title: Erectile dysfunction is associated with low total serum testosterone levels and impaired flow-mediated vasodilation in intermediate risk men according to the Framingham risk score.
abstract: BACKGROUND
  The role erectile dysfunction (ED) coupled with low testosterone levels as early markers of atherosclerosis is not well understood.
  
  
  OBJECTIVE
  To analyze the relationship between serum testosterone levels with both ED and brachial artery flow-mediated vasodilation (FMD), in a primary prevention sample of men.
  
  
  METHODS
  We enrolled 802 asymptomatic, intermediate CV risk patients, according to the Framingham Risk Score, aged 40-80 years, who underwent the ultrasound examination of FMD, the evaluation of ED and the assessment of total serum testosterone levels.
  
  
  RESULTS
  Testosterone levels correlated both with FMD (r = 0.85; p < 0.0001) and IIEF-5 score (rs = 0.65; p < 0.0001). Multivariable logistic regression analyses revealed that lower serum testosterone levels were strongly associated (p < 0.001) with severe (OR 0.78; 95% CI: 0.62-0.86), and moderate ED (OR 0.85; 95% CI: 0.72-0.97), while impaired FMD percentages were strongly associated (p < 0.001) with severe (OR 0.68; 95% CI: 0.59-0.79), moderate (OR 0.76; 95% CI: 0.63-0.83) and mild to moderate ED (OR 0.8; 95% CI: 0.69-0.94). Mild ED resulted statistically associated with lower FMD (OR 0.94; 95% CI: 0.82 - 1.07; p = 0.03) but not with serum testosterone levels. These relations were not substantially affected by adjustments for further potential confounders including smoking status, hypertension, diabetes mellitus and body mass index.
  
  
  CONCLUSIONS
  lower total serum testosterone levels are associated with impaired FMD and ED in this sample of intermediate CV risk men according to the Framingham Risk Score.
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy. Electronic address: salvatore.novo@unipa.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Iacona
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Bonomo
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Evola
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
authors.forename: Egle
authors.initials: E
authors.lastname: Corrado
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
authors.forename: Mariaconcetta
authors.initials: M
authors.lastname: Di Piazza
authors.affiliation: Chair and Division of Cardiology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.affiliation: Chair and Division of Urology, University Hospital "Paolo Giaccone", via del Vespro 129, 90127 Palermo, Italy. Electronic address: carlo.pavone@unipa.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pavone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000503:physiopathology*; D016009:Chi-Square Distribution; D007172:Erectile Dysfunction / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D012039:Regional Blood Flow; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013739:Testosterone / Q000097:blood* / Q000172:deficiency; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D013739:Testosterone
keywords: Endothelial function; Erectile dysfunction; Flow mediated vasodilation; Serum testosterone levels