Determination of the presence of metabolic syndrome in patients of erectile dysfunction and assess correlation of its components with erectile dysfunction in a tertiary care hospital in central India
Keywords:Erectile dysfunction, Metabolic syndrome, Urology, Hypogonadism
Background: Erectile dysfunction (ED) is a common medical condition that affects approximately 100 million men worldwide and is currently recognized as a major public health problem. Metabolic syndrome (Met S) is a complex entity consisting of multiple interrelated factors including insulin resistance, central adiposity, dyslipidaemia, endothelial dysfunction and atherosclerotic disease, low-grade inflammation, and in males, low testosterone levels. we aimed to investigate the relationship between metabolic syndrome and ED presence and severity.
Methods: Patient who came to urology OPD with c/o of ED and were evaluated for it with physical examination, questionnaire, investigations>after confirmation of ED were evaluated for presence of metabolic syndrome and its individual components
Results: Out of these 202 patients, 98 patients were found to have metabolic syndrome. The mean age of participating patients in this study was 47.2±5.6 years. Metabolic syndrome was diagnosed in 98 (34.78%) of 202 patients. Statistically significant association was found between ED and metabolic syndrome, waist circumference and fasting blood glucose (p<0.001 with each parameter). We also found a significant correlation between hypertension and ED but no significant correlation with triglyceride levels or HDL levels.
Conclusions: ED is strongly associated with metabolic syndrome and the efforts for treatment of erectile dysfunction must be made in the context of metabolic syndrome and its constituents with a low threshold to diagnose the cardiovascular disease.
Owiredu WK, Amidu N, Alidu H, Sarpong C, Gyasi-Sarpong CK. Determinants of sexual dysfunction among clinically diagnosed diabetic patients. Reprod Biol Endocrinol. 2011;9:70.
Bansal TC, Guay AT, Jacobson J, Woods BO, Nesto RW. Incidence of metabolic syndrome and insulin resistance in a population with organic erectile dysfunction. J Sex Med. 2005;2:96-103.
Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A et al. Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol. 2006;50:595-604.
Wilson PW, Kannel WB, Silbershatz H, D’Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med. 1999;159:1104-9.
Corona G, Mannucci E, Mansani R. Organic, relational and psychological factors in erectile dysfunction in men with diabetes mellitus. Eur Urol. 2004;46:222-8.
Shiri R, Koskimaki J, Hakkinen J, Tammela TLJ, Huhtala H, Hakama M et al. Effects of age, comorbidity and lifestyle factors on erectile function: Tampere Ageing Male Urological Study (TAMUS). Eur Urol. 2004;45:628-33.
Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol. 2004;171:2341-5.
Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF, Burgos-Rodriguez R. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. J Urol. 2001;166:569-74.
Rimm EB, Stampfer MJ, Giovannucci E. Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol. 1995;141:1117-27.
Esposito K, Guigliano F, Di Palo C, Giugliano G, Marfella R, D'Andrea F et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291:2978-84.
Walczak MK, Lokhandwala N, Hodge MB, Guay AT. Prevalence of cardiovascular risk factors in erectile dysfunction. J Gend Specif Med. 2002;5:19-24.
Demir T. Prevalence of erectile dysfunction in patients with metabolic syndrome. Int J Urol. 2006;13:385-8.
McFarlane SI, Banerji M, Sowers JR. Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab. 2001;86:713-18.
Guerre-Millo M. Adipose tissue hormones. J Endocrinol Invest. 2002;25:855-61.
Grundy SM. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation. 2002;105:2696-8.
Lakka HM, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J. 2002;23:706-13.
Corona G, Mannucci E, Ricca V, Lotti F, Boddi V, Bandini E et al. The age-related decline of testosterone is associated with different specific symptoms and signs in patients with sexual dysfunction. Int J Androl. 2009;32:720-8.
Reilly CM, Zamorano P, Stopper VS, Mills TM. Androgenic regulation of NO availability in rat penile erection. J Androl. 1997;18:110-15.
Yassin AA, Saad F, Gooren LJ. Metabolic syndrome, testosterone deficiency and erectile dysfunction never come alone. Andrologia. 2008;40:259-64.
Nehra A, Azadzoi KM, Moreland RB, Pabby A, Siroky MB, Krane RJ et al. Cavernosal expandability is an erectile tissue mechanical property which predicts trabecular histology in an animal model of vasculogenic erectile dysfunction. J Urol. 1998;159:2229-36.
Koca O, Caliskan S, Ozturk MI, Gunes M, Kilicoglu G, Karaman MI. Vasculogenic erectile dysfunction and metabolic syndrome. J Sex Med. 2010;7:3997-4002.
Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009;2:231-7.
Laaksonen DE, Niskanen L, Punnonen K, Nyyssönen K, Tuomainen TP, Salonen R et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol 2003;149:601-8.