Association between serum homocysteine and erectile dysfunction: a systematic review and meta-analysis

Area of Science:

• Cardiovascular Health
• Metabolic Syndrome
• Urology

Background:

• Erectile dysfunction (ED) is a prevalent condition affecting millions globally.
• Elevated serum homocysteine (Hcy) levels are increasingly recognized as a potential risk factor for cardiovascular diseases.
• The association between ED and Hcy requires further elucidation.

Purpose of the Study:

• To conduct a meta-analysis investigating the relationship between serum Hcy levels and ED.
• To quantify the difference in Hcy levels between ED patients and control groups.
• To explore potential moderating factors influencing this association.

Main Methods:

• A systematic literature search was performed across major databases (Web of Science, PubMed, Cochrane Library) up to July 2023.
• Meta-analysis included 12 studies comprising 1766 ED patients and 2340 controls.
• Standardized Mean Differences (SMDs) and 95% Confidence Intervals (CIs) were calculated using STATA software.

Main Results:

• Pooled analysis revealed significantly higher serum Hcy levels in ED patients compared to controls (SMD = 0.97, p < 0.001).
• Subgroup analyses indicated greater Hcy elevation in ED patients over 40 years, those who were overweight, and individuals with mild-moderate International Index of Erectile Function (IIEF) scores.
• Higher Hcy levels were also observed in ED patients from Mediterranean countries.

Conclusions:

• This meta-analysis demonstrates a significant association between elevated serum Hcy levels and erectile dysfunction.
• Factors such as age, overweight status, and ED severity may influence this relationship.
• Further large-scale, rigorous studies are warranted to confirm these findings and address potential publication bias.