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Chen C, Zhai H, Huang G, Cheng J, Xia F, Zhao L, Chen Y, Chen Y, Han B, Li Q, Jiang B, Wang N, Lu Y. Is lower low-density lipoprotein cholesterol associated with lower androgen and erectile dysfunction in men? Nutr Metab Cardiovasc Dis 2018; 28:1304-1310. [PMID: 30459056 DOI: 10.1016/j.numecd.2018.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/22/2018] [Accepted: 08/21/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS Therapeutic possibilities now exist to lower low-density lipoprotein cholesterol (LDL-C) to very low levels. However, substantial controversy remains in clinical practice with regard to its safety, and the question of whether low LDL-C levels per se may provoke adverse effects in humans arises. We aimed to explore the association of LDL-C with androgen and erectile dysfunction (ED) in a general population of men. METHODS AND RESULTS A total of 4203 men without hormone replacement therapy were enrolled from 22 sites in East China. Total testosterone (T) and Free T were assessed. Free androgen index (FAI) was calculated. The IIEF-5 questionnaire was used to assess ED. We found that free T and FAI gradually and markedly increased with increasing LDL-C levels. Using linear regression, after adjusting for age, educational level, economic status, smoking status, drinking status, BMI, diabetes, and use of lipid-lowering medication, LDL-C was positively associated with free T (B = 0.175, 95% CI: 0.084, 0.266) and FAI (B = 0.064, 95% CI: 0.016, 0.112). Meanwhile, there was a U-shaped curvilinear relationship between LDL-C and prevalence of ED. In the logistic regression analysis, compared to those with LDL-C among the 10th-90th percentile, the ORs of ED in men in the lowest and highest deciles were 1.938 (95% CI: 1.121, 3.349) and 1.804 (95% CI: 1.117, 2.916), respectively. CONCLUSION Lower LDL-C levels were significantly associated with lower free T and lower FAI in a general population of men. Moreover, both low and high levels of LDL-C might be risk factors for ED.
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Affiliation(s)
- C Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - H Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - G Huang
- Institute and Department of Endocrinology and Metabolism, Fengcheng Hospital, Shanghai, China
| | - J Cheng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - F Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - L Zhao
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Y Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Y Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - B Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Q Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - B Jiang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - N Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
| | - Y Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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