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Hyperhomocysteinemia is a risk factor for erectile dysfunction in men with adult-onset diabetes mellitus
Adel Al-Hunayan1, Lukman Thalib, Elijah O Kehinde
1Department of Surgery, Division of Urology, Kuwait University, Kuwait. alhunayan@hsc.edu.kw
Insights
High homocysteine levels are linked to erectile dysfunction (ED) in men with diabetes. This study found elevated plasma total homocysteine (tHcy) in diabetic men with ED, suggesting a significant association.
Area of Science:
- Endocrinology
- Cardiovascular Science
- Urology
Background:
- Hyperhomocysteinemia (HHcy) is a known risk factor for cardiovascular diseases like atherosclerosis and stroke.
- The association between HHcy and vasculogenic erectile dysfunction (ED) remains under investigation.
Purpose of the Study:
- To investigate the relationship between plasma total homocysteine (tHcy) levels and the presence of vasculogenic ED in men with adult-onset diabetes mellitus.
Main Methods:
- A case-control study involving 97 diabetic men with vasculogenic ED and 97 diabetic controls without ED.
- Logistic regression models were used to calculate odds ratios (ORs) for risk estimation.
- Cardiovascular risk factors and HbA1c levels were assessed in both groups.
Main Results:
- Plasma tHcy was significantly higher in the ED group (11.2 ± 3.5 µmol/L) compared to controls (8.8 ± 2.6 µmol/L).
- Men with HHcy had 5.2 times higher odds of developing vasculogenic ED (OR 5.2, 95% CI 1.4 to 18.9).
- ED risk was significantly influenced by smoking and hypertension, but not BMI, cholesterol, triglycerides, CRP, or HbA1c.
Conclusions:
- Elevated plasma tHcy is associated with vasculogenic ED in patients with adult-onset diabetes mellitus.
- This finding suggests HHcy as a potential contributing factor to ED in this population.
Objectives:
Hyperhomocysteinemia (HHcy) is associated with cardiovascular disease such as coronary arteriosclerosis and stroke. However, its role in the development of vasculogenic erectile dysfunction (ED) is still putative. In this study, we evaluated the relationship between plasma total homocysteine (tHcy) and the presence of vasculogenic ED in men with adult-onset diabetes mellitus.
Methods:
This was a case-control study of 97 adult-onset diabetics with vasculogenic ED and 97 concurrently sampled control diabetics, who were free from ED. We obtained risk estimates of odds ratios (ORs), both crude and adjusted, using logistic regression models. We then determined cardiovascular risk factors and HbA1c levels in both groups of patients.
Results:
Plasma tHcy was significantly higher in cases compared with controls. The mean +/- standard deviation plasma tHcy in cases was 11.2 +/- 3.5 micromol/L versus 8.8 +/- 2.6 micromol/L in controls (P <0.001). Moreover, those with HHcy had 5.2 times the odds of vasculogenic ED compared with men without HHcy (OR 5.2, 95% confidence interval, 1.4 to 18.9). Although the risk of ED did not vary significantly according to body mass index, serum cholesterol, triglycerides, C-reactive protein, and blood HbA1c levels, it was significantly affected by smoking status and hypertension.
Conclusions:
High plasma tHcy appears to be associated with ED in patient with adult-onset diabetes mellitus.
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