Endothelial Dysfunction and Erectile Dysfunction: Evidence From EASIX Score in NHANES 2001-2004

Area of Science:

• Cardiovascular Health
• Urology
• Public Health

Background:

• Erectile dysfunction (ED) is a common condition and an early indicator of systemic vascular dysfunction.
• The Endothelial Activation and Stress Index (EASIX) measures endothelial injury and microvascular stress.
• The relationship between EASIX and ED in population-based studies is not well-characterized.

Purpose of the Study:

• To evaluate the association between EASIX and ED in a large population-based sample of U.S. adult men.
• To investigate potential effect modification of the EASIX-ED relationship by demographic and clinical factors.

Main Methods:

• Cross-sectional analysis of 3,540 adult men from the National Health and Nutrition Examination Survey (NHANES) 2001-2004.
• Survey-weighted multivariable logistic regression models were used to assess the association between EASIX and ED.
• Subgroup and interaction analyses were performed to examine effect modification.

Main Results:

• Overall, 28.22% of participants reported ED.
• Higher EASIX levels were independently associated with increased odds of ED.
• Each one-unit increase in log2-transformed EASIX was associated with a 31% higher likelihood of ED (OR = 1.31).
• Significant interactions were observed by age, race, poverty-income ratio, and hypertension status, with stronger associations in older men, non-Hispanic White individuals, those with higher socioeconomic status, and participants with hypertension.

Conclusions:

• Elevated EASIX is independently associated with ED in U.S. adult men.
• The association between EASIX and ED varies across demographic and clinical subgroups.
• Endothelial dysfunction may play a significant role in male sexual health.