title: [Erectile dysfunction as a marker of silent cardiovascular disease in type-2 diabetic patients in Spain. The DIVA (DIabetes and VAscular disease) study].
abstract: OBJECTIVE
  Erectile dysfunction (ED) is a sign of vascular disease in type 2 diabetic patients. The present subanalysis of the DIVA Registry, whose main objective was to estimate the prevalence of clinical vascular disorder and silent vascular disorder, as well as risk factors in type 2 diabetic patients treated in Spain, aims to analyze the relationship between those data and the prevalence of ED in these patients.
  
  
  METHODS
  A total of 2444 type 2 diabetic patients (56% male; mean age 65.2 years) attended by 387 cardiologists and endocrinologists at ambulatory care were included.
  
  
  RESULTS
  Coronary heart disease was present in 37% of the patients, cerebrovascular disease in 12%, and peripheral arterial disease in 13%. Forty percent of male patients had ED (according to the IIEF criteria), although in this group, as compared to those patients without ED, the prevalence of cardiovascular disease and signs of subclinical vascular disorder (microalbuminuria and abnormal ankle/brachial index (ABI)) was higher. The only independent predictor of ED was left ventricular hypertrophy (OR 5.2; 95% CI: 1.1-24.1; P=.03), with the ABI <0,9 being of borderline significance (OR 5.9; 95% CI: 0.9-39.9; P=.06). Poor glycemic and lipemic control (P<.05 in both cases) as well as cerebrovascular and peripheral arterial disease (P<.01 in both cases) and renal dysfunction (P<.001) were all more frequent among patients with severe ED.
  
  
  CONCLUSIONS
  Forty percent of diabetic patients suffer from ED. The results of this study suggest that ED may be considered as an atherosclerosis marker and could be included in algorithms for risk stratification and subclinical vascular disorder detection.
authors.affiliation: Servicio de Cardiología, Complejo Hospitalario Universitario, Santiago de Compostela, A Coruña, España. jose.ramon.gonzalez.juanatey@sergas.es
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alegría Ezquerra
authors.forename: Ramón
authors.initials: R
authors.lastname: Gomis Barberá
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Salvador Taboada
authors.forename: Lilian
authors.initials: L
authors.lastname: Grigorian Shamagian
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Casasnovas Lenguas
authors.forename: Víctor López
authors.initials: VL
authors.lastname: García-Aranda
authors.forename: Domingo
authors.initials: D
authors.lastname: Acosta Delgado
authors.forename: Javier
authors.initials: J
authors.lastname: Salvador Rodríguez
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández Mijares
authors.forename: Arantxa
authors.initials: A
authors.lastname: Matalí Gilarranz
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D018783:Impotence, Vasculogenic / Q000209:etiology*; D008297:Male