title: Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease.
abstract: The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction(ED) in young men with low risk of coronary heart disease and no well-known aetiology. To conduct this study, 122 patients with ED under the age of 40 were enrolled, along with 33 age-matched normal control subjects. The patients with ED had significantly higher levels of systolic blood pressure (SBP), total cholesterol and triglyceride, high sensitivity C-reactive protein (hs-CRP), greater carotid intima-media thickness (CIMT) and Framingham risk score (FRS) than the control group, though all of these values were within the respective normal range. Further, the brachial artery flow- mediated vasodilation (FMD) values were significantly lower in ED patients and correlated positively with the severity of ED (r = 0.714, p < 0.001). When these significant factors were studied in the multivariate logistic regression model, FMD, SBP, hs-CRP and FRS remained the statistical significance. The receiver-operating characteristic (ROC) analysis demonstrated that FMD had a high ability to predict ED in young male with low FRS [area under the curve (AUC) 0.921, p < 0.001]. The cutoff value of FMD <10.25% had sensitivity of 82.8% and specificity of 100% for diagnosis of ED. FRS and hs- CRP were also proven to be predictors of ED (AUC 0.812, p < 0.001; AUC 0.645, p = 0.011, respectively). The results of this study validated that subclinical endothelial dysfunction and low-grade inflammation may be the underlying pathogenesis of ED with no well-known aetiology. Young patients complaining of ED should be screened for cardiovascular risk factors and possible subclinical atherosclerosis. Measurement of FMD, hs-CRP and FRS can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early for young male.
authors.affiliation: Division of Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: F
authors.initials: F
authors.lastname: Yao
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Dong
authors.forename: H
authors.initials: H
authors.lastname: Ma
authors.forename: C
authors.initials: C
authors.lastname: Deng
authors.forename: H
authors.initials: H
authors.lastname: Lin
authors.forename: D
authors.initials: D
authors.lastname: Liu
authors.forename: K
authors.initials: K
authors.lastname: Lu
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis; D001794:Blood Pressure; D001916:Brachial Artery / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D008297:Male; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology