Low levels of androgens in men with erectile dysfunction and obesity
Low levels of androgens in men with erectile dysfunction and obesity
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DOI：
10.1111/j.1743-6109.2008.00856.x
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发表时间：
2008-10-01
影响因子：
3.5
通讯作者：
Maggi, Mario
中科院分区：
文献类型：
--
作者：
Corona, Giovanni;Mannucci, Edoardo;Maggi, Mario
介绍。肥胖与勃起功能障碍（ED）之间的关系尚未完全阐明。本研究的目的是调查不同肥胖类别（世界卫生组织定义）与ed患者的几个激素和仪器参数之间的关系。连续研究2435例（平均年龄52.1±13.0岁）男性ED患者。主要结果测量。研究了一些激素和生化参数，以及勃起功能障碍的结构化访谈（SIEDY），心理测量问卷（中院问卷）和阴茎多普勒超声（PDU）。在研究的患者中，41.5%体重正常，42.4%、12.1%和4.0% BMI在25-29.9、30-34.9和35 kg/m(2)及以上，雄激素水平（包括性激素结合球蛋白结合和非结合睾酮）随肥胖等级而下降，而促黄体激素水平无明显变化。肥胖与较高的器质性ED（由SIEDY量表1评分评估）和较差的PDU参数显著相关。在多元线性回归分析中，调整混杂因素（包括代谢综合征）后，低雄激素水平仍与BMI相关，而PDU基础和动态（前列腺素El [PGE1]刺激后）收缩压峰值（PSV）与年龄和血压升高均显著相关（年龄、高血压和基础和动态PSV的相对值r分别为-0.179、-0.285和-0.094、-0.071，均P < 0.05）。在调整合并症后，ED患者的雄激素水平低是肥胖的特征。肥胖相关的合并症，特别是高血压，是动脉源性肥胖相关ED的最重要决定因素。
Introduction. The relationship between obesity and erectile dysfunction (ED) has not been completely clarified.Aim. The aim of this study is to investigate the association between different obesity class (the World Health Organization definition) with several hormonal and instrumental parameters, in a large sample of patients with ED.Methods. A consecutive series of 2,435 (mean age 52.1 +/- 13.0 years) male patients with ED was investigated.Main Outcome Measures. Several hormonal and biochemical parameters were studied, along with a structured interview on erectile dysfunction (SIEDY), a psychometric questionnaire (Middle Hospital Questionnaire), and penile doppler ultrasound (PDU).Results. Among patients studied, 41.5% were normal weight, while 42.4%, 12.1% and 4.0% showed a BMI of 25-29.9, 30-34.9 and 35 kg/m(2) or higher, respectively Androgen levels (including sex hormone-binding globuline bound and unbound testosterone) decreased as a function of obesity class, while luteinising hormone levels did not show any significant change. Obesity was significantly associated with a higher organic contribution to ED (as assessed by SIEDY scale 1 score), and worse PDU parameters. At multivariate linear regression analysis, after adjustment for confounders (including metabolic syndrome), low androgens remained associated with BMI, while both basal and dynamic (after prostaglandin El [PGE1] stimulation) peak systolic velocity (PSV) at PDU resulted Significantly associated with age and elevated blood pressure (Adj. r = -0.179, -0.285 and -0.094, -0.071 for age, hypertension and for basal and dynamic PSV respectively; all P < 0.05).Conclusions. Obesity is characterized by low levels of androgens in men with ED, after adjustment for comorbidities. Obesity associated comorbidities, particularly, hypertension, are the most important determinants of arteriogenic obesity-associated ED.