Erectile dysfunction in patients with chronic viral liver disease: its relevance to protein malnutrition.
BACKGROUND
In patients with chronic liver disease (CLD), quality of life is generally accepted as poor, especially for physical function. However, sufficient data regarding erectile function has not been shown in patients with CLD. The international index of erectile function (IIEF) is widely used to assess erectile function, and a short form of the IIEF was recently developed (IIEF-5). Using this questionnaire, we evaluated erectile dysfunction (ED) in patients with CLD.


METHODS
A total of 117 Japanese patients (64 with chronic hepatitis [CH] and 53 with liver cirrhosis [LC]) were analyzed. The etiologies were hepatitis B virus (HBV) in 21, HCV in 94, and non-B non-C in 2. The IIEF-5 and Medical Outcomes Study Short Form 36 (SF-36) were administered to the patients, and biochemical analyses for items serum albumin, prothrombin time, bilirubin, and ammonia were also performed.


RESULTS
The incidence of ED was 85% in the total cohort with CLD, 78% in those with CH, and 92% in those with LC (P < 0.05 between CH and LC). ED was found in 50% of CLD patients under age 50 years, in 79% aged 50-59, and in 100% aged over 60 (P, overall <0.001). The scores for ED severity correlated with increasing grades of a modified Child-Pugh classification (P < 0.05). Simple regression analysis showed age (P < 0.01), physical function (P < 0.001), role physical (P < 0.001), and social functioning (P < 0.05) on the SF-36, and serum albumin (P < 0.001) as significant determinants of ED. Multiple regression analysis identified age (P < 0.001) and serum albumin (P < 0.001) as independent significant factors that determined ED.


CONCLUSIONS
These data clearly demonstrate that liver disease is the cause of ED in patients with CLD, and serum protein status could be relevant to this condition in these patients.
Toda
Katsuhisa
K
Department of Internal Medicine, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
Miwa
Yoshiyuki
Y
Kuriyama
Shoko
S
Fukushima
Hideki
H
Shiraki
Makoto
M
Murakami
Nobuo
N
Shimazaki
Makoto
M
Ito
Yoichiro
Y
Nakamura
Toshiyuki
T
Sugihara
Jun'ichi
J
Tomita
Eiichi
E
Nagata
Chisato
C
Suzuki
Kazutomo
K
Moriwaki
Hisataka
H
D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000378:metabolism; D002908:Chronic Disease; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000150:complications*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014505:Urban Population
D001798:Blood Proteins