title: The influence of different metabolic syndrome definitions in predicting vasculogenic erectile dysfunction: is there a role for the index of central obesity?
abstract: OBJECTIVE
  Analyze the capacity of ICO, the ratio of waist circumference (WC) and height, in predicting hemodynamic impairment in Erectile Dysfunction (ED) patients, independently and integrated in Metabolic Syndrome (MetS) definitions.
  
  
  METHODS
  Four hundred and eighty-five ED patients followed in Urology consult from January 2008 until March 2012 were evaluated by a standardized protocol: health questionnaire, anthropometric measurements (AM), blood pressure and analysis, and Penile Duplex Doppler Ultrasound (PDDU) exam. Associations between AM and MetS definitions, including ATPIII, IDF and a new definition replacing WC by ICO in ATPIII MetS definition (ModATPIII), and PDDU were calculated.
  
  
  RESULTS
  ICO was the measure of obesity more strongly correlated with diminished mean Peak Systolic Velocity (mPSV) (r = -0.189, p < 0.001). A positive association remained when replacing WC by ICO ≥ 0.60 (a nationally obtained ratio) in ATPIII MetS definition (ModATPIII). Patients with ModATPIII had lower mPSV when compared to non-MetS patients (30.8 versus 37.1, p < 0.001). Only the IDF definition had a significant association with AD (OR = 1853; 95%CI, 1.202-2.857).
  
  
  CONCLUSIONS
  ICO revealed potential value to predict PDDU changes in a MetS context. However, IDF definition presented a stronger correlation with arteriogenic ED. Although longitudinal studies are necessary to confirm this hypothesis, our study highlights the importance of different MetS definitions for ED assessment.
authors.affiliation: Faculty of Medicine of Universidade do Porto, Porto, Portugal. carvalho.hn@gmail.com
authors.forename: H N
authors.initials: HN
authors.lastname: Carvalho
authors.forename: I M
authors.initials: IM
authors.lastname: Campos Costa
authors.forename: I N
authors.initials: IN
authors.lastname: Campos Costa
authors.forename: F
authors.initials: F
authors.lastname: Botelho
authors.forename: N
authors.initials: N
authors.lastname: Tomada
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D006801:Humans; D018783:Impotence, Vasculogenic / Q000175:diagnosis*; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis*; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal; D010413:Penis / Q000000981:diagnostic imaging; D011174:Portugal; D011237:Predictive Value of Tests; D014463:Ultrasonography; D055105:Waist Circumference