Prevalence of and risk factors for erectile dysfunction in Hong Kong diabetic patients

To estimate the prevalence of erectile dysfunction (ED) in Chinese diabetic men and to identify its risk factors, we carried out a cross-sectional survey of 500 Chinese diabetic men attending a community hospital diabetic clinic in Hong Kong.

Patients were interviewed and asked to report on their experience of ED as defined in the National Institutes of Health Consensus Conference 1993. Diabetic complications and patient clinical data were obtained from patients' medical records.

Of the 486 patients studied, the prevalence of ED was 63.6% (95% confidence interval 59.3-67.9%). The prevalence of ED increased with age, from 33.3% to 73.8% for diabetic men aged between 21 and 80 years (P = 0.001). Severity of ED also increased with age. Among diabetic men with ED, there was no report of complete ED for diabetic men aged 40 years and below, whereas the proportion of patients with complete ED increased from 7.4% to 71.1% between the ages of 41 and 80 years. ED occurred early in the course of the disease, with a prevalence increasing from 56.0% in men with diabetes mellitus (DM) for < 5 years to 72.0% in those with DM for > 20 years (P = 0.038). Duration of DM was also associated with severity; the proportion of patients with complete ED increased from 30.8% for those with DM for < 5 years to 72.2% for those with DM for > or = 20 years (P < 0.001). Using logistic regression analysis, DM duration, diabetic complications including retinopathy, abnormal albuminuria and sensory neuropathy, and higher level of education were associated with a higher risk of ED. By polychotomous logistic regression, age was the only factor found to be associated with the severity of ED, after adjusting for other variables.

Chinese diabetic patients have a prevalence of self-reported ED that appears to be higher than that of Western populations. This may be due to cultural differences and the association of abnormal albuminuria and hypertension.