Zhang Yuhao, Zang Nan, Xiang Yingyue, Lin Fanlu, Liu Xue, Zhang Jing
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Department of Urology, Linyi Central Hospital, Linyi, Shandong, China.
Front Endocrinol (Lausanne). 2025 Jan 13;15:1412369. doi: 10.3389/fendo.2024.1412369. eCollection 2024.
Erectile dysfunction (ED) is characterized by the inability to achieve or maintain penile erection sufficient for intercourse. While previous research suggests a potential link between ED and prostate pathologies, the association between benign prostatic hyperplasia (BPH), prostatitis, prostatic cancer (PCa), and ED remains to be elucidated.
Data from participants (40-80 years, n=2225) were extracted from the NHANES 2001-2004 for this observational study. The investigation encompassed the following aspects: assessment of ED prevalence within subgroups, comparison of baseline characteristics between individuals with and without ED, analysis of associations between BPH, prostatitis, PCa, and ED using multivariable weighted logistic regression in the 40-60 and 60-80 age groups and subgroup analysis based on body mass index, hypertension, diabetes, and smoking status.
Among the 2225 participants, the weighted prevalence of ED was 27.47%, with 16.17% in the 40-60 years age group and 56.98% in the 60-80 years age group. BPH had an ED prevalence of 47.57%, prostatitis 34.62%, and PCa 85.62%. Comparative analysis between ED and non-ED groups revealed significant differences in education levels, PIR, smoking and alcohol status, creatinine, total cholesterol, LDL cholesterol, diabetes, hypertension, BPH, and PCa. Multivariate logistic regression analysis identified BPH as an independent risk factor for ED in the 60-80 years age group (OR=1.93; 95% CI, 1.18-3.18, P=0.02), and PCa was positively associated with ED in both the 40-60 years group (OR=11.90; 95% CI, 1.41-100.50, P=0.03) and the 40-80 years group (OR=7.30; 95% CI, 2.12-25.08, P=0.01). No clear correlation was found between prostatitis and ED. Subgroup analyses indicated that the association between BPH and ED was significant in non-diabetic, overweight/obese, and smoking groups, while the association between PCa and ED was more pronounced in non-diabetic, hypertensive individuals across all body mass index (BMI) categories, and in both smoking and non-smoking groups. Prostatitis showed no significant relationship with ED in any subgroup.
The study established BPH and PCa as significant risk factors for ED, with no substantial link detected between prostatitis and ED. This finding highlights the necessity for tailored screening and management protocols for individuals with BPH and PCa to mitigate the burden of ED.
勃起功能障碍（ED）的特征是无法实现或维持足以进行性交的阴茎勃起。虽然先前的研究表明ED与前列腺疾病之间存在潜在联系，但良性前列腺增生（BPH）、前列腺炎、前列腺癌（PCa）与ED之间的关联仍有待阐明。
从2001 - 2004年美国国家健康与营养检查调查（NHANES）中提取参与者（40 - 80岁，n = 2225）的数据用于这项观察性研究。调查包括以下方面：评估亚组内的ED患病率，比较有ED和无ED个体的基线特征，在40 - 60岁和60 - 80岁年龄组中使用多变量加权逻辑回归分析BPH、前列腺炎、PCa与ED之间的关联，并基于体重指数、高血压、糖尿病和吸烟状况进行亚组分析。
在2225名参与者中，ED的加权患病率为27.47%，40 - 60岁年龄组为16.17%，60 - 80岁年龄组为56.98%。BPH患者的ED患病率为47.57%，前列腺炎患者为34.62%，PCa患者为85.62%。ED组与非ED组的比较分析显示，在教育水平、贫困收入比、吸烟和饮酒状况、肌酐、总胆固醇、低密度脂蛋白胆固醇、糖尿病、高血压、BPH和PCa方面存在显著差异。多变量逻辑回归分析确定BPH是60 - 80岁年龄组中ED的独立危险因素（OR = 1.93；95% CI，1.18 - 3.18，P = 0.02），PCa在40 - 60岁组（OR = 11.90；95% CI，1.41 - 100.50，P = 0.03）和40 - 80岁组（OR = 7.30；95% CI，2.12 - 25.08，P = 0.01）中均与ED呈正相关。未发现前列腺炎与ED之间有明显相关性。亚组分析表明，BPH与ED之间的关联在非糖尿病、超重/肥胖和吸烟组中显著，而PCa与ED之间的关联在所有体重指数（BMI）类别的非糖尿病、高血压个体中以及吸烟和非吸烟组中更为明显。前列腺炎在任何亚组中与ED均无显著关系。
该研究确定BPH和PCa是ED的重要危险因素，未检测到前列腺炎与ED之间有实质性联系。这一发现凸显了为BPH和PCa患者制定针对性筛查和管理方案以减轻ED负担的必要性。
