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Zhang X, Zhu Z, Tang G. Global prevalence of erectile dysfunction and its associated risk factors among men with type 1 diabetes: a systematic review and meta-analysis. Int J Impot Res 2024; 36:365-374. [PMID: 38396263 DOI: 10.1038/s41443-024-00855-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
Various observational studies have examined the prevalence and determinants of erectile dysfunction (ED) in men with type 1 diabetes across different geographical areas. Nevertheless, a comprehensive systematic review and meta-analysis to consolidate the worldwide prevalence and risk factors remains lacking. Hence, the primary study objective was to perform an extensive systematic review and meta-analysis that specifically examined ED prevalence and determinants in men with type 1 diabetes. A thorough exploration was conducted by examining electronic databases, such as PubMed, Embase, and Web of Science. The general ED prevalence and a 95% confidence interval (CI) in men with type 1 diabetes were summarized. The relevant risk factors were analyzed by deriving a comprehensive odds ratio (OR) from merging the ORs using fixed- or random-effects models. The sources of heterogeneity were investigated using subgroup analyses and meta-regression. This systematic review and meta-analysis included 19 articles involving 3788 men with type 1 diabetes. The meta-analysis revealed that men with type 1 diabetes had a combined ED prevalence of 42.5% (95% CI: 34.3%-50.8%). This prevalence showed significant heterogeneity (I2 = 96.2%, P < 0.01). Meta-regression revealed that age (P = 0.016) and type 1 diabetes duration (P = 0.004) were significant causes of heterogeneity. Furthermore, the ED risk in men with type 1 diabetes was significantly influenced by age, type 1 diabetes duration, body mass index, glycated hemoglobin (HbA1c), retinopathy, and smoking habits (all P < 0.05). In summary, this systematic review and meta-analysis revealed a significant prevalence of ED in men with type 1 diabetes, highlighting the importance of clinicians addressing concerns regarding ED in this specific group of individuals.
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Affiliation(s)
- Xiaolong Zhang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Zhirong Zhu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Guiliang Tang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
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2
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Smith E, Lewis A, Narine SS, Emery RJN. Unlocking Potentially Therapeutic Phytochemicals in Capadulla ( Doliocarpus dentatus) from Guyana Using Untargeted Mass Spectrometry-Based Metabolomics. Metabolites 2023; 13:1050. [PMID: 37887375 PMCID: PMC10608729 DOI: 10.3390/metabo13101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
Doliocarpus dentatus is thought to have a wide variety of therapeutic phytochemicals that allegedly improve libido and cure impotence. Although a few biomarkers have been identified with potential antinociceptive and cytotoxic properties, an untargeted mass spectrometry-based metabolomics approach has never been undertaken to identify therapeutic biofingerprints for conditions, such as erectile dysfunction, in men. This study executes a preliminary phytochemical screening of the woody vine of two ecotypes of D. dentatus with renowned differences in therapeutic potential for erectile dysfunction. Liquid chromatography-mass spectrometry-based metabolomics was used to screen for flavonoids, terpenoids, and other chemical classes found to contrast between red and white ecotypes. Among the metabolite chemodiversity found in the ecotype screens, using a combination of GNPS, MS-DIAL, and SIRIUS, approximately 847 compounds were annotated at levels 2 to 4, with the majority of compounds falling under lipid and lipid-like molecules, benzenoids and phenylpropanoids, and polyketides, indicative of the contributions of the flavonoid, shikimic acid, and terpenoid biosynthesis pathways. Despite the extensive annotation, we report on 138 tentative compound identifications of potentially therapeutic compounds, with 55 selected compounds at a level-2 annotation, and 22 statistically significant therapeutic biomarkers, the majority of which were polyphenols. Epicatechin methyl gallate, catechin gallate, and proanthocyanidin A2 had the greatest significant differences and were also relatively abundant among the red and white ecotypes. These putatively identified compounds reportedly act as antioxidants, neutralizing damaging free radicals, and lowering cell oxidative stress, thus aiding in potentially preventing cellular damage and promoting overall well-being, especially for treating erectile dysfunction (ED).
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Affiliation(s)
- Ewart Smith
- Environmental and Life Sciences Graduate Program, Trent University, Peterborough, ON K9J 0G2, Canada
| | - Ainsely Lewis
- Department of Biology, Trent University, Peterborough, ON K9J 0G2, Canada
| | - Suresh S. Narine
- Trent Centre for Biomaterials Research, Trent University, Peterborough, ON K9J 0G2, Canada
- Departments of Physics & Astronomy and Chemistry, Trent University, Peterborough, ON K9J 0G2, Canada
| | - R. J. Neil Emery
- Department of Biology, Trent University, Peterborough, ON K9J 0G2, Canada
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3
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El-Osta A, Kerr G, Alaa A, El Asmar ML, Karki M, Webber I, Riboli Sasco E, Blume G, Beecken WD, Mummery D. Investigating self-reported efficacy of lifestyle medicine approaches to tackle erectile dysfunction: a cross-sectional eSurvey based study. BMC Urol 2023; 23:15. [PMID: 36740686 PMCID: PMC9901095 DOI: 10.1186/s12894-023-01180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/27/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is the most common sexual dysfunction in men. Some types of ED are amenable to treatment using lifestyle medicine approaches with or without pharmacotherapy. AIM Investigate self-reported efficacy of lifestyle medicine approaches to tackle ED. METHODS A cross-sectional online survey of 1177 community dwelling adults explored the prevalence and methods used to tackle ED in the community setting. We examined differences between participants with and without ED. Variables associated with ED in univariable analyses were included in a multivariable logistic regression to identify variables independently associated with the condition. OUTCOMES Self-reported measure: perceived effectiveness of lifestyle medicine interventions to tackle ED. RESULTS Most respondents (76.5%) had experienced ED, and this was associated with having a long-term condition, taking anti-hypertensive medication, hypercholesterolaemia and obesity. Medication was the most common management strategy overall (65.9%), followed by stress management (43.5%) and weight loss (40.4%). Over half (53.9%) did not use any lifestyle modification strategies to tackle ED. Only 7.0% of ED sufferers received a mental health assessment and 29.2% received other tests (e.g., blood test, medical imaging) by GPs. Cardiovascular training was identified as the best rated strategy by its users (37.8%). Supplements (35.1%) and weight training/physical activity (32.6%) were also positively rated. CLINICAL IMPLICATIONS Structured education to general practitioners and community dwelling adults about the impact of lifestyle behaviour modification and how this could influence the appearance or trajectory of ED could help improve personal choice when tackling ED. STRENGTHS AND LIMITATIONS To our knowledge, this is the first study to collect eSurvey responses from community dwelling adults to gauge their reliance and perceived effectiveness of lifestyle medicine approaches to tackle ED. The principal limitation was the lack of follow-up, and not recording other information including lifestyle factors such as nutrition, smoking, and the use of alcohol and recreational drugs, which may have enabled a fuller exploration of the factors that could influence the primary outcome measures examined. CONCLUSION Despite the high prevalence of ED, there is not enough awareness in the community setting about effective and low-cost lifestyle medicine strategies, including cardiovascular training and the use of supplements and weight training, to help tackle this common condition.
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Affiliation(s)
- Austen El-Osta
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Gabriele Kerr
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Aos Alaa
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Marie Line El Asmar
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Manisha Karki
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Iman Webber
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Eva Riboli Sasco
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
| | - Giordano Blume
- UroGate Praxisnetzwerk, Berliner Platz 2, 61476 Kronberg, Germany
| | - Wolf-D. Beecken
- UroGate Praxisnetzwerk, Berliner Platz 2, 61476 Kronberg, Germany
| | - David Mummery
- grid.7445.20000 0001 2113 8111Self-Care Academic Research Unit (SCARU), Department of Primary Care and Public Health, School of Public Health, Imperial College London, 323 Reynolds Building, Charing Cross Hospital, St Dunstan’s Road, London, W6 8RP UK
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Defeudis G, Mazzilli R, Di Tommaso AM, Zamponi V, Carlomagno F, Tuccinardi D, Watanabe M, Faggiano A, Gianfrilli D. Effects of diet and antihyperglycemic drugs on erectile dysfunction: A systematic review. Andrology 2023; 11:282-294. [PMID: 35485604 PMCID: PMC10084359 DOI: 10.1111/andr.13192] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Erectile dysfunction is recognized as one of the complications of diabetes mellitus. To date, a wide gap of knowledge is present on the efficacy of pharmacological treatments of diabetes mellitus on erectile function, acting not only through metabolic control. Similarly, the effects of different diet regimens on erectile dysfunction are still debated. OBJECTIVES We aimed to explore the effects of diet and antihyperglycemic drugs, considering both old and novel therapeutic approaches, on erectile function. MATERIALS/METHODS We performed a systematic review, following the PRISMA guidelines. The research was conducted on studies reporting erectile dysfunction assessment in subjects with diabetes and the relationship with diet and antihyperglycemic drugs. RESULTS The Mediterranean diet was effective in most studies for the protection of erectile function. Furthermore, antihyperglycemic drugs seem to show an overall protective role on erectile function. DISCUSSION/CONCLUSION Although encouraging results are present for all classes of antihyperglycemic drugs, several studies are needed in humans, mainly on acarbose, pioglitazone, dipeptidyl-peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors.
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Affiliation(s)
- Giuseppe Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Rossella Mazzilli
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Alfonso Maria Di Tommaso
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Virginia Zamponi
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Carlomagno
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Dario Tuccinardi
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Antongiulio Faggiano
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
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5
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Yang H, Breyer BN, Rimm EB, Giovannucci E, Loeb S, Kenfield SA, Bauer SR. Plant-based diet index and erectile dysfunction in the Health Professionals Follow-Up Study. BJU Int 2022; 130:514-521. [PMID: 35484829 PMCID: PMC9474604 DOI: 10.1111/bju.15765] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the longitudinal association between plant-based diet index (PDI) score and incident erectile dysfunction (ED). MATERIALS AND METHODS We conducted a prospective analysis of 21 942 men aged 40 to 75 years who were enrolled in the Health Professionals Follow-Up Study. ED was assessed with questionnaires every 4 years starting in 2000. Dietary data were collected via validated food frequency questionnaires completed every 4 years and were used to calculate total PDI scores, as well as healthy (hPDI) and unhealthy (uPDI) subscores. Multivariable Cox proportional hazards models were used to compute hazard ratios (HRs) for incident ED. All models were stratified by age (<60, 60 to <70, ≥70 years). RESULTS Among men aged 60 to <70 years, hPDI was inversely associated with incident ED. Those in the highest quintile of hPDI in that age group had an 18% lower risk of ED (HR 0.82, 95% confidence interval (CI) 0.73-0.91; P-trend <0.001) compared to those in the lowest quintile. Conversely, uPDI was positively associated with ED in men aged <60 years (HR 1.27, 95% CI 1.01-1.60; P-trend = 0.02). CONCLUSIONS Encouraging a healthy plant-based diet may be an environmentally sustainable intervention for men interested in maintaining erectile function.
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Affiliation(s)
| | | | - Eric B. Rimm
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital
| | - Edward Giovannucci
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs
| | - Stacey A. Kenfield
- Department of Urology, UCSF
- Department of Epidemiology & Biostatistics, UCSF
| | - Scott R. Bauer
- Department of Urology, UCSF
- Division of General Internal Medicine, Department of Medicine, UCSF
- San Francisco Veterans Affairs Healthcare System
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6
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Defeudis G, Di Tommaso AM, Di Rosa C, Cimadomo D, Khazrai YM, Faggiano A, Cincione RI, Napoli N, Mazzilli R. The Role of Antihyperglycemic Drugs and Diet on Erectile Function: Results from a Perspective Study on a Population with Prediabetes and Diabetes. J Clin Med 2022; 11:jcm11123382. [PMID: 35743453 PMCID: PMC9224931 DOI: 10.3390/jcm11123382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of diet and antihyperglycemic drugs on erectile dysfunction (ED) in a setting of subjects affected by diabetes mellitus (DM) or preDM. METHODS This is a prospective observational study on 163 consecutive subjects with preDM or DM. All patients have undergone a medical evaluation (age, Body Mass Index (BMI), family history of DM, duration of DM, smoking, physical activity, dyslipidemia, cardiovascular comorbidities, and testosterone and HbA1c levels) and the International Index of Erectile Function (IIEF)-5 questionnaire. RESULTS Overall, the mean age was 62.8 ± 9.3 years, and the mean BMI was 28.4 ± 4.6 kg/m2. The IIEF-5 score mean value was 14.4 ± 6.2 (range 4-25). Among all confounders investigated for their association with the IIEF-5 score, only age and the duration of DM among diabetic patients showed a significant trend. The IIEF-5 score was higher in patients using GLP-1a compared to insulin (16.7 ± 4.7 vs. 12.9 ± 6.2; p = 0.02). This association was confirmed after adjustment for age and duration of DM (p = 0.01). All other treatments were similar (14.9 ± 6.2, 14.8 ± 9.2, 15.3 ± 5.4, and 13.6 ± 6.8 for metformin, sulfonylureas (SU), dipeptidyl-peptidase-4 inhibitors (DPP-4i), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) treatment, respectively). CONCLUSIONS This prospective observational study increases attention and focus on the effect of antihyperglycemic drugs and diet on ED, above all about the role of new classes, showing a significant higher IIEF-5 mean value in patients using GLP-1a compared to patients on insulin treatment.
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Affiliation(s)
- Giuseppe Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; (A.M.D.T.); (N.N.)
- Correspondence: or
| | - Alfonso Maria Di Tommaso
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; (A.M.D.T.); (N.N.)
| | - Claudia Di Rosa
- Unit of Food Science and Nutrition, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (C.D.R.); (Y.M.K.)
| | - Danilo Cimadomo
- Clinica Valle Giulia, GeneraLife IVF Center, 00197 Rome, Italy;
| | - Yeganeh Manon Khazrai
- Unit of Food Science and Nutrition, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (C.D.R.); (Y.M.K.)
| | - Antongiulio Faggiano
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.); (R.M.)
| | - Raffaele Ivan Cincione
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; (A.M.D.T.); (N.N.)
| | - Rossella Mazzilli
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.); (R.M.)
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7
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Impact of Environmental and Dietary Issues on Male Sexual Health. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-021-00317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Carto C, Pagalavan M, Nackeeran S, Blachman-Braun R, Kresch E, Kuchakulla M, Ramasamy R. Consumption of a healthy plant-based diet is associated with a decreased risk of erectile dysfunction: a cross-sectional study of the National Health and Nutrition Examination Survey. Urology 2021; 161:76-82. [PMID: 34979217 DOI: 10.1016/j.urology.2021.12.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the association between the plant-based content of diet and erectile dysfunction in men from the National Health and Nutrition Examination Survey (NHANES). METHODS We collected de-identified information from the NHANES database on demographics, comorbidities, diet, and erectile dysfunction (ED). Exclusion criteria were age <20 or >70 years, incomplete plant-based diet index information, history of prostate cancer, or other missing information. Using the food frequency questionnaire, an overall plant-based diet index (PDI) and healthful plant-based diet index (hPDI) were developed. A higher score on the PDI and hPDI is indicative of greater consumption of plant-based foods. RESULTS A total of 2549 men were analyzed, of those 1085 (42.6%) have good erectile function and 1464 (57.4%) have some degree of ED [usually have erections 521 (20.4%), sometimes have erection 690 (27.1%), or never have erections 253 (9.9%)]. The median age and BMI were 54 [41 - 64] years and 28.8 [25.5 - 32.6] kg/m2, respectively. The median PDI and hPDI were 50 [46 - 54] and 50 [45 - 56], respectively. In multivariable adjusted logistic regression analysis, hPDI was negatively associated with ED (OR = 0.98, 95% CI: 0.96 - 0.99; p = 0.001). There was no association between PDI and ED. CONCLUSION In a well characterized national database, we showed that a healthful plant-based diet is associated with less chance of having erectile dysfunction. Whether interventions with a plant-based diet will improve erectile function remains to be studied.
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Affiliation(s)
- Chase Carto
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St., Suite 1563, Miami, FL 33136, USA
| | | | - Sirpi Nackeeran
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St., Suite 1563, Miami, FL 33136, USA
| | - Ruben Blachman-Braun
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St., Suite 1563, Miami, FL 33136, USA
| | - Eliyahu Kresch
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St., Suite 1563, Miami, FL 33136, USA
| | - Manish Kuchakulla
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St., Suite 1563, Miami, FL 33136, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St., Suite 1563, Miami, FL 33136, USA.
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9
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Mediterranean diet in type 2 diabetes: An updated overview of pharmacological activities of cardiometabolic and reproductive outcomes. Curr Opin Pharmacol 2021; 60:27-33. [PMID: 34314947 DOI: 10.1016/j.coph.2021.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/12/2021] [Accepted: 06/22/2021] [Indexed: 12/16/2022]
Abstract
Mediterranean diet represents an optimal "way of living" to pursue in order to preserve health and well-being. A large body of evidence indicates that the Mediterranean diet is effective in preventing diabetes and improving both glycemic control and cardiometabolic health in people with type 2 diabetes. Moreover, in the recent years a growing interest risen on the importance of dietary style choice in both male and female sexual and reproductive health. This review aims at providing an updated overview of the latest available evidence on the effects of Mediterranean diet on cardiovascular, metabolic, and reproductive health in the context of type 2 diabetes.
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10
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Lu Y, Kang J, Li Z, Wang X, Liu K, Zhou K, Wang W, Shen C. The association between plant-based diet and erectile dysfunction in Chinese men. Basic Clin Androl 2021; 31:11. [PMID: 33980148 PMCID: PMC8117588 DOI: 10.1186/s12610-021-00129-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background Diet, one of the components of lifestyle, has been believed to have associations with erectile dysfunction (ED). However, whether there is an association between plant-based diet and ED is remains to be explored. Thus, we conducted the nested case-control study to investigate the relationship between the plant-based diet and ED in China. Results ED group (92 subjeczts) and ED free group (92 subjects) were similar in terms of basic features (P > 0.05), except for lifestyle (P < 0.05). The plant-diet index (PDI) and healthy plant-diet index (hPDI) in the ED group were significantly lower than those in the control group (P < 0.001). Adjusted multivariate analysis indicated that the presence of ED was negatively associated with nitric oxide levels, PDI, and hPDI (all P < 0.05), and was positively related to body mass index, metabolic syndrome, and E-selectin levels. Furthermore, both the PDI and hPDI increased significantly as the International Index of Erectile Function (IIEF-5) scores increased within the ED group (P < 0.05). Multi-model multivariate analysis indicated the robustness of results. Conclusions More plant-based diet intake was associated with a reduced presence of ED and less severe ED in China. Committing to plant-based diet can be encouraged for many health benefits and to lower ED burden. Further well-designed studies are warranted to validate our findings. Supplementary Information The online version contains supplementary material available at 10.1186/s12610-021-00129-5.
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Affiliation(s)
- Yi Lu
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, 116023, China.,Tianjin Medical University, Tianjin, 300070, China.,Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jiaqi Kang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Zhongjia Li
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Xiao Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Kang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Kechong Zhou
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Wei Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, 116023, China. .,Tianjin Medical University, Tianjin, 300070, China.
| | - Chen Shen
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, 116023, China. .,Tianjin Medical University, Tianjin, 300070, China.
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11
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Ostfeld RJ, Allen KE, Aspry K, Brandt EJ, Spitz A, Liberman J, Belardo D, O'Keefe JH, Aggarwal M, Miller M, Batiste C, Kopecky S, White B, Shah N, Hawamdeh H, Batts T, Blankstein R, Reddy K, Ornish D, Freeman AM. Vasculogenic Erectile Dysfunction: The Impact of Diet and Lifestyle. Am J Med 2021; 134:310-316. [PMID: 33227246 DOI: 10.1016/j.amjmed.2020.09.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/15/2022]
Abstract
Vasculogenic erectile dysfunction has been aptly called the "canary in the coal mine" for cardiovascular disease because it almost always precedes other manifestations of atherosclerotic cardiovascular disease, including myocardial infarction and stroke. It is common, associated with the presence of modifiable cardiovascular risk factors, and impacted by diet and lifestyle choices. This concise review provides an update on the use of dietary and other lifestyle interventions to improve vasculogenic erectile dysfunction and atherosclerotic cardiovascular disease.
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Affiliation(s)
| | | | - Karen Aspry
- Lifespan Cardiovascular Institute, and Department of Medicine, Division of Cardiology, Brown University, Alpert Medical School, Providence, RI
| | - Eric J Brandt
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn
| | - Aaron Spitz
- Partner, Orange County Urology Associates, Volunteer Clinical Assistant Professor, University of California, Irvine Department of Urology, Orange
| | - Joshua Liberman
- Ascension Wisconsin Cardiovascular Specialists, Milwaukee, Wis
| | - Danielle Belardo
- Division of Cardiology, Lankenau Medical Center, Wynnewood, Penn
| | - James H O'Keefe
- Medical Director of the Charles and Barbara Duboc Cardio Health & Wellness Center, Saint Luke's Mid America Heart Institute, Kansas City, Mo
| | | | - Michael Miller
- Professor of Cardiovascular Medicine, Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore
| | - Columbus Batiste
- Division of Cardiology, Kaiser Permanente Riverside and Moreno Valley, Riverside, Calif
| | - Stephen Kopecky
- Division of Cardiology, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minn
| | - Beth White
- Department of Cardiology and Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV
| | - Nikhil Shah
- Division of Cardiology, University of Florida, Gainesville
| | | | - Travis Batts
- Division of Cardiology, Department of Medicine, Wilford Hall Ambulatory Surgical Center, San Antonio, Tex
| | - Ron Blankstein
- Division of Cardiology, Brigham and Women's Hospital, Boston, Mass
| | - Koushik Reddy
- Division of Cardiology, James A. Haley VA Medical Center, Tampa, Fla
| | - Dean Ornish
- Clinical Professor of Medicine, University of California, San Francisco
| | - Andrew M Freeman
- Department of Medicine, Division of Cardiology, National Jewish Health, Denver, Colo
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Bauer SR, Breyer BN, Stampfer MJ, Rimm EB, Giovannucci EL, Kenfield SA. Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study. JAMA Netw Open 2020; 3:e2021701. [PMID: 33185675 PMCID: PMC7666422 DOI: 10.1001/jamanetworkopen.2020.21701] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Erectile dysfunction, especially in younger men, is an early sign of cardiovascular disease and may decrease quality of life. Men may be motivated to adopt a healthy dietary pattern if it lowers their risk of erectile dysfunction. OBJECTIVE To assess the association between adherence to a diet quality index based on healthy dietary patterns and erectile dysfunction in men. DESIGN, SETTING, AND PARTICIPANTS This population-based prospective cohort study included men from the Health Professionals Follow-up Study with follow-up from January 1, 1998, through January 1, 2014. Participants included US male health professionals aged 40 to 75 years at enrollment. Men with erectile dysfunction or a diagnosis of myocardial infarction, diabetes, stroke, or genitourinary cancer at baseline were excluded. Analyses were completed in February 2020. EXPOSURES A food frequency questionnaire was used to determine nutrient and food intake every 4 years. MAIN OUTCOMES AND MEASURES Diet quality was assessed by Mediterranean Diet score and the Alternative Healthy Eating Index 2010 score, with higher scores indicating healthier diet. Dietary index scores were cumulatively updated from 1986 until men developed erectile dysfunction, cardiovascular disease, died, or were lost to follow-up. Incident erectile dysfunction was assessed with questionnaires in 2000, 2004, 2008, and 2012. Hazard ratios (HRs) by prespecified categories or quintiles of dietary index scores were estimated using Cox proportional hazards regression analyses stratified by age. RESULTS Among 21 469 men included in analysis, mean (SD) age at baseline was 62 (8.4) years. During a mean (SD) follow-up of 10.8 (5.4) years and 232 522 person-years, there were 968 incident erectile dysfunction cases among men younger than 60 years, 3703 cases among men aged 60 to less than 70 years, and 4793 cases among men aged 70 years or older. Men younger than 60 years and in the highest category of the Mediterranean Diet score had the lowest relative risk of incident erectile dysfunction compared with men in the lowest category (HR, 0.78; 95% CI, 0.66-0.92). Higher Mediterranean diet scores were also inversely associated with incident erectile dysfunction among older men (age 60 to <70 years: HR, 0.82; 95% CI, 0.76-0.89; age ≥70 years: HR, 0.93; 95% CI, 0.86-1.00). Men scoring in the highest quintile of the Alternative Healthy Eating Index 2010 also had a lower risk of incident erectile dysfunction, particularly among men age younger than 60 years (quintile 5 vs quintile 1: HR, 0.78; 95% CI, 0.63-0.97). CONCLUSIONS AND RELEVANCE This cohort study found that adherence to healthy dietary patterns was associated with a lower risk for erectile dysfunction, suggesting that a healthy dietary pattern may play a role in maintaining erectile health.
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Affiliation(s)
- Scott R. Bauer
- Department of Medicine, University of California, San Francisco
- Department of Urology, University of California, San Francisco
- Division of General Internal Medicine, San Francisco VA Medical Center, San Francisco, California
| | - Benjamin N. Breyer
- Department of Urology, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Meir J. Stampfer
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Eric B. Rimm
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Edward L. Giovannucci
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Stacey A. Kenfield
- Department of Urology, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
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Maiuolo J, Gliozzi M, Musolino V, Carresi C, Nucera S, Macrì R, Scicchitano M, Bosco F, Scarano F, Ruga S, Zito MC, Oppedisano F, Mollace R, Paone S, Palma E, Muscoli C, Mollace V. The Role of Endothelial Dysfunction in Peripheral Blood Nerve Barrier: Molecular Mechanisms and Pathophysiological Implications. Int J Mol Sci 2019; 20:ijms20123022. [PMID: 31226852 PMCID: PMC6628074 DOI: 10.3390/ijms20123022] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 02/06/2023] Open
Abstract
The exchange of solutes between the blood and the nerve tissue is mediated by specific and high selective barriers in order to ensure the integrity of the different compartments of the nervous system. At peripheral level, this function is maintained by the Blood Nerve Barrier (BNB) that, in the presence, of specific stressor stimuli can be damaged causing the onset of neurodegenerative processes. An essential component of BNB is represented by the endothelial cells surrounding the sub-structures of peripheral nerves and increasing evidence suggests that endothelial dysfunction can be considered a leading cause of the nerve degeneration. The purpose of this review is to highlight the main mechanisms involved in the impairment of endothelial cells in specific diseases associated with peripheral nerve damage, such as diabetic neuropathy, erectile dysfunction and inflammation of the sciatic nerve.
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Affiliation(s)
- Jessica Maiuolo
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Micaela Gliozzi
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Vincenzo Musolino
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Cristina Carresi
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Saverio Nucera
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Roberta Macrì
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Miriam Scicchitano
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Francesca Bosco
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Federica Scarano
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Stefano Ruga
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Maria Caterina Zito
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Francesca Oppedisano
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Rocco Mollace
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Sara Paone
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Ernesto Palma
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Carolina Muscoli
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Via di Valcannuta 247, 00133 Rome, Italy.
| | - Vincenzo Mollace
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Via di Valcannuta 247, 00133 Rome, Italy.
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Mulhall JP, Giraldi A, Hackett G, Hellstrom WJ, Jannini EA, Rubio-Aurioles E, Trost L, Hassan TA. The 2018 Revision to the Process of Care Model for Management of Erectile Dysfunction. J Sex Med 2018; 15:1434-1445. [DOI: 10.1016/j.jsxm.2018.05.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 01/29/2023]
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Abstract
OBJECTIVE To explore physical activity and eating behaviors among men following the implementation of a gender-sensitive, workplace health promotion program. METHODS Using a pre-post within-subjects design, computer-assisted telephone interviewing (CATI) was used to collect health-related information along with physical activity and fruit/vegetable intake at baseline and after 6 months. RESULTS At baseline, participants (N = 139) consumed 3.58 servings of fruit and vegetables/day and engaged in an average of 229.77 min/week moderate-vigorous physical activity (MVPA). At 6 months, daily fruit/vegetable intake did not increase, whereas MVPA increased by 112.3 min/week. CONCLUSIONS The POWERPLAY program successfully increased weekly MVPA. Engaging men in health promotion can be a challenge; here, the workplace served as a valuable environment for achieving positive change.
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Mykoniatis I, Grammatikopoulou MG, Bouras E, Karampasi E, Tsionga A, Kogias A, Vakalopoulos I, Haidich AB, Chourdakis M. Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction. J Sex Med 2018; 15:176-182. [DOI: 10.1016/j.jsxm.2017.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/14/2017] [Accepted: 12/17/2017] [Indexed: 01/11/2023]
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Diet and Men's Sexual Health. Sex Med Rev 2018; 6:54-68. [DOI: 10.1016/j.sxmr.2017.07.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/05/2017] [Accepted: 07/05/2017] [Indexed: 01/08/2023]
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Di Francesco S, Tenaglia RL. Mediterranean diet and erectile dysfunction: a current perspective. Cent European J Urol 2017; 70:185-187. [PMID: 28721287 PMCID: PMC5510347 DOI: 10.5173/ceju.2017.1356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 04/15/2017] [Accepted: 04/18/2017] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION In this current perspective we analyzed the role of Mediterranean diet (MedDiet) in sexual function and particularly in erectile dysfunction (ED), according to the latest scientific evidence. MATERIAL AND METHODS We conducted a systematic search of relevant full-length papers identified during the time period from 1 January 2010 to the present. RESULTS Published studies showed that adherence to a MedDiet contributes to preventing ED through an improved lipid and glucose metabolism, increased antioxidant defenses, and increased arginine levels which could raise nitric oxide activity. CONCLUSIONS Our findings suggest that the encouragement of a healthy lifestyle, such as MedDiet promotion, could be an attractive dietary approach to prevent ED and preserve sexual function.
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Affiliation(s)
- Simona Di Francesco
- G. D'Annunzio University of Chieti-Pescara, Department of Medical and Oral Sciences and Biotechnologies, Chieti, Italy
| | - Raffaele Lanfranco Tenaglia
- G. D'Annunzio University of Chieti-Pescara, Department of Medical and Oral Sciences and Biotechnologies, Chieti, Italy
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Hackett G, Krychman M, Baldwin D, Bennett N, El-Zawahry A, Graziottin A, Lukasiewicz M, McVary K, Sato Y, Incrocci L. Coronary Heart Disease, Diabetes, and Sexuality in Men. J Sex Med 2017; 13:887-904. [PMID: 27215685 DOI: 10.1016/j.jsxm.2016.01.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 01/09/2016] [Accepted: 01/12/2016] [Indexed: 12/30/2022]
Abstract
Erectile dysfunction (ED) has been well recognized as a marker of increased cardiovascular risk for more than 15 years, especially in younger men. Early detection of ED represents an opportunity to intervene to decrease the risk of future cardiovascular events and limit the progression of ED severity. Evidence suggests there is a window of opportunity of 3 to 5 years from the onset of ED to subsequent cardiovascular events. This opportunity is usually missed if the onus is placed on the patient to seek care for his sexual problems. Unfortunately, these clear messages have not been incorporated into routine cardiovascular care. The reasons for these disparities within specialties are discussed in this article, in addition to management algorithms. Lifestyle modification is usually recommended as the first-line treatment to correct ED and lessen cardiovascular risk, but evidence suggests that this might be effective only in men without established cardiovascular comorbidities. In men with type 2 diabetes mellitus and established cardiovascular disease, lifestyle modification alone is unlikely to be effective. Cardiovascular medications are often associated with sexual dysfunction but changes in medication are more likely to be beneficial in men with milder recent-onset ED. A balanced view must be taken related to medication adverse events, taking into account optimal management of established cardiovascular disease. Testosterone deficiency has been associated with different metabolic disorders, especially metabolic syndrome and type 2 diabetes mellitus. Testosterone deficiency syndrome has been associated with an independent burden on sexual function globally and increased cardiovascular and all-cause mortality. Testosterone replacement therapy has been shown to improve multiple aspects of sexual function and, in some studies, has been associated with a decrease in mortality, especially in men with type 2 diabetes mellitus. Recent studies have suggested that phosphodiesterase type 5 inhibitors, the first-line medications to treat ED, could decrease cardiovascular and all-cause mortality, through multiple mechanisms, predominantly related to improved endothelial function.
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Affiliation(s)
| | - Michael Krychman
- Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, USA
| | - David Baldwin
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nelson Bennett
- Department of Urology, Lahey Hospital, Burlington, MA, USA
| | - Ahmed El-Zawahry
- Division of Urology, SIU School of Medicine, Springfield, IL, USA
| | | | | | - Kevin McVary
- Division of Urology, SIU School of Medicine, Springfield, IL, USA
| | - Yoshikazu Sato
- Department of Urology, Sanjukai Hospital, Sapporo, Japan
| | - Luca Incrocci
- Erasmus MC Cancer Institute, Department of Radiation Oncology, Rotterdam, The Netherlands
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Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected? Asian J Androl 2016; 17:5-10. [PMID: 25248655 PMCID: PMC4291878 DOI: 10.4103/1008-682x.137687] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Erectile dysfunction (ED) is a common medical disorder whose prevalence is increasing worldwide. Modifiable risk factors for ED include smoking, lack of physical activity, wrong diets, overweight or obesity, metabolic syndrome, and excessive alcohol consumption. Quite interestingly, all these metabolic conditions are strongly associated with a pro-inflammatory state that results in endothelial dysfunction by decreasing the availability of nitric oxide (NO), which is the driving force of the blood genital flow. Lifestyle and nutrition have been recognized as central factors influencing both vascular NO production, testosterone levels, and erectile function. Moreover, it has also been suggested that lifestyle habits that decrease low-grade clinical inflammation may have a role in the improvement of erectile function. In clinical trials, lifestyle modifications were effective in ameliorating ED or restoring absent ED in people with obesity or metabolic syndrome. Therefore, promotion of healthful lifestyles would yield great benefits in reducing the burden of sexual dysfunction. Efforts, in order to implement educative strategies for healthy lifestyle, should be addressed.
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Affiliation(s)
| | | | - Katherine Esposito
- Department of Clinical and Experimental Medicine, Second University of Naples, via Pansini n° 5, Naples, Italy
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Abstract
Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including organic, relational and psychological. Roles for nonendocrine (neurogenic, vasculogenic and iatrogenic) and endocrine pathways have been proposed. Owing to its strong association with metabolic syndrome and cardiovascular disease, cardiac assessment may be warranted in men with symptoms of erectile dysfunction. Minimally invasive interventions to relieve the symptoms of erectile dysfunction include lifestyle modifications, oral drugs, injected vasodilator agents and vacuum erection devices. Surgical therapies are reserved for the subset of patients who have contraindications to these nonsurgical interventions, those who experience adverse effects from (or are refractory to) medical therapy and those who also have penile fibrosis or penile vascular insufficiency. Erectile dysfunction can have deleterious effects on a man's quality of life; most patients have symptoms of depression and anxiety related to sexual performance. These symptoms, in turn, affect his partner's sexual experience and the couple's quality of life. This Primer highlights numerous aspects of erectile dysfunction, summarizes new treatment targets and ongoing preclinical studies that evaluate new pharmacotherapies, and covers the topic of regenerative medicine, which represents the future of sexual medicine.
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Liu ZM, Wong CKM, Chan D, Tse LA, Yip B, Wong SYS. Fruit and Vegetable Intake in Relation to Lower Urinary Tract Symptoms and Erectile Dysfunction Among Southern Chinese Elderly Men: A 4-Year Prospective Study of Mr OS Hong Kong. Medicine (Baltimore) 2016; 95:e2557. [PMID: 26825896 PMCID: PMC5291566 DOI: 10.1097/md.0000000000002557] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The role of fruit and vegetable (FV) intake in relation to prostate health remains inconclusive. This 4-year longitudinal study aims to explore the association of FV intake and the development of lower urinary tract symptoms (LUTS, a cluster of chronic urinary symptoms occurring in bladder, prostate and urethra), incidence of symptomatic benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) in Chinese elderly men. Data were obtained from a 4 years longitudinal study (Mr OS Hong Kong, the largest prospective study on bone health in Chinese elderly). Two thousand Chinese men aged 65 years and older were recruited from the local community, of whom 1998 (99.9%) at baseline and 1564 (78.2%) at 4-year follow-up reported data on LUTS, which were evaluated by a validated International Prostate Symptoms Scale (IPSS). Erectile function was evaluated by the International Index of Erectile Dysfunction-5 (IIEF-5) questionnaires at 2- (n = 386) and 4-year (n = 475) follow-ups. Dietary intake was assessed using a validated food frequency questionnaire at baseline. Analysis was conducted using multivariate linear and logistic regression. For total FV and most of their subclasses, moderate consumption had the lowest mean changes of LUTS; we thus applied the moderate levels as the reference in the regression models. The high levels of total FV intake (>350 g/1000 kcal/day) were significantly associated with reduced IPSS by scores of -1.174 ± 0.459 (or -17.3% of basal IPSS, P = 0.011) relative to the moderate groups (250-350 g/1000 kcal/day). FV consumption had no significant association with the score change of ED or the odds of sexual activities at 4-year (all P > 0.05). High intake of dark and leafy vegetables (>50 g/1000 kcal/day) significantly reduced the risk of LUTS progression by 37.2% [odds ratio (OR) (95% confidence interval, 95% CI): 0.628 (0.466∼0.848), P = 0.002] or risk of symptomatic BPH by 34.3% [OR (95% CI): 0.657 (0.442-0.976), P = 0.038] after 4 years compared with the moderate group (25-50 g/1000 kcal/day). Adequate FV intakes, especially dark and leafy vegetables, were associated with improved LUTS among Chinese elderly men, but lack an association with ED and sexuality.
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Affiliation(s)
- Zhao-Min Liu
- From the Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Shatin, Hong Kong SAR (Z-ML, CKMW, DC, BY, SY-SW); and Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Shatin, Hong Kong SAR (LAT)
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Abstract
INTRODUCTION Erectile dysfunction (ED) has been significantly associated with many chronic conditions including obesity, the metabolic syndrome, hypogonadism, diabetes mellitus, cardiovascular disease (CVD), lower urinary tract symptoms, and psychiatric/psychological disorders. ED is also a well-established predictor of CVD. AIM This review will focus on the association of ED with cardiovascular, metabolic, and cognitive conditions and discuss the effects of managing lifestyle factors in order to reduce the burden of ED and consequently outcomes in patients with chronic conditions. METHODS A literature search using Medline, PubMed (U.S. National Library of Medicine and the National Institutes of Health), and abstracts from scientific meetings was performed from 1990. MAIN OUTCOME MEASURES Main outcome measures were improvements in sexual function. RESULTS A total of 59 reviews on the topic were evaluated. CONCLUSIONS Targeting several lifestyle factors associated with CVD/metabolic/cognitive disorders, e.g., smoking, alcohol consumption, obesity, and physical activity, can have significant benefits, leading to an improvement in ED as well as testosterone levels and consequently CVD. Kirby M. The circle of lifestyle and erectile dysfunction. Sex Med Rev 2015;3:169-182.
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Affiliation(s)
- Michael Kirby
- The Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, Hatfield, Herts, UK; The Prostate Centre, London, UK.
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Silva FH, Alexandre EC, Calmasini FB, Calixto MC, Antunes E. Treatment With Metformin Improves Erectile Dysfunction in a Murine Model of Obesity Associated With Insulin Resistance. Urology 2015. [PMID: 26199165 DOI: 10.1016/j.urology.2015.04.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effects of treatment with metformin on a murine model of obesity-associated erectile dysfunction. MATERIAL AND METHODS C57BL/6 male mice were fed for 10 weeks with standard chow or high-fat diet. Lean and obese mice were treated with the insulin sensitizer metformin (300 mg/kg/day, 2 weeks). Intracavernosal pressure (ICP) and in vitro corpus cavernosum (CC) relaxations to both acetylcholine and electrical field stimulation, as well as phenylephrine-induced contractions, were obtained. Levels of cyclic guanosine monophosphate in CC were detected by enzyme immunoassay. RESULTS High-fat-fed mice exhibited higher body weight and insulin resistance. Cavernous nerve stimulation caused frequency-dependent ICP increases, which were significantly lower in obese compared with lean mice (P <.05). Two-week therapy with metformin reversed the decreased ICP in obese group. The maximal response to acetylcholine in CC was 35% lower (P <.05) in the obese compared to the lean group, which were restored by metformin treatment. Likewise, the impaired electrical field stimulation-induced CC relaxations in obese mice were also partly restored by metformin. Contractile responses to phenylephrine were significantly greater (P <.05) in obese compared to lean mice, which were fully restored by metformin. Basal and stimulated cyclic guanosine monophosphate productions in the erectile tissues were significantly lower (P <.05) in the obese group, an effect fully restored by metformin. CONCLUSION Treatment with metformin restored the erectile function in obese mice, through improvement of in vitro endothelial and nitrergic cavernosal relaxations. Therefore, use of metformin may be a good pharmacologic approach to treat insulin resistance-associated erectile dysfunction.
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Affiliation(s)
- Fábio H Silva
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil.
| | - Eduardo C Alexandre
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Fabiano B Calmasini
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Marina C Calixto
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
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