Zhu Leilei, Gao Qingqiang, Guo Xiaojia, Xu Zeqiao, Zhang Jian
Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, China.
Department of Andrology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, China.
Arch Med Sci. 2024 Jun 12;21(2):597-604. doi: 10.5114/aoms/188718. eCollection 2025.
Although several observational studies have explored the association between sleep traits and the risk of erectile dysfunction (ED), it remains controversial. In the present study, we included a wide range of sleep traits that are commonly observed in clinical practice. We investigated the causal relationship between these sleep traits and ED using univariate and multivariate Mendelian randomization (MR) methods.
Instrumental variables (IVs) for eight sleep traits (insomnia, sleep duration, chronotype, and sleep apnea syndrome), five confounders (depression, body mass index, smoking initiation, alcohol consumption, and type 2 diabetes), and ED were derived from genome-wide association study (GWAS) data of individuals of European ancestry. The primary analysis technique used was the inverse-variance weighted (IVW) approach. Furthermore, several sensitivity analyses were conducted to evaluate heterogeneity, horizontal pleiotropy, and stability.
MR analysis revealed that increased snoring, short sleep, and frequent insomnia were associated with a higher risk of ED. Furthermore, we found evidence of a significant association between being a morning person and the risk of developing ED. This association persisted in multivariable MR analyses after adjusting for potential confounding factors. Sensitivity analysis suggested that the results were robust with no evidence of pleiotropy or heterogeneity.
This study provides further evidence supporting the association between genetically predicted snoring, insomnia, and an increased risk of ED. Additionally, the study highlights the causal relationship of short sleep duration and chronotype with ED.
尽管多项观察性研究探讨了睡眠特征与勃起功能障碍(ED)风险之间的关联,但仍存在争议。在本研究中,我们纳入了临床实践中常见的多种睡眠特征。我们使用单变量和多变量孟德尔随机化(MR)方法研究了这些睡眠特征与ED之间的因果关系。
从欧洲血统个体的全基因组关联研究(GWAS)数据中得出了八种睡眠特征(失眠、睡眠时间、生物钟类型和睡眠呼吸暂停综合征)、五种混杂因素(抑郁、体重指数、开始吸烟、饮酒和2型糖尿病)以及ED的工具变量(IVs)。使用的主要分析技术是逆方差加权(IVW)方法。此外,还进行了多项敏感性分析以评估异质性、水平多效性和稳定性。
MR分析显示,打鼾增加、睡眠时间短和频繁失眠与ED风险较高有关。此外,我们发现有证据表明早起的人与患ED的风险之间存在显著关联。在调整潜在混杂因素后,这种关联在多变量MR分析中仍然存在。敏感性分析表明结果具有稳健性,没有多效性或异质性的证据。
本研究提供了进一步的证据支持基因预测的打鼾、失眠与ED风险增加之间的关联。此外,该研究突出了睡眠时间短和生物钟类型与ED之间的因果关系。