AUTONOMIC-SYMPATHETIC HYPERACTIVITY (AH) AND ERECTILE DYSFUNCTION

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 代谢综合征（MESY）由于其在美国的患病率不断增加（23.7%）而引起了最近的关注，在美国，它影响了超过4700万人。由于其与非胰岛素依赖型糖尿病（DM）、高血压（HTN）、血脂异常（DYS）、交感神经功能亢进（AH）和心血管疾病（CVD）相关，因此被认为具有巨大的社会经济成本。 病理生理学研究将MESY的病因归咎于两个关键组成部分：1）全身性炎症（C-反应蛋白（CRP）升高）和2）交感神经-交感神经功能亢进（AH）。 MESY是勃起功能障碍（艾德）的一个新兴“风险因素”，因为许多异常本身就是艾德的独立风险因素（即DM、HTN、DYS和CVD）。 AH作为MESY的一个组成部分，与HTN、胰岛素抵抗和DYS的发生发展有很好的关系。 AH和下尿路症状（LUTS）之间的关系已经建立，此外，它已被假设，AH可能是一个关键的病理生理机制联系艾德与LUTS。 艾德和AH之间的关系是完全未经调查的，即使所有其他方面的MESY的关键因素ED。我们现在假设，AH是一个关键的和未被认识到的病因因素的发展艾德，它有一个因果关系的症状进展。 为了验证这一假设，我们建议对艾德患者的自主神经系统的功能状态进行评估。 我们建议进行一系列的非侵入性评估，反映交感神经功能，并将它们与艾德和阴茎动脉血流测量。 我们假设男性艾德患者的艾德严重程度与AH水平的增加呈线性关系。 拟定的研究是一项单中心临床研究，其中艾德男性将接受一系列非侵入性研究，以记录自主神经张力水平、对循环应激的自主神经反应、阴茎血流量、艾德风险因素分析和评价。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The Metabolic Syndrome (MESY) has gained recent attention due to its increasing prevalence in the US (23.7%), where it affects over 47 million people. It is thought to have great socioeconomic cost because of its association with non-insulin dependent diabetes mellitus (DM), hypertension (HTN), dyslipidemia (DYS), autonomic-sympathetic hyperactivity (AH) and cardiovascular disease (CVD). Pathophysiologic investigations blame two key components in the etiology of MESY: 1) systemic inflammation (elevated C-reactive protein (CRP)) and 2) autonomic-sympathetic hyperactivity (AH). MESY is an emerging "risk factor" for erectile dysfunction (ED) as many of the abnormalities are themselves independent risk factors for ED (i.e. DM, HTN, DYS, and CVD). AH, as a component of MESY has a well established relationship with the development of HTN, insulin resistance and DYS. A relationship between AH and Lower Urinary Tract Symptoms (LUTS) has been established, additionally it has been hypothesized that AH may be one of the crucial pathophysiologic mechanisms linking ED with LUTS. The relationship between ED and AH is completely uninvestigated even though all other aspects of the MESY are key factors for ED. We now hypothesize that AH is a crucial and unrecognized etiologic factor in the development of ED and it has a casual relationship in symptomatic progression. To test this hypothesis, we propose to make an assessment of the functional state of the autonomic nervous system in ED patients. We propose to carry out a series of non-invasive assessments that reflect sympathetic function and correlate them with ED and penile arterial flow measurements. We hypothesize that men with ED will have a linear relationship between ED severity and increasing level of AH. The proposed study is a single site clinical investigation in which men with ED will undergo a series of non-invasive studies to document the level of autonomic tone, autonomic reactivity to circulatory stress, penile blood flow, ED risk factor profiling and evaluation.