Raharinavalona Sitraka Angelo, Ranjandriarison Tafitarilova Dorland, Razanamparany Thierry, Randriamahavonjy Romuald, Rakotomalala Andrianirina Dave Patrick
Cardiovascular Diseases and Internal Medicine Department, Soavinandriana Hospital Center, Antananarivo, Madagascar.
Obstetrics and Gynecology Department, Soavinandriana Hospital Center, Antananarivo, Madagascar.
Endocrinol Diabetes Metab. 2025 Sep;8(5):e70098. doi: 10.1002/edm2.70098.
Our study aims to determine the prevalence of erectile dysfunction (ED) and its associations with atherosclerotic cardiovascular disease (ASCVD) in Malagasy patients with diabetes mellitus (DM).
This cross-sectional study was conducted over a period of 3 years at the Soavinandriana Hospital Center. Erectile function was assessed using the International Index of Erectile Function 5-item version (IIEF-5) questionnaire, with a score of less than 22 indicating ED. The presence of ASCVD was confirmed in cases where carotid atherosclerosis (CAS), lower limb arteriopathy (LLA), coronary heart disease (CHD) and/or ischaemic stroke were present.
The study population included 305 patients diagnosed with diabetes mellitus (DM). The prevalence of erectile dysfunction (ED) was 73.4%. According to the bivariate analysis, the risk factors for ED were age ≥ 55 years (odds ratio [OR] 12.0 (6.34-23.4)), hypertension (OR 6.02 (3.27-11.3)), physical inactivity (OR 8.86 (4.85-16.6)), smoking (OR 2.53 (1.32-5.09)), dyslipidemia (OR 4.11 (2.33-7.32)), type 2 DM (OR 8.80 (1.53-91.0)) and diabetes duration ≥ 10 years (OR 2.24 (1.11-4.87)), renin-angiotensin-aldosterone system blockers (OR 6.27 (3.43-11.6)), calcium-channel blockers (OR 3.01 (1.69-5.48)), diuretics (OR 2.14 (1.06-4.66)) and beta-blockers (OR 4.55 (1.85-13.5)). After adjusting for age, hypertension, physical inactivity, smoking and dyslipidemia, ED was significantly associated with ASCVD (OR 1.88 (1.01-3.69)), and CAS (OR 1.89 (1.03-3.22)). Adjusting for age, type and duration of DM, ED was found to be significantly associated with ASCVD (OR 1.91 (1.01-3.58)) and CAS (OR 2.31 (1.11-4.85)). However, there was no statistically significant association between ED, LLA, CHD and ischaemic stroke.
ED was very common and may be a predictor of ASCVD in patients with DM, particularly CAS. Consequently, the presence of ED should prompt the search for ASCVD, and vice versa.
我们的研究旨在确定马达加斯加糖尿病（DM）患者勃起功能障碍（ED）的患病率及其与动脉粥样硬化性心血管疾病（ASCVD）的关联。
这项横断面研究在索阿维南德里亚纳医院中心进行了3年。使用国际勃起功能指数5项版本（IIEF-5）问卷评估勃起功能，得分低于22表明存在ED。在存在颈动脉粥样硬化（CAS）、下肢动脉病变（LLA）、冠心病（CHD）和/或缺血性卒中的情况下确认存在ASCVD。
研究人群包括305例诊断为糖尿病（DM）的患者。勃起功能障碍（ED）的患病率为73.4%。根据双变量分析，ED的危险因素为年龄≥55岁（比值比[OR]12.0（6.34 - 23.4））、高血压（OR 6.02（3.27 - 11.3））、身体活动不足（OR 8.86（4.85 - 16.6））、吸烟（OR 2.53（1.32 - 5.09））、血脂异常（OR 4.11（2.33 - 7.32））、2型DM（OR 8.80（1.53 - 91.0））和糖尿病病程≥10年（OR 2.24（1.11 - 4.87））、肾素 - 血管紧张素 - 醛固酮系统阻滞剂（OR 6.27（3.43 - 11.6））、钙通道阻滞剂（OR 3.01（1.69 - 5.48））、利尿剂（OR 2.14（1.06 - 4.66））和β受体阻滞剂（OR 4.55（1.85 - 13.5））。在调整年龄、高血压、身体活动不足、吸烟和血脂异常后，ED与ASCVD（OR 1.88（1.01 - 3.69））和CAS（OR 1.89（1.03 - 3.22））显著相关。在调整DM的年龄、类型和病程后，发现ED与ASCVD（OR 1.91（1.01 - 3.58））和CAS（OR 2.31（1.11 - 4.85））显著相关。然而，ED与LLA、CHD和缺血性卒中之间没有统计学上的显著关联。
ED非常常见，可能是DM患者ASCVD的预测指标，尤其是CAS。因此，ED的存在应促使对ASCVD的筛查，反之亦然。
