title: Vitamin D treatment improves levels of sexual hormones, metabolic parameters and erectile function in middle-aged vitamin D deficient men.
abstract: BACKGROUND
  The associations between serum vitamin D (VD), serum testosterone (TT) and metabolic syndrome are complex and with limited published research, particularly on the effects of VD treatment on sexual hormones, erectile function and the metabolic syndrome.
  
  
  OBJECTIVE
  This study assessed whether a monthly high dose VD treatment for 12 months in VD deficient middle-aged men was associated with: changes in levels of sexual hormones, improvement of diabetes control and metabolic syndrome components, better erectile function [International Index of Erectile Function (IIEF)-5 questionnaire]; and changes in a prostate marker.
  
  
  METHODS
  Descriptive research of a prospective study, conducted between October 2014 and September 2015, 102 male patients ≥35 [(±SD: 53.2 ± 10.5), (range 35-64)] years with deficient serum VD level (<30 ng/mL) were included in the study. Participants were followed up for one year, with monitoring at 3-, 6-, 9- and 12-months. At the initial baseline visit, a complete medical examination was conducted, and blood was drawn for laboratory tests for above biochemical and hormonal variables under examination. Participants received an initial VD (Ergocalciferol; oral solution 600 000 IU/1.5 ml), and followed a VD treatment regime thereafter. At the four follow up visits (3, 6, 9 and 12 months), blood was collected, and patients' erectile function was evaluated by IIEF-5 questionnaire.
  
  
  METHODS
  During the follow up visits, all the biochemical and hormonal (TT, estradiol and luteinizing hormones, HbA1c, serum lipids profile) were assessed, and patients' erectile function was evaluated by IIEF-5 questionnaire.
  
  
  RESULTS
  Patients' mean age was 53.2 ± 10.4 years. Serum VD exhibited significant increments (p <0.001) from baseline (15.16 ± 4.64 ng/mL), to 3 (31.90 ± 15.99 ng/mL), 6 (37.23 ± 12.42 ng/mL), 9 (44.88 ± 14.49 ng/mL) and 12 months (48.54 ± 11.62 ng/mL), and there was significant stepladder increases in both serum TT level (12.46 ± 3.30 to 15.99 ± 1.84 nmol/L) and erectile function scores (13.88 ± 3.96 to 20.25 ± 3.24) (p <0.001 for both). We also observed significant stepladder decreases in estradiol (87.90 ± 27.16 to 69.85 ± 14.80 pmol/L, p = 0.001), PTH (from 58.52 ± 28.99 to 38.33 ± 19.44 pg/mL, p <0.001) and HbA1c levels (7.41 ± 2.85 to 6.66 ± 1.67%, p = 0.001). Mean BMI significantly decreased from 33.91 ± 6.67 to 33.14 ± 6.35 kg/m2(p = 0.001); and PSA values significantly increased from 0.59 ± 0.30 to 0.82 ± 0.39 ng/mL (p <0.001) at the end of the 12 months' follow-up. There were no changes in LH levels.
  
  
  CONCLUSIONS
  This study demonstrated that VD treatment improves testosterone levels, metabolic syndrome and erectile function in middle-aged men. More randomized placebo-controlled interventional trials of VD treatment in patients with the metabolic syndrome and low TT could assist in uncovering the putative roles of VD.
authors.affiliation: a Department of Urology and.
authors.forename: Onder
authors.initials: O
authors.lastname: Canguven
authors.affiliation: a Department of Urology and.
authors.forename: Raidh A
authors.initials: RA
authors.lastname: Talib
authors.affiliation: b Department of Surgery , Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar , and.
authors.forename: Walid
authors.initials: W
authors.lastname: El Ansari
authors.affiliation: c Institute of Urology and Andrology , Hamburg , Germany.
authors.forename: Dany-Jan
authors.initials: DJ
authors.lastname: Yassin
authors.affiliation: a Department of Urology and.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Naimi
mesh_terms: D000328:Adult; D004958:Estradiol / Q000097:blood; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy*; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy*; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D004958:Estradiol; D006442:Glycated Hemoglobin; D007986:Luteinizing Hormone; D013739:Testosterone; D014807:Vitamin D; D014815:Vitamins; C517652:hemoglobin A1c protein, human
keywords: 25(OH)D; HbA1c; Vitamin D; erectile function; metabolic syndrome; testosterone