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Erectile dysfunction is associated with low total serum testosterone levels and impaired flow-mediated vasodilation
Salvatore Novo1, Rosanna Iacona1, Vito Bonomo1
1Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
Background:
The role erectile dysfunction (ED) coupled with low testosterone levels as early markers of atherosclerosis is not well understood.
Objectives:
To analyze the relationship between serum testosterone levels with both ED and brachial artery flow-mediated vasodilation (FMD), in a primary prevention sample of men.
Methods:
We enrolled 802 asymptomatic, intermediate CV risk patients, according to the Framingham Risk Score, aged 40-80 years, who underwent the ultrasound examination of FMD, the evaluation of ED and the assessment of total serum testosterone levels.
Results:
Testosterone levels correlated both with FMD (r = 0.85; p < 0.0001) and IIEF-5 score (rs = 0.65; p < 0.0001). Multivariable logistic regression analyses revealed that lower serum testosterone levels were strongly associated (p < 0.001) with severe (OR 0.78; 95% CI: 0.62-0.86), and moderate ED (OR 0.85; 95% CI: 0.72-0.97), while impaired FMD percentages were strongly associated (p < 0.001) with severe (OR 0.68; 95% CI: 0.59-0.79), moderate (OR 0.76; 95% CI: 0.63-0.83) and mild to moderate ED (OR 0.8; 95% CI: 0.69-0.94). Mild ED resulted statistically associated with lower FMD (OR 0.94; 95% CI: 0.82 - 1.07; p = 0.03) but not with serum testosterone levels. These relations were not substantially affected by adjustments for further potential confounders including smoking status, hypertension, diabetes mellitus and body mass index.
Conclusions:
lower total serum testosterone levels are associated with impaired FMD and ED in this sample of intermediate CV risk men according to the Framingham Risk Score.