Abstract
IntroductionErectile dysfunction (ED) is strongly associated with physiological and metabolic disturbances, and hyperuricemia has been proposed to predict the onset of ED.AimTo investigate if hyperuricemia is an independent predictor for ED when all relevant confounding factors are taken into account.MethodsThis is a cross-sectional study of men aged between 45 and 70 years. The population was well characterized for established cardiovascular risk factors, metabolic syndrome, as well as kidney function, depression, and socioeconomic factors. Analysis was limited to 254 men with complete data and also serum uric acid (SUA) measurements were available. This included 150 men with and 104 without ED. The presence and severity of ED was evaluated using International Index of Erectile Function-5 questionnaire. Risk of ED by SUA level was calculated using univariate and multivariable-adjusted logistic regression. Effect modification by participant characteristics were evaluated in subgroup analyses.Main Outcome measuresThe main outcome measures of this study are prevalence and severity of erectile dysfunction.ResultsPatients with ED (59% of the study population) were older than men without ED (59 vs 54 years) and had lower serum testosterone (14.3, 95% CI 11.3–17.3 vs 15.1 nmol/l, 95% CI 12.1–18.8, respectively). Regarding all other variables, the groups were comparable. No significant difference was found for SUA by ED. SUA was not associated with ED risk in univariate or multivariable analysis (multivariable-adjusted OR 1.14, 95% CI 0.59–2.19, P = .7) for SUA level higher than median compared with median or lesser (OR 1.00, 95% CI 0.997–1.006, P = .7 for continuous variable). No subgroup analysis modified the association. After multivariable adjustment age, education level and depression were statistically significant predictors of ED.ConclusionsElevated SUA was not found to be an independent risk factor for ED. Metabolic syndrome, glomerular filtration rate, or cardiovascular risk factors did not modify this result. ED cannot be predicted based on the level of SUA.A Tuokko, T Murtola, P Korhonen, et al. Hyperuricemia Is Not an Independent Predictor of Erectile Dysfunction. Sex Med 2021;9:100319.
Highlights
Erectile dysfunction (ED) is strongly associated with physiological and metabolic disturbances, and hyperuricemia has been proposed to predict the onset of ED
In addition to causing distress in itself, it has been associated with onset of cardiovascular disease (CVD) and metabolic syndrome (MetS).[3,4]
The association of ED with CVD can be largely explained by common risk factors such as aging, diabetes, hypertension, obesity, dyslipidemia, and smoking, but ED is an independent predictor of CVD as well.[5,6]
Summary
Erectile dysfunction (ED) is strongly associated with physiological and metabolic disturbances, and hyperuricemia has been proposed to predict the onset of ED. The prevalence of ED is 10e20% in overall male population and reaches 50e60% at age of 70 years.[1,2] In addition to causing distress in itself, it has been associated with onset of cardiovascular disease (CVD) and metabolic syndrome (MetS).[3,4] The association of ED with CVD can be largely explained by common risk factors such as aging, diabetes, hypertension, obesity, dyslipidemia, and smoking, but ED is an independent predictor of CVD as well.[5,6] The pathophysiology and risk factors of ED and CVD are not yet completely understood. This could provide new ways to intervene in the development of ED
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