title: Infection induced inflammation is associated with erectile dysfunction in men with diabetes.
abstract: BACKGROUND
  In diabetic patients with erectile dysfunction, endothelial dysfunction is a major underlying cause. Infection-induced inflammation may be associated with endothelial dysfunction. The goal of this study was to determine whether erectile dysfunction in patients with diabetes is associated with infections of Chlamydia pneumoniae or cytomegalovirus and/or with low-grade inflammation.
  
  
  METHODS
  Diabetic patients, 57 with and 33 without erectile dysfunction, were enrolled in a case-control study. Both groups of patients consists of type 1 and type 2 diabetics. Serum antibodies against cytomegalovirus and C. pneumoniae and markers of inflammation, including high-sensitivity C-reactive protein and fibrinogen, were measured.
  
  
  RESULTS
  Adjusted odds ratios for erectile dysfunction in cytomegalovirus IgG, C. pneumoniae IgG and C. pneumoniae IgA seropositive men were 2.4 (95%CI; 1.0-6.0), 3.0 (95%CI; 1.2-8.1) and 1.8 (95%CI; 0.7-4.6), respectively. Odds ratios for the highest tertiles of high-sensitivity C-reactive protein and fibrinogen concentrations compared to the lowest tertile were 4.3 (95%CI; 1.4-13.1) and 6.6 (95%CI; 2.1-21.2), respectively.
  
  
  CONCLUSIONS
  Elevated high-sensitivity C-reactive protein or fibrinogen serum levels and infection with cytomegalovirus or C. pneumoniae were associated with erectile dysfunction in diabetes. The relation between cytomegalovirus and erectile dysfunction is markedly present in patients with elevated high-sensitivity C-reactive protein and fibrinogen levels, suggesting a modifying effect by the inflammation.
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Gelre Hospitals, 7300 DS Apeldoorn, The Netherlands. m.wegdam@gelre.nl
authors.forename: M C A
authors.initials: MC
authors.lastname: Blans
authors.forename: F L J
authors.initials: FL
authors.lastname: Visseren
authors.forename: J D
authors.initials: JD
authors.lastname: Banga
authors.forename: J B L
authors.initials: JB
authors.lastname: Hoekstra
authors.forename: Y
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: R J A
authors.initials: RJ
authors.lastname: Diepersloot
authors.forename: K P
authors.initials: KP
authors.lastname: Bouter
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D023521:Chlamydophila Infections / Q000150:complications* / Q000276:immunology; D016993:Chlamydophila pneumoniae; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology; D048909:Diabetes Complications / Q000276:immunology / Q000382:microbiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology / Q000382:microbiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000276:immunology / Q000382:microbiology; D007172:Erectile Dysfunction / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D015415:Biomarkers; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D002097:C-Reactive Protein