title: Physical activity and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study.
abstract: OBJECTIVE
  To date, there is no evidence regarding the association between physical activity (PA) and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. We investigated this issue among Japanese patients with type 2 diabetes mellitus.
  
  
  METHODS
  Study participants were 460 male Japanese patients with type 2 diabetes mellitus. The definitions of exercise habit, walking habit and fast walking were based on a self-administered questionnaire regarding PA behavior. Participants were classified into one of four PA levels based on the number of 'Yes' answers to the three questions in the questionnaire: (i) lowest; (ii) lower; (iii) moderate; and (iv) higher. Severe ED and moderate-to-severe ED were based on Sexual Health Inventory for Men score <8 and <12, respectively.
  
  
  RESULTS
  The prevalence of moderate-to-severe ED, severe ED, exercise habit, walking habit, and fast walking was 64.6, 51.1, 36.3, 41.3 and 37.6%, respectively. Walking habit was independently inversely associated with moderate-to-severe ED and severe ED. Exercise habit was independently inversely associated with severe ED, but not moderate-to-severe ED. Higher PA was independently inversely associated with moderate-to-severe ED and severe ED (adjusted odds ratio 0.42, 95% confidence interval 0.21-0.85; and adjusted odds ratio 0.38, 95% CI: 0.19-0.73, respectively). There was a statistically significant inverse exposure-response relationship between the PA level and moderate-to-severe ED and severe ED (P for trend = 0.02 and 0.005), respectively.
  
  
  CONCLUSIONS
  PA might be inversely associated with ED in Japanese patients with type 2 diabetes mellitus.
authors.affiliation: Department of Internal Medicine, Ehime Niihama Hospital, Ehime, Japan.
authors.forename: Hisaka
authors.initials: H
authors.lastname: Minami
authors.affiliation: Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.|Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
authors.forename: Shinya
authors.identifier: http://orcid.org/0000-0002-0041-7688
authors.initials: S
authors.lastname: Furukawa
authors.affiliation: Department of Internal Medicine, Yawatahama General City Hospital, Ehime, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Internal Medicine, Matsuyama Shimin Hospital, Ehime, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Niiya
authors.affiliation: Department of Internal Medicine, Saiseikai Matsuyama Hospital, Ehime, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyaoka
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Miyake
authors.affiliation: Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Kanzaki
authors.affiliation: Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Koutatsu
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.|Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Internal Medicine, Ehime Prefectural Central Hospital, Ehime, Japan.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.|Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Senba
authors.affiliation: Department of Internal Medicine, Saiseikai Saijo Hospital, Ehime, Japan.
authors.forename: Masamoto
authors.initials: M
authors.lastname: Torisu
authors.affiliation: Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tanigawa
authors.affiliation: Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Yoichi
authors.identifier: http://orcid.org/0000-0003-4117-339X
authors.initials: Y
authors.lastname: Hiasa
authors.affiliation: Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.|Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
authors.forename: Yoshihiro
authors.identifier: http://orcid.org/0000-0003-1244-4488
authors.initials: Y
authors.lastname: Miyake
mesh_terms: D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000150:complications / Q000453:epidemiology*; D015444:Exercise; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: Exercise; Physical activity; Sexual function