Are Reference Intervals for Calculated Free Testosterone in Healthy Men Reliable Also in Men With Erectile...

Area of Science:

• Endocrinology
• Urology
• Men's Health

Background:

• Calculated free testosterone (cFT) reference intervals exist for healthy men but lack validation in those with erectile dysfunction (ED).
• Assessing cFT in ED populations is crucial for accurate diagnosis and management.

Purpose of the Study:

• To evaluate the clinical significance of newly established cFT reference intervals in men experiencing new-onset ED.
• To determine if healthy-derived cFT values can identify subgroups within the ED population with distinct clinical profiles.

Main Methods:

• Analysis of data from 410 healthy, nonobese men (2015-2023).
• Calculated free testosterone (cFT) assessed using Vermeulen's formula and compared against Jasuja et al. (2022) reference values.
• International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI) administered at baseline; statistical analyses included descriptive statistics and linear regression.

Main Results:

• In men with ED, cFT percentiles differed from healthy controls, with 74 men falling into a range normal for ED but pathological by healthy standards.
• This subgroup (cFT 10-66 pg/mL) was older, exhibited lower IIEF-EF scores, and reported higher BDI scores compared to those with cFT >66 pg/mL.
• Lower cFT levels (<10 pg/mL and 10-66 pg/mL) were significantly associated with higher rates of severe ED and poorer psychometric profiles.

Conclusions:

• Reference thresholds for cFT established in healthy men effectively identify a subgroup of men with ED characterized by less favorable erectile function and psychological well-being.
• The application of healthy-derived cFT reference values appears clinically valuable for assessing men presenting with ED.
• This approach may refine diagnostic strategies and treatment decisions for men with erectile dysfunction.