Albuminuria is an independent risk factor of erectile dysfunction in men with type 2 diabetes.
BACKGROUND
Erectile dysfunction (ED) is a frequent comorbidity in men with diabetes and is frequently overlooked in routine clinical evaluation. Albuminuria, a marker of endothelial dysfunction, may link to ED.


OBJECTIVE
The study evaluated the association of albuminuria with risk factors of ED in men with type 2 diabetes.


METHODS
The diagnosis of ED was based on a self-administered questionnaire containing Sexual Health Inventory for Men. Urinary albumin excretion rate was determined by urine albumin-to-creatinine ratio (UACR) in spot urine.


METHODS
The clinical variables and diabetes-associated complications to risk of ED were evaluated.


RESULTS
Of 666 patients who received the questionnaire, 455 patients completed it. Among them, 82.0%, 28.1%, and 35.8% reported having ED, severe ED, and albuminuria, respectively. The UACR level was significantly higher in ED (0.20 ± 0.83) and severe ED (0.34 ± 1.18) groups compared with non-ED group (0.07 ± 0.33). The presence of albuminuria adjusted for age and duration of diabetes was significantly associated with ED (OR = 2.76), and macroalbuminuria has stronger impact (OR = 4.49) than microalbuminuria (OR = 2.48). The other associated risk factors included hypertension, higher level of systolic blood pressure, lower level of serum hemoglobin, and estimated glomerular filtration rate. The presence of retinopathy, neuropathy, insulin therapy, using calcium channel blocker, and higher level of HbA1c further correlated with severe ED. Men with severe ED have higher prevalence of subnormal testosterone than the no ED patients. The high sensitivity C-reactive protein level, and the presence of metabolic syndrome were not risk factors. The 211 nonrespondents to the questionnaire had similar or worse risk profiles compared with the ED patients.


CONCLUSIONS
Albuminuria is an important independent risk factor of ED in men with diabetes after adjustment of age and diabetes mellitus duration. Identification and control of albuminuria and other associated risk factors might play a role in the prevention or reversal of ED.
Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan.
Yao-Chi
YC
Chuang
Min-Shen
MS
Chung
Pei-Wen
PW
Wang
Wei-Chia
WC
Lee
Chung-Dar
CD
Chen
Hsueh-Wen
HW
Chang
Kuender D
KD
Yang
Michael B
MB
Chancellor
Rue-Tsuan
RT
Liu
D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000378:metabolism; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D018783:Impotence, Vasculogenic / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D002097:C-Reactive Protein