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Assessing Causality between Obstructive Sleep Apnea and Erectile Dysfunction: A Bidirectional Mendelian Randomization

Qingqiang Gao1, Peng Chen2, Yuanzhi Li3

  • 1Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 210008 Nanjing, Jiangsu, China.

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|October 20, 2025
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Summary
This summary is machine-generated.

This study found no causal link between obstructive sleep apnea (OSA) and erectile dysfunction (ED) using bidirectional Mendelian randomization. Further research is needed to understand the complex relationship between OSA and ED.

Keywords:
erectile dysfunctionmendelian randomizationobstructive sleep apneasingle nucleotide polymorphisms

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Area of Science:

  • Genetics
  • Epidemiology
  • Urology

Background:

  • Obstructive sleep apnea (OSA) is increasingly recognized as a potential risk factor for erectile dysfunction (ED).
  • Existing evidence linking OSA and ED is inconsistent, necessitating further investigation.
  • Genome-wide association studies (GWAS) provide valuable genetic data for exploring such relationships.

Purpose of the Study:

  • To investigate the potential bidirectional causal relationship between obstructive sleep apnea (OSA) and erectile dysfunction (ED).
  • To leverage aggregated GWAS data and employ robust Mendelian randomization (MR) methods for causal inference.
  • To clarify the etiological connection between OSA and ED.

Main Methods:

  • Utilized a two-sample Mendelian randomization (MR) design with single nucleotide polymorphisms (SNPs) as instrumental variables.
  • Applied five advanced MR analysis methods: inverse-variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode.
  • Conducted comprehensive sensitivity analyses, including heterogeneity and pleiotropy assessments, to ensure result validity.

Main Results:

  • Bidirectional MR analysis, primarily using the IVW method, found no significant causal association between OSA and ED.
  • Reverse MR analysis also indicated no causal effect of ED on OSA.
  • Sensitivity analyses confirmed the robustness and consistency of the findings, with no evidence of heterogeneity or pleiotropy.

Conclusions:

  • The Mendelian randomization analysis revealed no clear bidirectional causal link between obstructive sleep apnea and erectile dysfunction.
  • The findings suggest that OSA may not be an independent genetic risk factor for ED, or vice versa.
  • Further research may be warranted to explore other potential mediating factors in the relationship between OSA and ED.