title: Erectile dysfunction is associated with severe retinopathy in diabetic men.
abstract: OBJECTIVE
  Erectile dysfunction (ED) and retinopathy are prevalent in diabetic men. However, the association between ED and diabetic retinopathy (DR) with relation to DR severity levels has never been studied.
  
  
  METHODS
  For this cross-sectional study, data were obtained prospectively at the retina clinic of a tertiary medical center. The study group included men with proliferative diabetic retinopathy (PDR) or with severe nonproliferative diabetic retinopathy (NPDR). The control group included diabetic men without retinopathy or with mild NPDR. All men had type 2 diabetes mellitus. All men filled in the Sexual Health Inventory for Males questionnaire (SHIM) to detect significant ED. Significant ED was defined as SHIM questionnaire score <17.
  
  
  RESULTS
  The cohort included 102 diabetic men: 64 (62.7%) men in the study group and 38 (37.3%) men in the control group. Mean age for the entire cohort was 64.0 ± 8.2 years, and mean diabetes duration was 14.5 ± 8.9 years. Mean SHIM score for the entire cohort was 11.4 ± 6.5, and 75 (73.5%) men had significant ED. Men in the study group had higher prevalence of significant ED compared with men in the control group (87.5% vs 50.0%; P <.0001), as well as lower mean SHIM questionnaire scores (9.5 ± 5.4 vs 14.7 ± 6.9; P <.0001). Binary logistic regression analysis and linear regression analysis showed that significant ED and SHIM scores, respectively, were associated with DR severity (P = .001 for both), independent of age, diabetes duration, ischemic heart disease, cerebrovascular disease, hypertension, hyperlipidemia, and smoking.
  
  
  CONCLUSIONS
  Significant ED is associated with DR severity independent of age, diabetes duration, macrovascular comorbidities, and cardiovascular risk factors.
authors.affiliation: Sackler School of Medicine, Tel-Aviv University, Israel.
authors.forename: Oren
authors.initials: O
authors.lastname: Henis
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Shahar
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
authors.forename: Talya
authors.initials: T
authors.lastname: Finn
authors.forename: Rafi
authors.initials: R
authors.lastname: Heruti
authors.forename: Anat
authors.initials: A
authors.lastname: Loewenstein
authors.forename: Dan
authors.initials: D
authors.lastname: Justo
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000150:complications*; D007172:Erectile Dysfunction / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index