title: Gout is associated with organic and psychogenic erectile dysfunction.
abstract: BACKGROUND
  Gout is a deposition disease with an inflammatory response that can increase the risk of cardiovascular disease. Gout is stressful for affected individuals, and can cause erectile dysfunction (ED). The objective of this study was to identify the association between gout and psychogenic ED (PED) and organic ED (OED).
  
  
  METHODS
  We analyzed 35,265 patients from the National Health Insurance Research Database who had been diagnosed with gout between 2000 and 2011. A total of 70,529 matched controls were included in the study as a comparison. Patients with a history of PED and OED occurring before the index date, aged less than 20 years, or with incomplete demographic information were excluded. Control patients were selected from the population of people without a history of gout, PED, or OED. The following risk factors for PED and OED were included as covariates in the multivariable models: age, comorbidities of coronary artery disease (CAD), peripheral arterial disease, chronic kidney disease (CKD), hypertension, diabetes, hyperlipidemia, depression and anxiety.
  
  
  RESULTS
  Men with gout were more likely to have an increased risk (1.21 times) of ED than were those without gout. Patients with gout were 1.52 times more likely to develop OED and 1.18 times more likely to develop PED than patients in the control group. The risk of developing ED was greater for patients with comorbidities of CKD, diabetes, hyperlipidemia, depression and anxiety.
  
  
  CONCLUSIONS
  Gout is associated with organic and psychogenic ED. Clinical physicians should consider this association when treating patients with gout.
authors.affiliation: Department of Medical Education and Research, Puli Christian Hospital, Puli, Taiwan; Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan; Center for General Education, National Chi Nan University, Puli, Taiwan; Center for General Education, National Taichung University of Science and Technology, Taichung, Taiwan; The General Education Center, Chaoyang University of Technology, Taichung, Taiwan; Department of General Education, National Chin-Yi University of Technology, Taichung, Taiwan.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D016208:Databases, Factual; D003863:Depression / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology*; D006073:Gout / Q000150:complications*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Erectile dysfunction; Gout; Psychogenic