title: Gout and a Subsequent Increased Risk of Erectile Dysfunction in Men Aged 64 and Under: A Nationwide Cohort Study in Taiwan.
abstract: OBJECTIVE
  Few studies have examined the relationship between gout and erectile dysfunction (ED). We investigated whether patients with gout exhibited an increased risk of ED.
  
  
  METHODS
  This longitudinal nationwide cohort study investigated the incidence and risk of ED in 19,368 men with gout who were newly diagnosed between January 2002 and December 2008. A total of 77,472 controls without gout were randomly selected from the general population and frequency-matched according to age and sex. The patients were followed up from the date on which they were included in the study cohort to the date of an ED event, censoring, or December 31, 2010. We conducted the Cox proportional hazard model to estimate the effects of gout on ED risk including age and comorbidities.
  
  
  RESULTS
  The gout cohort exhibited a 1.21-fold adjusted HR of subsequent ED development compared with the non-gout cohort (95% CI 1.03-1.44). The incidence of ED increased with age in both cohorts and was higher among the patients in the gout cohort than among those in the non-gout cohort. Compared to the patients without gout and comorbidities, the patients with both gout and any type of comorbidity exhibited a 2.04-fold risk of developing ED (95% CI 1.63-2.57). Further, the patients with gout who had numerous comorbidities exhibited the dose-response effect in developing ED.
  
  
  CONCLUSIONS
  This nationwide cohort study revealed that ED risk is significantly higher in patients with gout than in the general population.
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare.
authors.forename: Yung-Fu
authors.initials: YF
authors.lastname: Chen
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare.
authors.forename: Hsuan-Hung
authors.initials: HH
authors.lastname: Lin
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare.
authors.forename: Chuan-Chin
authors.initials: CC
authors.lastname: Lu
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare.
authors.forename: Chin-Tung
authors.initials: CT
authors.lastname: Hung
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare.
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Lee
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: From the Department of Healthcare Administration, and Department of Dental Technology and Materials Science, and Department of Management Information Systems, Central Taiwan University of Science and Technology; Department of Health Services Administration, China Medical University; Department of Physical Therapy, Hungkuang University, Taichung; Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung; Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, Nantou; Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital, Nantou, Taiwan.Y.F. Chen, PhD, Department of Healthcare Administration, and Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University; H.H. Lin, PhD, Department of Management Information Systems, Central Taiwan University of Science and Technology; C.C. Lu, MD, Department of Rheumatology, Nantou Hospital, Ministry of Health and Welfare, and Department of Physical Therapy, Hungkuang University; C.T. Hung, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology; M.H. Lee, MD, Department of Urology, Feng Yuan Hospital, Ministry of Health and Welfare; C.Y. Hsu, MD, PhD, Department of Family Medicine, and Department of Medical Education, Puli Christian Hospital; W.S. Chung, MD, PhD, Department of Healthcare Administration, Central Taiwan University of Science and Technology, and Department of Health Services Administration, China Medical University, and Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare. chung.w53@msa.hinet.net.
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Chung
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D006073:Gout / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology
keywords: ERECTILE DYSFUNCTION; GOUT; POPULATION-BASED COHORT STUDY