Association of Erectile Dysfunction and Hypogonadism with Metabolic Syndrome in Men with Lower Urinary Tract Symptoms of Younger and Older Age Groups

The aim of this study was to evaluate the incidence and severity of erectile dysfunction (ED) and hypogonadism in 193 men presenting with lower urinary tract symptoms (LUTSs) in the younger (20 - 39 years old) and older (40 - 60 years old) age groups depending on the presence of metabolic syndrome (MetS). Triglycerides, glucose and high-density lipoprotein cholesterol, serum total testosterone (TT), sex hormone-binding globulin, prostate-specific antigen, pituitary hormones levels were measured in serum. Standardized criteria (2009) were used to determine the prevalence of MetS. Patients were assessed based on the International Prostate Symptom Score (IPSS) and the IPSS-Quality of Life (IPSS-QoL) for LUTSs and the International Index of Erectile Function (IIEF) for ED. Hypogonadism was determined in accordance with the ISA, ISSAM, EAU, EAA and ASA recommendations. In men with MetS in the younger age group the incidence of ED was 2.4 times higher, and that of low TT level and hypogonadism was 8.4 times higher compared to men without the syndrome. In the older age group, an increased incidence of ED and low TT level in men with MetS compared to men without the syndrome was on the trend level, but the incidence of hypogonadism was for sure higher (by 1.6 times). In conclusion, the study showed that ED and hypogonadism are associated with MetS by a high degree of certainty in young men with LUTSs. In men of the older age group with LUTSs, the presence of MetS is not so clearly associated with ED and hypogonadism due to the fact that the incidence of these urogenital diseases is also high in men without MetS.

The Association between Interpersonal Relationship and Erectile Dysfunction of Middle-Aged and Elderly Men in a Rural Area of Zhejiang,China

Objective:To explore the association between interpersonal relationship and erectile dysfunction(ED)of middle-aged and elderly men.Methods:A population-based cross-sectional research was conducted in the rural area of Jiashan County,Zhejiang Province,in 2016.Middle-aged and elderly men(aged 40-80)were selected as study participants.The face-to-face questionnaire was collected,including basic information,lifestyles,interpersonal relationship,and sexual function.The interpersonal relationship was evaluated based on marital relationship,neighborhood relationship,and relatives/friends relationship.According to the International index of erectile function,the study participants were divided into ED group(mild ED,moderate-to-severe ED),and non-ED group.Correlations were evaluated between interpersonal relationship indices and the prevalence or the severity of ED.Potential confounders were adjusted by the logistical regression model.Results:There were 674 study participants with average age of 60.4±8.5 years,and 489 ED patients with prevalence of 72.6%.With age increasing,the prevalence and the severity of ED increased significantly.The men who could get help from spouse when an emergency occurred or who were more cared about by their neighbors had lower ED risk,and odds ratios(ORs)(95%confidence intervals[CIs])were 0.23(0.13-0.42)and 0.58(0.46-0.75),respectively.After the adjustment of the covariates(age,education degree,household income,smoking,and drinking),the ORs(95%CIs)were 0.29(0.14-0.60)and 0.54(0.39-0.74),respectively.Good marital relationship and good neighborhood relationship were associated with a less severity of ED.

上海市某社区中老年男性勃起功能障碍与性激素的关系研究

目的：探索中老年男性勃起功能障碍（erectile dysfunction，ED）与多种性激素之间的关系。方法：对上海市某社区928名40-70岁中老年男性进行问卷调查，采用“勃起功能国际问卷-5（ⅡEF-5）”量表进行评估，并抽取空腹静脉血，采用免疫学方法测定血清总睾酮（TT）、游离睾酮（FT）、催乳素（PRL）、黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇（Ez）TX性激素结合球蛋白（SHBG）水平。按照各激素的四分位数点将对象分为4组（PO～P24组、P25～P49组、P50-P74组和P75～P100组），比较不同水平激素ED的患病风险。结果：40～50岁、51～60岁、61～70岁组的ED患病率分别为52．34％、73．14％、90．18％。调整潜在混杂因素后，FT水平的P0～P24组、P25～P49组、P50-P74组ED的患病危险性，比P75~P100组高，aOR分别为1．54、1．42、1．52，但其95％可信区间（95％CI）下限略小于1。PRL和FSH水平低的对象，患病风险较低；PRL水平在P0～P24组，P25～P49组、P50～P74组的aOR分别为0．61、0．79、0．58，除P25～P49组外，关联均有统计学意义；FSH水平在P0～P24组、P25～P49组、P50～P74组的aOR分别为0．55、0．48、0．60，除P50-P74组95％CI上限稍大于1外，关联均有统计学意义。而ED与TT、SHBG、LH、E2等的关联没有统计学意义。以上各激素与重度ED的关联均无统计学意义。结论：调整年龄及其他混杂因素后，ED与血清PRL、FSH水平存在统计学关联，与FT水平的关联较弱，与TT、LH、SHBG、Ez水平的关联没有统计学意义。就现有研究结果，尚不能认为激素水平的变化对中老年人ED的发生起主要作用。