title: Hormonal association and sexual dysfunction in patients with impaired fasting glucose: a cross-sectional and longitudinal study.
abstract: BACKGROUND
  The category of impaired fasting glucose (IFG) denotes a state of nondiabetic hyperglycemia, considered a risk factor for the further development of diabetes mellitus (DM) and cardiovascular (CV) diseases.
  
  
  OBJECTIVE
  The aim of the present study is to evaluate the impact of IFG on sexual health in men. In addition, its effect on CV morbidity and mortality will also be addressed.
  
  
  METHODS
  A consecutive series of 3,451 men (mean age 57.3 ± 10.1 years) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (N = 1,687) was enrolled in a longitudinal study.
  
  
  METHODS
  Several clinical, biochemical (including testosterone), and instrumental (penile color Doppler ultrasound) factors were evaluated. IFG was defined by fasting glucose concentrations between 5.6 and 6.9 mmol/L (100-125 mg/dL). A higher threshold (6.1-6.9 mmol/L, 110-125 mg/dL) was also considered.
  
  
  RESULTS
  Among the patients studied, 747 (21.7%) had DM. In addition, 659 (19.1%) subjects were classified as IFG. Patients with IFG, however defined, more often had severe ED, reduced penile blood flow, and overt hypogonadism when compared with patients with normal glucose levels. In addition, men with ED and IFG show poorer blood pressure and lipid profile with an overall increase in CV risk. Unadjusted incidence of major adverse CV events was significantly associated with baseline DM, whereas there was a trend toward higher risk also for IFG, but this did not reach statistical significance. Conversely, both IFG and DM were significantly associated with a higher risk of fatal and nonfatal cerebral events.
  
  
  CONCLUSIONS
  Checking glucose and testosterone levels is mandatory in subjects with ED because testosterone substitution in impotent IFG subjects might ameliorate not only their sexual life but also their overall health.
authors.affiliation: Andrology and Sexual Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.forename: Giulia
authors.initials: G
authors.lastname: Rastrelli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.forename: Francesco
authors.initials: F
authors.lastname: Lotti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sforza
authors.forename: Matteo
authors.initials: M
authors.lastname: Monami
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology*; D007006:Hypogonadism / Q000453:epidemiology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010413:Penis / Q000098:blood supply; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood*; D018608:Ultrasonography, Doppler
chemical_list: D013739:Testosterone