Xu Yang, Li Shuofeng
Department of Urology, Huzhou Central Hospital, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, China.
Department of Urology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China.
Front Endocrinol (Lausanne). 2025 Mar 25;16:1545272. doi: 10.3389/fendo.2025.1545272. eCollection 2025.
Erectile dysfunction (ED) is a prevalent condition closely associated with systemic inflammation and metabolic disorders. The red cell distribution width to albumin ratio (RAR) is an emerging inflammatory marker; however, its relationship with ED remains poorly understood.
This study conducted a cross-sectional analysis of data from 3,950 participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2004 cycle to evaluate the association between RAR and ED risk. A Multivariable logistic regression model was employed to assess the relationship between RAR and ED, while a generalized additive model (GAM) and dose-response analysis were utilized to explore potential nonlinear associations. Subgroup analyses were performed to investigate interactions with demographic and lifestyle factors.
Among the study population, 1,157 individuals reported a history of ED. The prevalence of ED was significantly higher in individuals aged 50 years and older (86.78%) and was associated with increased rates of hypertension, diabetes mellitus, and cardiovascular disease ( < 0.001). A J-shaped relationship was identified between RAR and ED risk. Specifically, the risk of ED significantly increased below the RAR threshold of 3.42 (OR = 3.01, 95% CI: 2.08-4.36, < 0.001), while the risk plateaued at higher RAR values. Subgroup analyses revealed significant interactions with ethnicity (P = 0.018) and moderate-intensity physical activity ( = 0.004). Non-Hispanic whites (OR = 2.85) and individuals engaging in moderate-intensity activity (OR = 3.83) exhibited a heightened risk of ED. No significant interactions were observed for other variables, including age and BMI.
The results demonstrated that RAR was independently associated with ED risk, exhibiting a J-shaped relationship. There was a significant increase in risk below RAR = 3.42, with saturation occurring after exceeding this threshold.
勃起功能障碍（ED）是一种普遍存在的疾病，与全身炎症和代谢紊乱密切相关。红细胞分布宽度与白蛋白比值（RAR）是一种新兴的炎症标志物；然而，其与ED的关系仍知之甚少。
本研究对2001 - 2004年全国健康与营养检查调查（NHANES）中3950名参与者的数据进行横断面分析，以评估RAR与ED风险之间的关联。采用多变量逻辑回归模型评估RAR与ED之间的关系，同时利用广义相加模型（GAM）和剂量反应分析来探索潜在的非线性关联。进行亚组分析以研究与人口统计学和生活方式因素的相互作用。
在研究人群中，1157人报告有ED病史。50岁及以上人群中ED的患病率显著更高（86.78%），且与高血压、糖尿病和心血管疾病的发生率增加相关（<0.001）。在RAR与ED风险之间发现了一种J形关系。具体而言，当RAR阈值低于3.42时，ED风险显著增加（OR = 3.01，95%CI：2.08 - 4.36，<0.001），而在较高的RAR值时风险趋于平稳。亚组分析显示与种族（P = 0.018）和中等强度体力活动（= 0.004）存在显著相互作用。非西班牙裔白人（OR = 2.85）和从事中等强度活动的个体（OR = 3.83）患ED的风险更高。对于包括年龄和BMI在内的其他变量，未观察到显著的相互作用。
结果表明，RAR与ED风险独立相关，呈现J形关系。在RAR = 3.42以下风险显著增加，超过该阈值后出现饱和。
