一，与炎症和脂质代谢紊乱密切相关。最近，一种新型的炎症 - 脂质复合标志物CRP/HDL被提出，以综合这两种途径对健康的影响，但其与ED的关系仍未得到探索。因此，我们的研究旨在调查CRP/HDL比值与ED之间的潜在关联。
我们利用了以全面和高质量信息著称的美国国家健康与营养检查调查（NHANES）数据库的数据。纳入了2001 - 2004周期的3633名符合条件的参与者。使用单项问卷评估ED，同时从血液样本中测量CRP和HDL。在调整潜在混杂因素后，进行多变量回归分析以评估CRP/HDL与ED之间的关联。此外，进行亚组和敏感性分析以检验结果的稳健性，并通过平滑曲线拟合直观显示CRP/HDL与ED之间的线性趋势。
在3633名参与者中，1027人有ED病史。与没有ED的参与者相比，有ED的参与者的CRP/HDL比值显著更高（10.53±0.69对7.43±0.35，P<0.001）。在回归分析中，即使在完全调整后，较高的连续CRP/HDL比值也与ED风险增加显著相关（比值比：1.17，95%置信区间：1.05，1.30；P = 0.01）。与CRP/HDL比值的第一四分位数相比，第二、第三和第四四分位数的参与者ED风险逐渐升高：第二四分位数（比值比：1.40，95%置信区间：1.01，1.95；P = 0.05），第三四分位数（比值比：1.58，95%置信区间：1.10，2.27；P = 0.02），第四四分位数（比值比：1.85，95%置信区间：1.31，2.60；P = 0.005），呈现出明显的线性趋势。亚组分析表明，在不同人群中结果一致，无显著交互作用，敏感性分析显示CRP/HDL比值也增加了严重ED的风险（比值比：1.14，95%置信区间：1.03，1.26；P = 0.02）。
这是第一项证实升高的CRP/HDL比值与ED风险之间存在显著正相关的研究，表明其在筛查ED风险和指导及时干预方面的潜在作用。然而，需要进一步的大规模研究来证实我们的发现并探索潜在机制。
