Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis
Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis
复制标题
DOI：
10.1093/eurheartj/ehi749
复制
发表时间：
2006-04-01
影响因子：
39.3
通讯作者：
Lerman, A
中科院分区：
文献类型：
--
作者：
Elesber, AA;Solomon, H;Lerman, A
目的冠状动脉内皮功能障碍（CED）先于动脉粥样硬化并与心血管事件相关。CED和勃起功能障碍（ED）都部分由一氧化氮途径的损伤介导。ED与已建立的冠状动脉粥样硬化有关，但其与早期冠状动脉粥样硬化和ED的关系尚不清楚。本研究旨在验证早期冠状动脉粥样硬化患者的ED与CED相关的假设。此外，还研究了一氧化氮合酶抑制剂不对称二甲基精氨酸（ADMA）的作用；ADMA是一种新型的内源性竞争性一氧化氮合酶抑制剂，已被证明是心血管疾病的独立标志物。方法和结果对56例非阻塞性冠状动脉疾病（CAD）患者行冠状动脉内皮功能检查。测定ADMA水平，并要求所有男性完成国际勃起功能指数-5问卷，以评估勃起功能。根据存在（n=32）或不存在（n=24） CED进行分组。与内皮功能正常的男性相比，患有CED的男性勃起功能明显受损（P=0.008）， ADMA水平显著升高（0.50 +/- 0.06比0.45 +/- 0.07 ng/mL， P=0.017）。勃起功能与冠状动脉内皮功能呈正相关。这种相关性与年龄、体重指数、高密度脂蛋白、c反应蛋白、胰岛素抵抗指数的稳态模型评估和吸烟状况无关。结论男性早期冠状动脉粥样硬化患者ED与血浆ADMA浓度独立相关。本研究进一步支持了内皮在全身性血管疾病中的作用，以及ADMA在内皮功能障碍的全身性表现中的作用。
Aims Coronary endothelial dysfunction (CED) precedes atherosclerosis and is associated with cardiovascular events. Both CED and erectile dysfunction (ED) are partly mediated by impairment in the nitric oxide pathway. ED is associated with established coronary atherosclerosis, but its relationship with early coronary atherosclerosis and CED is unknown. This study was designed to test the hypothesis that CED is associated with ED in men with early coronary atherosclerosis. Moreover, the role of the nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) was investigated; ADMA is a novel endogenous competitive inhibitor of nitric oxide synthase and has been shown to be an independent marker for cardiovascular disease.Methods and results Fifty-six men without obstructive coronary artery disease (CAD) who underwent coronary endothelial function testing were studied. ADMA levels were determined and all men were asked to complete the International Index of Erectile Function-5 questionnaire to assess erectile function. Patients were divided according to the presence (n=32) or absence (n=24) of CED. Men with CED had significant impairment of erectile function (P=0.008) and significantly higher ADMA levels (0.50 +/- 0.06 vs. 0.45 +/- 0.07 ng/mL, P=0.017) compared with men with normal endothelial function. Erectile function positively correlated with coronary endothelial function. This correlation was independent of age, body mass index, high-density lipoprotein, C-reactive protein, homeostasis model assessment of insulin resistance index, and smoking status.Conclusion CED is independently associated with ED and plasma ADMA concentration in men with early coronary atherosclerosis. This study further supports the role of the endothelium in systemic vascular diseases and the role of ADMA in the systemic manifestations of endothelial dysfunction.