Associations of different insulin resistance indices with the erectile dysfunction incidence: a cross-sectional analysis of the NHANES 2001-2004

Insulin resistance (IR) has been related to erectile dysfunction (ED). IR indices refer to calculation-based indices that estimate insulin sensitivity using routine clinical or biochemical parameters. However, there are fewer studies comparing the advantages of the relationship between different IR indices and ED. This study aimed to investigate the relationship between IR indices and the presence of ED.

Data from the National Health and Nutrition Examination Survey (NHANES) 2001-2004 were analyzed. The associations of estimated glucose disposal rate (eGDR), triglyceride glucose (TyG) index, Homeostatic Model Assessment of IR (HOMA-IR), and TyG-body mass index (TyG-BMI) with ED were evaluated using weighted logistic regression and restricted cubic spline analysis.

There were 1,737 subjects examined. Only the eGDR was an independent predictor for ED in the model adjusted for all covariates in the weighted logistic regression analysis. Lower eGDR was associated with an increased risk of ED, even following covariate adjustment [continuous eGDR: odds ratio (OR) =0.91, 95% confidence interval (CI): 0.83-0.99, P=0.03; quartile 3 (Q3) vs. quartile 1 (Q1): OR =0.59, 95% CI: 0.37-0.95, P=0.03]. Restricted cubic spline analysis indicated a nonlinear relationship between eGDR and ED (P for nonlinearity <0.001). Subgroup analyses consistently showed that higher eGDR levels were linked to a lower risk of ED in all subgroups, with significant interactions observed in education level and physical activity subgroups.

eGDR was inversely associated with an increased risk of ED, suggesting that it might be as a potential and reliable predictor for ED incidence.