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Longo M, Caruso P, Varro C, Tomasuolo M, Cirillo P, Scappaticcio L, Romano L, Arcaniolo D, Maiorino MI, Bellastella G, De Sio M, Esposito K. Semen quality and metabolic profile in people with type 1 diabetes with and without erectile dysfunction: a cross-sectional study. J Endocrinol Invest 2024; 47:1787-1795. [PMID: 38225528 PMCID: PMC11196288 DOI: 10.1007/s40618-023-02285-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE The aim of the present study is to evaluate the association of metabolic and glycemic variables with semen parameters in patients with type 1 diabetes (T1D) with and without erectile dysfunction (ED). METHODS The study population included 88 adults with T1D using a continuous glucose monitoring, of whom 28 with ED (ED group) and 60 without it (NO ED group). All men completed the International Index of Erectile Function (IIEF-5) and underwent body composition analysis (BIA) and semen analysis. RESULTS ED group showed worse HbA1c levels [median (IQR), 8.4 (7.7, 9.9) vs 7.4 (7, 8.2) %, P < 0.001)], higher insulin dose [60 (51, 65) vs 45 (38, 56) UI/die, P = 0.004)] and a higher total body water and intracellular water as compared with ED group. Men in the ED group presented higher semen volume [2.8 (2.6, 4.2) vs 2.5 (2.2, 2.7) mL, P < 0.001] and sperm concentration [24 (19, 29) vs 20 (12, 23) mil/mL, P = 0.010], but reduced sperm progressive motility [28 (25, 35) vs 35 (25, 36) %, P = 0.011], higher rate of non-progressive motility [15 (10, 15) vs 10 (5, 10) %, P < 0.001] and higher rate of typical morphology [7(5, 8) vs 5 (4, 5) %, P = 0.001]. Based on multivariate logistic regression analysis performed to assess the association between clinical variables and ED, intracellular water (OR 3.829, 95% CI 1.205, 12.163, P = 0.023) resulted as the only independent predictor of ED. CONCLUSION Men with T1D and ED showed worse metabolic profile which is associated with poor semen quality, as compared with those without ED.
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Affiliation(s)
- M Longo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy.
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - P Caruso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C Varro
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - M Tomasuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - P Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - L Scappaticcio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - L Romano
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - D Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - M I Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M De Sio
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - K Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
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Miron RJ, Estrin NE, Sculean A, Zhang Y. Understanding exosomes: Part 2-Emerging leaders in regenerative medicine. Periodontol 2000 2024; 94:257-414. [PMID: 38591622 DOI: 10.1111/prd.12561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024]
Abstract
Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with the ability to communicate with other tissues and cell types over long distances. Their use in regenerative medicine has gained tremendous momentum recently due to their ability to be utilized as therapeutic options for a wide array of diseases/conditions. Over 5000 publications are currently being published yearly on this topic, and this number is only expected to dramatically increase as novel therapeutic strategies continue to be developed. Today exosomes have been applied in numerous contexts including neurodegenerative disorders (Alzheimer's disease, central nervous system, depression, multiple sclerosis, Parkinson's disease, post-traumatic stress disorders, traumatic brain injury, peripheral nerve injury), damaged organs (heart, kidney, liver, stroke, myocardial infarctions, myocardial infarctions, ovaries), degenerative processes (atherosclerosis, diabetes, hematology disorders, musculoskeletal degeneration, osteoradionecrosis, respiratory disease), infectious diseases (COVID-19, hepatitis), regenerative procedures (antiaging, bone regeneration, cartilage/joint regeneration, osteoarthritis, cutaneous wounds, dental regeneration, dermatology/skin regeneration, erectile dysfunction, hair regrowth, intervertebral disc repair, spinal cord injury, vascular regeneration), and cancer therapy (breast, colorectal, gastric cancer and osteosarcomas), immune function (allergy, autoimmune disorders, immune regulation, inflammatory diseases, lupus, rheumatoid arthritis). This scoping review is a first of its kind aimed at summarizing the extensive regenerative potential of exosomes over a broad range of diseases and disorders.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Nathan E Estrin
- Advanced PRF Education, Venice, Florida, USA
- School of Dental Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
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3
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Longo M, Caruso P, Varro C, Tomasuolo M, Cirillo P, Scappaticcio L, Romano L, Arcaniolo D, Maiorino MI, Bellastella G, De Sio M, Esposito K. Semen quality and metabolic profile in people with type 1 diabetes with and without erectile dysfunction: a cross-sectional study. J Endocrinol Invest 2024. [DOI: https:/doi.org/10.1007/s40618-023-02285-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/14/2023] [Indexed: 03/28/2024]
Abstract
Abstract
Purpose
The aim of the present study is to evaluate the association of metabolic and glycemic variables with semen parameters in patients with type 1 diabetes (T1D) with and without erectile dysfunction (ED).
Methods
The study population included 88 adults with T1D using a continuous glucose monitoring, of whom 28 with ED (ED group) and 60 without it (NO ED group). All men completed the International Index of Erectile Function (IIEF-5) and underwent body composition analysis (BIA) and semen analysis.
Results
ED group showed worse HbA1c levels [median (IQR), 8.4 (7.7, 9.9) vs 7.4 (7, 8.2) %, P < 0.001)], higher insulin dose [60 (51, 65) vs 45 (38, 56) UI/die, P = 0.004)] and a higher total body water and intracellular water as compared with ED group. Men in the ED group presented higher semen volume [2.8 (2.6, 4.2) vs 2.5 (2.2, 2.7) mL, P < 0.001] and sperm concentration [24 (19, 29) vs 20 (12, 23) mil/mL, P = 0.010], but reduced sperm progressive motility [28 (25, 35) vs 35 (25, 36) %, P = 0.011], higher rate of non-progressive motility [15 (10, 15) vs 10 (5, 10) %, P < 0.001] and higher rate of typical morphology [7(5, 8) vs 5 (4, 5) %, P = 0.001]. Based on multivariate logistic regression analysis performed to assess the association between clinical variables and ED, intracellular water (OR 3.829, 95% CI 1.205, 12.163, P = 0.023) resulted as the only independent predictor of ED.
Conclusion
Men with T1D and ED showed worse metabolic profile which is associated with poor semen quality, as compared with those without ED.
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Bilen H, Dayanan R, Ciftel E, Bilen A, Ciftel S, Mercantepe F, Capoglu I. Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients? Int J Gen Med 2023; 16:5147-5156. [PMID: 37954658 PMCID: PMC10638931 DOI: 10.2147/ijgm.s441833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue. Patients and Methods All patients aged 18-65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination. Results The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems. Conclusion This study presents empirical findings that shed light on the inadequacies in healthcare providers' approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients' effective communication of these concerns.
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Affiliation(s)
- Habib Bilen
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Ramazan Dayanan
- Department of Endocrinology and Metabolism, Batman Training and Research Hospital, Batman, Turkey
| | - Enver Ciftel
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Arzu Bilen
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Serpil Ciftel
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Filiz Mercantepe
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Ilyas Capoglu
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
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van Pinxteren M, Delobelle P, Levitt N, Smith K, Majikela-Dlangamandla B, McGrath N. 'I accept his manhood is on life-support': A qualitative understanding of the impact of diabetes on sexual relationships among men and women living with type 2 diabetes and their partners in South Africa. Diabet Med 2023; 40:e15203. [PMID: 37594410 DOI: 10.1111/dme.15203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/19/2023]
Abstract
AIMS To explore the impact of diabetes on sexual relationships among men and women living with type 2 diabetes People living with type 2 diabetes (PLWD) and their partners in Cape Town, South Africa. METHODS As part of a larger study developing an intervention to improve type 2 diabetes mellitus (T2DM) self management, we conducted in-depth individual interviews with 10 PLWD and their partners without diabetes about experiences living with T2DM, between July 2020 and January 2021. We used inductive thematic analysis. RESULTS Both PLWD and partners felt that their sexual relationships and desires changed post-diagnosis, in ways beyond biomedical issues. Although couples' reports on the quality of their sexual relationships were concordant, most participants had not communicated their sexual desires and concerns with each other, causing unhappiness and fears of disappointing or losing their partner. Participants felt uninformed about sexual dysfunction but had not discussed this with their healthcare provider, leading to increased anxiety. CONCLUSION PLWD and their partners need more informational support to increase their understanding of diabetes-associated sexual dysfunction and to decrease fears and anxiety. Strengthening communication within couples on sexual issues may empower them to find solutions to problems experienced. This may improve couples' relationships and quality of life, and indirectly result in better self management of T2DM.
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Affiliation(s)
- Myrna van Pinxteren
- Department of Medicine, Chronic Diseases Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
| | - Peter Delobelle
- Department of Medicine, Chronic Diseases Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Naomi Levitt
- Department of Medicine, Chronic Diseases Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
| | - Kirsten Smith
- Computing, Faculty of Technology, University of Portsmouth, Portsmouth, UK
| | - Buyelwa Majikela-Dlangamandla
- Department of Medicine, Chronic Diseases Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
| | - Nuala McGrath
- Faculty of Medicine, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
- Department of Social Statistics and Demography, Faculty of Social Sciences, University of Southampton, Southampton, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
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Gobena MB, Abdosh T, Dheresa M, Dechasa DB. Erectile dysfunction and associated factors among patients with diabetes attending follow-up at a public hospital, Harar, Eastern Ethiopia. A cross-sectional study design. Front Endocrinol (Lausanne) 2023; 14:1131555. [PMID: 37383399 PMCID: PMC10294227 DOI: 10.3389/fendo.2023.1131555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/10/2023] [Indexed: 06/30/2023] Open
Abstract
Background The global prevalence of erectile dysfunction among patients with diabetes is high. It is the most underestimated problem but has a great physical, psychological, and social impact on the individual with the disease, family, and society in general. Thus, this study aimed to assess the magnitude of erectile dysfunction and associated factors among patients with diabetes attending follow-up at a public hospital, Harar, Eastern Ethiopia. Methods Facility-based cross-sectional study was conducted on selected 210 adult male patients with diabetes attending follow-up at a public hospital, Harar, Eastern Ethiopia, from 1 February to 30 March 2020. Simple random sampling was used to select study participants. A pre-tested interviewer-administered structured questionnaire was used to collect the data. The data were entered to EpiData version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariable binary logistic regression were carried out, and a P-value of <0.05 was taken as statistically significant. Result A total of 210 adult male patients with diabetes participated in the study. The overall magnitude of erectile dysfunction was 83.8%, with 26.7% suffering from mild, 37.5% mild to moderate, 29% moderate, and 6.8% severe erectile dysfunctions. Age 46-59 years [adjusted odds ratio (AOR): 2.560; 95% confidence interval (CI) (1.73, 6.53)], age ≥ 60 years [AOR: 2.9; 95% CI (1.48, 5.67)], and poor glycemic control [AOR: 2.140; 95% CI (1.9, 7.44)] were significantly associated with erectile dysfunction among patients with diabetes. Conclusion The present study revealed a high magnitude of erectile dysfunction among population with diabetes. The age categories of 46-59 and ≥60 and having poor glycemic control were the only variables significantly associated with erectile dysfunction. Thus, routine screening and management for erectile dysfunction in patients with diabetes should be part of routine medical care particularly for adult male patients and those with poor glycemic control.
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Affiliation(s)
- Matebu Bekele Gobena
- Department of Internal Medicine, School of Medicine, Collage of Medicine and Health sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tekabe Abdosh
- Department of Internal Medicine, School of Medicine, Collage of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, Collage of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele Dechasa
- School of Nursing and Midwifery, Collage of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Robinson DJ, Hanson K, Jain AB, Kichler JC, Mehta G, Melamed OC, Vallis M, Bajaj HS, Barnes T, Gilbert J, Honshorst K, Houlden R, Kim J, Lewis J, MacDonald B, MacKay D, Mansell K, Rabi D, Sherifali D, Senior P. Diabetes and Mental Health. Can J Diabetes 2023; 47:308-344. [PMID: 37321702 DOI: 10.1016/j.jcjd.2023.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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Hadisuyatmana S, Boyd JH, Efendi F, Malik G, Bauer M, Reisenhofer S. Non-medical and non-invasive interventions for erectile dysfunction in men with type 2 diabetes mellitus: A scoping review. Heliyon 2023; 9:e15778. [PMID: 37187905 PMCID: PMC10176068 DOI: 10.1016/j.heliyon.2023.e15778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/17/2023] Open
Abstract
Background Erectile dysfunction (ED) often affects men with type 2 diabetes mellitus (T2DM) due to microvascular damage. However, medical interventions are not always appropriate. Aim This scoping review aimed to answer the following question: What evidence is available about the effects of non-medical and non-invasive healthcare interventions to improve ED in men with T2DM? Method Potential studies were collected from the Cumulative Index to Nursing and Allied Health Literature via EBSCO, Embase via Ovid, MEDLINE via Ovid, Web of Science, PubMed, ProQuest, and PsycINFO via Ovid. Findings From 2,611 identified titles, 17 studies, including 11 interventional and 6 observational studies, were included. Four main alternatives to medical interventions were identified from the included studies. Amongst these, four studies recommended patient education on lifestyle modification, twelve studies encouraged dietary changes and physical activities, two studies emphasized the use of vacuum erectile device, and three studies suggested the application of low-intensity extracorporeal shockwave therapy by healthcare professionals. Discussion Dietary modification and physical activities were promoted as effective interventions to help maintaining the erectile function in men with T2DM. Several methods of patient education were identified as the approach to facilitate lifestyle modification in men with T2DM-associated ED. The positive outcomes of this review support early ED screening to help preventing T2DM complications such as ED in men. Further, T2DM management is a shared responsibility between the men and healthcare professionals. Despite the success of Vacuum Erectile Device and Low-intensity Extracorporeal Shockwave Therapy in regaining erectile function, further research is needed in this area based on the recommendations of the American Urological Association. Moreover, the health and quality of life of men with T2DM must be improved.
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Affiliation(s)
- Setho Hadisuyatmana
- School of Psychology & Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
- Faculty of Nursing, Universitas Airlangga Indonesia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia
| | - James H. Boyd
- School of Psychology and Public Health, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga Indonesia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia
- Honorary Fellow at La Trobe University of Australia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia
| | - Gulzar Malik
- School of Nursing & Midwifery, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - Michael Bauer
- School of Engineering, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - Sonia Reisenhofer
- Bairnsdale Regional Health Service, Victoria, Australia, 122 Day St, Bairnsdale, VIC, 3875, Australia
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Katsimardou A, Patoulias D, Zografou I, Siskos F, Stavropoulos K, Imprialos K, Tegou Z, Boulmpou A, Georgopoulou V, Hatzipapa N, Papadopoulos C, Doumas M. The Impact of Metabolic Syndrome Components on Erectile Function in Patients with Type 2 Diabetes. Metabolites 2023; 13:metabo13050617. [PMID: 37233658 DOI: 10.3390/metabo13050617] [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: 03/15/2023] [Revised: 03/31/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
Erectile dysfunction is commonly encountered in diabetic patients and in patients with metabolic syndrome; however, only a few studies have assessed patients with metabolic syndrome and type 2 diabetes mellitus (T2DM) regarding their sexual function. The purpose of this study is to examine the effect of metabolic syndrome and its components on the erectile function of T2DM patients. A cross-sectional study including T2DM patients was conducted from November 2018 until November 2020. Participants were evaluated for the presence of metabolic syndrome and their sexual function was assessed using the International Index of Erectile Function (IIEF) questionnaire. A total of 45 consecutive male patients participated in this study. Metabolic syndrome was diagnosed in 84.4% and erectile dysfunction (ED) in 86.7% of them. Metabolic syndrome was not associated with ED or ED severity. Among metabolic syndrome components, only high-density lipoprotein cholesterol (HDL) was associated with ED [x2 (1, n = 45) = 3.894, p = 0.048; OR = 5.5 (95% CI: 0.890-33.99)] and with the IIEF erectile function scores (median 23 vs. 18, U = 75, p = 0.012). Multiple regression analyses showed that HDL was non-significantly associated with the IIEF erectile function scores. In conclusion, among T2DM patients HDL is associated with ED.
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Affiliation(s)
- Alexandra Katsimardou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Dimitrios Patoulias
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Ioanna Zografou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Fotios Siskos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Konstantinos Stavropoulos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Konstantinos Imprialos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Zoi Tegou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Aristi Boulmpou
- 3rd Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Vivian Georgopoulou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Nikoleta Hatzipapa
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Christodoulos Papadopoulos
- 3rd Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Michael Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
- Veterans Affairs Medical Center, George Washington University, Washington, DC 20422, USA
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Hasnani D, Chavda V, Jha S, Gandhi T, Patel A, Raninga H, Chaudhari A. The efficacy of Tadalafil and Tadalafil + Dapoxetine in managing sexual dysfunction in individuals with type-2 diabetes mellitus: A clinical study. JOURNAL OF DIABETOLOGY 2023. [DOI: 10.4103/jod.jod_123_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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11
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Kang WH, Mohamad Sithik MN, Khoo JK, Ooi YG, Lim QH, Lim LL. Gaps in the management of diabetes in Asia: A need for improved awareness and strategies in men's sexual health. J Diabetes Investig 2022; 13:1945-1957. [PMID: 36151988 DOI: 10.1111/jdi.13903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022] Open
Abstract
Sexual dysfunction, which is defined as 'difficulty during any stage of the sexual encounter that prevents or impairs the individual or couple from enjoying sexual activity', is globally prevalent in males with prediabetes and diabetes. It is an early harbinger of cardiovascular diseases and has a profound impact on one's physical, mental, and social health. Among patients with either prediabetes or diabetes, the most common male sexual dysfunctions are hypogonadism, erectile dysfunction, and premature ejaculation. In Asia, although sexual health is an important factor of men's health, it is rarely discussed freely in real-life practice. Addressing sexual health in Asian males has always been challenging with multiple barriers at the levels of patients and health care providers. Therefore, the assessment and management of sexual dysfunction in routine clinical practice should involve a holistic approach with effective patient-provider communication. In this review, we discuss the epidemiology, pathophysiology, and the management of hypogonadism, erectile dysfunction, and premature ejaculation among males with either prediabetes or diabetes (type 1 and type 2), as well as the evidence gaps across Asia.
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Affiliation(s)
- Waye-Hann Kang
- Department of Medicine, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Selangor, Malaysia
| | | | - Jun-Kit Khoo
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ying-Guat Ooi
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Quan-Hziung Lim
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lee-Ling Lim
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.,Asia Diabetes Foundation, Hong Kong SAR, China
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Analysis of the Factors Associated With ED in Type 2 Diabetics at the University Hospital of Libreville. Sex Med 2022; 10:100564. [PMID: 36126588 PMCID: PMC9780774 DOI: 10.1016/j.esxm.2022.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/20/2022] [Accepted: 08/02/2022] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is very common in diabetic males, especially type 2 diabetes mellitus (T2DM). Many factors and complications of diabetes such as macro- and micro-angiopathy are associated with risks leading to ED in male patients. AIM Analysis of factors associated with ED in T2DM. The purpose of this study is to shed light on potential associations between ED, type 2 diabetes, and some risks factors. MATERIAL AND METHODS This was a prospective analytic study of T2DM over 18. The study population consisted of diabetic patients seen at the endocrinology and urology departments of the University Hospital during the study period. Evaluation of ED was made by IIEF 5 score. OUTCOMES A total of 333 patients were selected for the study. The mean age was 56.6 ± 9.8 and the prevalence of ED was 82.6% (n = 275). RESULTS In univariate analysis, several associated factors were identified such as micro-angiopathic type complications including diabetic retinopathy (OR 4.88 [2.31-10.33], P < .001), diabetic nephropathy (OR 12.67 [1.71-93.66], P = .002) and macro-angiopathic type including arterial hypertension (OR 3.12 [1.69-5.75], P < .001). In multivariate analysis, duration of diabetes, micro and macroangiopathic complications, and hyperuricemia were independent risk factors for the occurrence of ED (P < .05). CLINICAL IMPLICATIONS The presence of certain complications of diabetes such as micro or macro angiopathy or hyperuricemia should lead to a search for a ED. The presence of these associated factors identified in type 2 diabetic patients should systematically prompt an ED diagnosis which is often moderate or severe. That diagnosis would help design a protocol for the management and improvement of the life quality of these patients. STRENGTHS AND LIMITATIONS The strength of this work is that it was conducted in the biggest hospital in the country which gives us a good idea of the trend of this ailment in the country. But the limitation of the study is that it only included patients who visited the hospital. This is monocentric hospital study was also transversal which does allow to establish a causal link. CONCLUSION ED has a significant prevalence in T2DM. Several associated factors identified in uni and multivariate analyses, including duration of diabetes, micro and macro angiopathic complications, and hyperuricemia, increase ED risk. Therefore, it is essential to investigate the existence of these factors to improve the management of ED, which may allow the patient to regain a better overall health status. SNN Milama, A Mougougou, S G Olagui, et al. Analysis of the Factors Associated With ED in Type 2 Diabetics at the University Hospital of Libreville. Sex Med 2022;10:100564.
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Ashrafizadeh M, Kumar AP, Aref AR, Zarrabi A, Mostafavi E. Exosomes as Promising Nanostructures in Diabetes Mellitus: From Insulin Sensitivity to Ameliorating Diabetic Complications. Int J Nanomedicine 2022; 17:1229-1253. [PMID: 35340823 PMCID: PMC8943613 DOI: 10.2147/ijn.s350250] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/07/2022] [Indexed: 12/11/2022] Open
Abstract
Diabetes mellitus (DM) is among the chronic metabolic disorders that its incidence rate has shown an increase in developed and wealthy countries due to lifestyle and obesity. The treatment of DM has always been of interest, and significant effort has been made in this field. Exosomes belong to extracellular vesicles with nanosized features (30-150 nm) that are involved in cell-to-cell communication and preserving homeostasis. The function of exosomes is different based on their cargo, and they may contain lipids, proteins, and nucleic acids. The present review focuses on the application of exosomes in the treatment of DM; both glucose and lipid levels are significantly affected by exosomes, and these nanostructures enhance lipid metabolism and decrease its deposition. Furthermore, exosomes promote glucose metabolism and affect the level of glycolytic enzymes and glucose transporters in DM. Type I DM results from the destruction of β cells in the pancreas, and exosomes can be employed to ameliorate apoptosis and endoplasmic reticulum (ER) stress in these cells. The exosomes have dual functions in mediating insulin resistance/sensitivity, and M1 macrophage-derived exosomes inhibit insulin secretion. The exosomes may contain miRNAs, and by transferring among cells, they can regulate various molecular pathways such as AMPK, PI3K/Akt, and β-catenin to affect DM progression. Noteworthy, exosomes are present in different body fluids such as blood circulation, and they can be employed as biomarkers for the diagnosis of diabetic patients. Future studies should focus on engineering exosomes derived from sources such as mesenchymal stem cells to treat DM as a novel strategy.
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Affiliation(s)
- Milad Ashrafizadeh
- Faculty of Engineering and Natural Sciences, Sabanci University, Tuzla, 34956, Istanbul, Turkey
| | - Alan Prem Kumar
- NUS Centre for Cancer Research (N2CR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117600, Singapore
- Cancer Science Institute of Singapore and Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599, Singapore
| | - Amir Reza Aref
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Translational Sciences, Xsphera Biosciences Inc., Boston, MA, 02210, USA
| | - Ali Zarrabi
- Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, 34396, Turkey
| | - Ebrahim Mostafavi
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
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Rao TSS, Banerjee D, Tandon A, Sawant NS, Jha A, Manohar S, Rao SS. Psychosexual Health and Sexual Medicine in Consultation-Liaison Psychiatry. Indian J Psychiatry 2022; 64:S429-S448. [PMID: 35602370 PMCID: PMC9122165 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- T S Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | | | - Abhinav Tandon
- Department of Psychiatry, United Institute of Medical Sciences, Allahabad, Uttar Pradesh, India
| | - Neena S Sawant
- Department of Psychiatry, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India
| | | | - Shivanand Manohar
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Suman S Rao
- Department of Psychiatry, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India E-mail:
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Pakpahan C, Ibrahim R, William W, Faizah Z, Juniastuti J, Lusida MI, Oceandy D. Stem cell therapy and diabetic erectile dysfunction: A critical review. World J Stem Cells 2021; 13:1549-1563. [PMID: 34786157 PMCID: PMC8567456 DOI: 10.4252/wjsc.v13.i10.1549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/04/2021] [Accepted: 09/23/2021] [Indexed: 02/06/2023] Open
Abstract
Erectile dysfunction (ED) has been identified as one of the most frequent chronic complications of diabetes mellitus (DM). The prevalence of ED is estimated to be about 67.4% in all DM cases worldwide. The pathophysiological process leading to ED involves endothelial, neurological, hormonal, and psychological factors. In DM, endothelial and neurological factors play a crucial role. Damages in the blood vessels and erectile tissue due to insulin resistance are the hallmark of ED in DM. The current treatments for ED include phosphodiesterase-5 inhibitors and penile prosthesis surgery. However, these treatments are limited in terms of just relieving the symptoms, but not resolving the cause of the problem. The use of stem cells for treating ED is currently being studied mostly in experimental animals. The stem cells used are derived from adipose tissue, bone, or human urine. Most of the studies observed an improvement in erectile quality in the experimental animals as well as an improvement in erectile tissue. However, research on stem cell therapy for ED in humans remains to be limited. Nevertheless, significant findings from studies using animal models indicate a potential use of stem cells in the treatment of ED.
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Affiliation(s)
- Cennikon Pakpahan
- Department of Biomedical Sciences, Universitas Airlangga, Surabaya 60132, Indonesia
- Andrology Program, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Raditya Ibrahim
- Andrology Program, Universitas Airlangga, Surabaya 60132, Indonesia
| | - William William
- Andrology Program, Universitas Airlangga, Surabaya 60132, Indonesia
- Department of Medical Biology, School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia, Jakarta 14440, Indonesia
| | - Zakiyatul Faizah
- Department of Biomedical Sciences, Universitas Airlangga, Surabaya 60132, Indonesia
| | | | - Maria I Lusida
- Institute for Tropical Disease, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Delvac Oceandy
- Division of Cardiovascular Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PT, United Kingdom
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Abstract
The science of penile erection, including recent advances in its molecular physiology and neuroanatomic pathways, is described. The pathophysiology of erectile dysfunction is presented, acknowledging associated disease states, and accordingly follows a practical classification scheme: vasculogenic, neurogenic, endocrine, and psychogenic.
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Affiliation(s)
- Susan M MacDonald
- Division of Urology, Penn State Health Milton S. Hershey Medical Center, Mail Code H055, 500 University Drive, Hershey, PA 17033, USA.
| | - Arthur L Burnett
- James Buchanan Brady Urological Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Marburg 407, Baltimore, MD 21287, USA
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17
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Caruso P, Cirillo P, Carbone C, Sarnataro A, Maiorino MI, Bellastella G, Esposito K. Sexual dysfunctions and short-term glucose variability in young men with type 1 diabetes. Hormones (Athens) 2021; 20:475-482. [PMID: 33928529 PMCID: PMC8357658 DOI: 10.1007/s42000-021-00295-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/19/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE Erectile dysfunction (ED) and premature ejaculation (PE) are common sexual disorders in people with diabetes. Glucose variability (GV) has been recognized as a predictor of microvascular complications. The aim of this study was to investigate the relationship between glucose variability and sexual dysfunctions in young men with type 1 diabetes. METHODS One hundred and twelve patients with type 1 diabetes, aged 18-30 years, were enrolled. Patients were divided into two groups according to glucose variability [group 1 (high GV with coefficient of variation ≥ 36%)] and group 2 (low GV with coefficient of variation < 36%)). The presence of sexual dysfunctions was investigated with validated questionnaires. RESULTS ED and PE prevalence rates in group 1 were 26% and 13%, respectively. Similarly, in group 2, the prevalence of ED was 24%, and the prevalence of PE was 13%. In both groups, no significant associations between sexual dysfunctions and parameters of glucose variability were found. Multiple regression analysis identified age and depression as independent predictors of ED and PE. CONCLUSION Young male patients affected by type 1 diabetes with high or low glucose variability show a similar prevalence of sexual dysfunctions. ED is the most common sexual dysfunction in diabetic men. Age and depression were the only independent predictive factors for sexual dysfunctions in this population.
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Affiliation(s)
- Paola Caruso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
| | - Carla Carbone
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Annalisa Sarnataro
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy.
- Unit of Diabetes, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
- Unit of Diabetes, University of Campania "Luigi Vanvitelli", Naples, Italy
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Getie Mekonnen E, Yeshita HY, Bishaw Geremew A. Sexual dysfunction among men with diabetes mellitus attending chronic out-patient department at the three hospitals of Northwest Amhara region, Ethiopia: Prevalence and associated factors. PLoS One 2021; 16:e0256015. [PMID: 34379695 PMCID: PMC8357135 DOI: 10.1371/journal.pone.0256015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 07/28/2021] [Indexed: 01/23/2023] Open
Abstract
Background Sexual dysfunction is the commonest reproductive health problem observed among men with diabetes mellitus affecting their quality of life. Previous studies conducted in this area were concentrated on the specific domains of sexual dysfunction, and factors were not well-addressed. Therefore, this study was aimed to determine the prevalence of all forms of sexual dysfunction and to identify its associated factors among diabetic men patients attending at the three hospitals of the Amhara region, Ethiopia. Method An institutional-based cross-sectional study was conducted involving 462 men diabetic patients at the three hospitals of the northwest Amhara region. A systemic random sampling technique was employed. A face-to-face interviewer-administered change in the sexual functioning questionnaire was used to collect the required data from the 20th of February to the 15th of April 2020. The binary logistic regression was employed and a multivariable logistic regressions model was used to control the effect of confounders. Variables that had an independent correlation with the sexual dysfunction were identified based on a p-value≤ 0.05. Likewise, the direction and strength of association were interpreted using Adjusted Odds Ratio (AOR) with its corresponding 95% CI. Results The prevalence of sexual dysfunction was found to be 69.5% (95%CI: (65.1–73.9)). The magnitude of sexual dysfunction was prevalently observed among participants who were older (> 50 years) (AOR = 8.7, 95%CI: (3.3–23.1)). Likewise, the odds of sexual dysfunction was significantly higher among men who have lived with diabetes for a longer duration (AOR = 10.8, 95%CI: (5.3–21.9)), with poor metabolic control (AOR = 3.57, 95%CI: (1.81–7.05)), with comorbid illnesses (AOR = 5.07, 95%CI: (2.16–11.9)), and diabetic-related complications (AOR = 3.01, 95%CI: 1.31–6.92). On the other hand, participants who were physically active (AOR = 0.41, 95%CI: (0.12–0.7)) and satisfied with their relationship (AOR = 0.15, 95%CI: (0.03–0.7)) showed a lesser risk of experiencing sexual dysfunction. Conclusion Well over two-thirds of men with diabetes mellitus have experienced sexual dysfunction, implying a public health pressing problem. Older age, lack of physical activity, living longer duration with diabetes, having diabetic complications, experiencing co-morbid illnesses, being unsatisfied with couple relationship, and poor metabolic control increased the risk of developing SD. Therefore, promoting physical exercise, preventing co-morbid illnesses, and couples counseling to build up a good couple relationship are recommended to promote the sexual and reproductive health of men with diabetes.
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Affiliation(s)
- Eskedar Getie Mekonnen
- Department of Reproductive and Child Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Hedija Yenus Yeshita
- Department of Reproductive and Child Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alehegn Bishaw Geremew
- Department of Reproductive and Child Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Khodarahimi S, Mazraeh N, Rahimian Bougar M, Sheikhi S. Hypogonadism and Sexual functioning in males with and without Diabetes Type II. SEXOLOGIES 2021. [DOI: 10.1016/j.sexol.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Colakerol A, Temiz MZ, Tavukcu HH, Aykan S, Ozsoy S, Sahan A, Kandirali E, Semercioz A. Effects of ozone treatment on penile erection capacity and nitric oxide synthase levels in diabetic rats. Int J Impot Res 2021; 33:1-8. [PMID: 32393847 DOI: 10.1038/s41443-020-0301-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/11/2020] [Accepted: 04/28/2020] [Indexed: 02/07/2023]
Abstract
We aimed to determine the effects of ozone treatment on functional and biochemical changes in corpus cavernosum of diabetic rats. A total of 18 rats were included in the study. The rats were divided into the three groups as control, diabetes mellitus, and diabetes mellitus + ozone therapy groups. In the latter, ozone gas mixture was administered intraperitoneally for 2 weeks after the induction of experimental diabetes model. Erectile response was evaluated by determining mean intracavernosal pressure. Tissue neuronal, inducible and endothelial nitric oxide synthase levels were evaluated with commercial ELISA kits. Immunohistochemical evaluation was also performed to determine the expression levels of nitric oxide synthases semiquantatively. Mean intracavernosal pressure and intracavernosal pressure/systemic arterial blood pressure ratio were significantly higher in the diabetes mellitus + ozone therapy group than those of diabetes mellitus group (24.57 ± 6.36 mmHg vs. 5.98 ± 2.04 mmHg, p = 0.005 and 0.81 ± 0.16 vs. 0.26 ± 0.11, p = 0.0001, respectively). The level of penile tissue endothelial nitric oxide synthase was significantly higher in diabetes mellitus + ozone therapy group compared with others (19.28 ± 3.40 ng/mL vs. 13.47 ± 2.06 ng/mL and 13.28 ± 1.48 ng/mL, P = 0.01). Endothelial nitric oxide synthase expression increased significantly with ozone therapy. Our results suggest that ozone therapy may be beneficial in reducing the negative effects of diabetes on erectile dysfunction as a result of enhanced enzymatic activity in endothelial nitric oxide synthase levels.
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Affiliation(s)
- Aykut Colakerol
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey.
| | - Mustafa Zafer Temiz
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Hasan Huseyin Tavukcu
- Department of Urology, University of Health Sciences Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Serdar Aykan
- Department of Urology, University of Health Sciences Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Sule Ozsoy
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Sahan
- Department of Urology, University of Health Sciences Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Engin Kandirali
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Atilla Semercioz
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
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21
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Fan J, Peng T, Hui J, Ding W, He B, Zhang H, Wei A. Erectile Dysfunction in Type-2 Diabetes Mellitus Patients: Predictors of Early Detection and Treatment. Urol Int 2021; 105:986-992. [PMID: 33951654 DOI: 10.1159/000514700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/24/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To identify risk factors and potential predictors of erectile dysfunction (ED) in type-2 diabetes mellitus (T2DM) patients for early detection and treatment. METHODS A retrospective cohort was used to assess the clinical data of 105 diabetic patients with ED from May 2019 to April 2020 age-matched to 105 diabetic patients without ED. Potential risk factors that could contribute to ED were compared between the groups. Erectile function was evaluated using the International Index of Erectile Function-5 questionnaire. RESULTS There were higher rates of diabetic peripheral neuropathy (p = 0.036) and retinopathy (p < 0.001), longer duration of diabetes (p < 0.001), lower estimated glomerular filtration rate (p = 0.010) values, and higher uric acid (p < 0.001) and C-reactive protein (p = 0.001) levels in the ED group compared to the non-ED group. Multivariate logistic analysis identified uric acid, diabetic retinopathy, and T2DM course as independent predictors of diabetic ED. Diabetics with retinopathy and T2DM for ≥49 months were 3.028 and 3.860 times more likely to have ED, respectively. Uric acid values ≥392.5 μmol/L were associated with 18.638 times greater risk of having ED, though the values were within normal range. CONCLUSION In T2DM patients, higher uric acid (≥392.5 μmol/L), longer diabetes duration (≥49 months), and the presence of diabetic retinopathy were important and reliable predictors for diabetic ED. For patients who have high risk factors for developing ED, diligent screening and early treatment are necessary.
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Affiliation(s)
- Junhong Fan
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Tianwen Peng
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialiang Hui
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wei Ding
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Urology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Binglin He
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haibo Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Anyang Wei
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Pretorius D, Couper ID, Mlambo MG. Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province. Afr J Prim Health Care Fam Med 2021; 13:e1-e7. [PMID: 33970010 PMCID: PMC8111628 DOI: 10.4102/phcfm.v13i1.2850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/19/2021] [Accepted: 03/04/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunction. AIM To develop an understanding of sexual history taking events, this study aimed to assess the proportion of patients living with symptoms of sexual dysfunction that could have been elicited or addressed during routine chronic illness consultations. SETTING The research was carried out in 10 primary care facilities in Dr Kenneth Kaunda Health District, the North West province, South Africa. This rural area is known for farming and mining activities. METHODS This study contributed to a broader research project with a focus on sexual history taking during a routine consultation. A sample of 151 consultations involving patients with chronic illnesses were selected to observe sexual history taking events. In this study, the patients involved in these consultations completed demographic and sexual dysfunction questionnaires (FSFI and IIEF) to establish the proportions of patients with sexual dysfunction symptoms. RESULTS A total of 81 women (78%) and 46 men (98%) were sexually active. A total of 91% of the women reported sexual dysfunction symptoms, whilst 98% of men had erectile dysfunction symptoms. The youngest patients to experience sexual dysfunction were a 19-year-old woman and a 26-year-old man. Patients expressed trust in their doctors and 91% of patients did not consider discussion of sexual matters with their doctors as too sensitive. CONCLUSION Clinical guidelines, especially for chronic illness care, must include screening for sexual dysfunction as an essential element in the consultation. Clinical care of patients living with chronic disease cannot ignore sexual well-being, given the frequency of problems. A referral to a sexual medicine specialist, psychologist or social worker can address consequences of sexual dysfunction and improve relationships.
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Affiliation(s)
- Deidre Pretorius
- Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.
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Hadisuyatmana S, Efendi F, Has EMM, Wahyuni SD, Bauer M, Boyd JH, Reisenhofer S. The Experience of Indonesian Men Living with Type-2 Diabetes Mellitus and Erectile Dysfunction: A Semi-structured Interview Study. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09687-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shendy WS, Elsoghier OM, El Semary MM, Ahmed AA, Ali AF, Saber-Khalaf M. Effect of low-intensity extracorporeal shock wave therapy on diabetic erectile dysfunction: Randomised control trial. Andrologia 2021; 53:e13997. [PMID: 33559168 DOI: 10.1111/and.13997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/25/2020] [Accepted: 01/14/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to assess the effectiveness of low-intensity extracorporeal shockwave therapy (Li-ESWT) in the management of erectile dysfunction in diabetic patients with mixed vasculogenic and neurogenic causes as confirmed by nerve conduction and Doppler studies. This randomised controlled trial included 42 patients 41-55 years of age with a confirmed diagnosis of erectile dysfunction and diabetic polyneuropathy. They were randomly allocated to one of two groups: shock wave group (n = 21) treated with Li-ESWT plus pelvic floor muscle training and control Group (n = 21) treated with pelvic floor muscle exercise and sham therapy by a shock wave. The erectile function was scored according to the five-item version of the International Index of Erectile Function (IIEF-5). Colour-coded duplex sonography was used for the evaluation of penile perfusion of the two cavernous arteries. The assessment was done before and three months after treatment. IIEF-EF increased significantly in the study group (p < .001), but not in the control group (p = .194). Peak systolic velocity increased significantly in the two groups; however, the post-treatment peak systolic velocity was significantly higher in the study group compared to the control group (p < .001, for both arteries).
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Affiliation(s)
- Wael S Shendy
- Faculty of physical therapy, Cairo University, Giza, Egypt
| | | | | | | | - Atef Fathi Ali
- Department of Urology, South Valley University, Qena, Egypt
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Ma JX, Wang B, Li HS, Yu J, Hu HM, Ding CF, Chen WQ. Uncovering the mechanisms of leech and centipede granules in the treatment of diabetes mellitus-induced erectile dysfunction utilising network pharmacology. JOURNAL OF ETHNOPHARMACOLOGY 2021; 265:113358. [PMID: 32896625 DOI: 10.1016/j.jep.2020.113358] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/17/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Diabetes mellitus-induced erectile dysfunction (DMED) is one of the most common complications of diabetes mellitus. Leech and centipede granules (LCG) have traditionally been used as blood-activating agents in various ethnomedicinal systems of East Asia, especially in China. It is often used to regulate bodily functions and considered as adjuvant therapy for promoting blood circulation, alleviating blood coagulation, activating meridians, and relieving stasis. AIM OF THE STUDY This study aimed to identify potential genes and mechanisms of LCG on DMED from the network pharmacological perspective. MATERIALS AND METHODS The active components of LCG were identified by UHPLC-Q-TOF-MS, TCMID, and the BATMAN-TCM databases, and the disease targets of DMED were obtained from the DisGeNET, CooLGeN, GeneCards databases. After identifying DMED targets of LCG, a protein-protein interaction (PPI) network was constructed. Hub genes and significant modules were identified via the MCODE plug-in of Cytoscape software. Then, significant signaling pathways of the modules were identified using the Metascape database. The probable interaction mode of compounds-hub genes is examined using Molecular Operating Environment (MOE) docking software. Besides, we investigated the effects and mechanisms of LCG on improving erectile function in the streptozotocin (STZ)-induced diabetic rats model. RESULTS Combined UHPLC-Q-TOF-MS analysis with network pharmacology study, 18 active compounds were selected for target prediction. There are 97 common target genes between LCG and DMED. Enrichment of the KEGG pathway mainly involves in the calcium signaling pathway, NF-kappa B signaling pathway, cGMP-PKG signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway, and mTOR signaling pathway. Nine hub genes were regulated by LCG in DMED, including CXCL8, NOS3, CRH, TH, BDNF, DRD4, ACE, CNR1, and HTR1A. The results of molecular docking analysis showed that the tyrosin, ursolic acid, and L-Histidine has a relatively stable interaction with corresponding hub genes via generating hydrogen bonds, H-π, and π-π interactions. Significantly, the results in docking predicted a higher affinity of vardenafil to the hub genes compared to the tyrosin, ursolic acid, and L-Histidine. Furthermore, LCG increased the testosterone, erection frequency, the ratio of ICP and MAP, SOD, cGMP, cAMP as well as decreased the MDA, and AGEs expression levels. And, LCG ameliorated the histological change of penile tissues in DMED rats. Hence, LCG attenuates oxidative stress, increases NO production; For the mechanism exploration, LCG could significantly upregulate the mRNA and protein expression of CNR1, NOS3, CRH, TH, BDNF, and DRD4, whereas CXCL8, ACE, and HTR1A levels were significantly higher than those in the DMED group. Moreover, LCG activates the NO/cGMP/PKG pathway, PI3K/Akt/nNOS pathway, cAMP/PKA pathway, and inhibits the HIF-1α/mTOR pathway to improve erectile function. CONCLUSIONS Our results suggest that LCG maybe offer a new therapeutic basis for the treatment of DMED via altering the gene expression of involved metabolic pathways.
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Affiliation(s)
- Jian Xiong Ma
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, China; Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Department of Reproductive Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital, Zhejiang, China
| | - Bin Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hai Song Li
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jia Yu
- Department of Reproductive Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital, Zhejiang, China
| | - Hui Min Hu
- Department of Reproductive Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital, Zhejiang, China
| | - Cai Fei Ding
- Department of Reproductive Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital, Zhejiang, China.
| | - Wang Qiang Chen
- Department of Reproductive Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital, Zhejiang, China.
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Kamal EE, Ali MEM, Mohamed MZ, Soliman M, El-Mahdy RI, Elsayed A, Badran AY. Relation of pharmacopenile duplex ultrasonography parameters and glycated hemoglobin (HbA1c) in diabetic patients with erectile dysfunction. Rev Int Androl 2020; 20:31-40. [PMID: 33334711 DOI: 10.1016/j.androl.2020.05.002] [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: 12/24/2019] [Revised: 04/22/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Erectile dysfunction (ED) is one of the main threats in diabetic patients. This research aimed to assess the relationship between glycated hemoglobin (HbA1c) level and pharmacopenile duplex ultrasonography (PPDU) indices in diabetic patients with ED. MATERIALS AND METHODS A total of 130 males with ED were recruited (100 had diabetes mellitus (DM) and 30 did not as control). The International Index of Erectile Function (IIEF) was used to evaluate patients for ED. Measurement of HbA1c, lipid profile and assessment of erectile function using PPDU were performed. All participants were assessed to take the medical history. RESULTS The mean age±SD was 53.8±8.9 and 53.6±2.8 years for patients and controls, respectively. Patients had variable grades of ED: mild in 20%, mild to moderate in 32.3%, moderate in 35.3%, and severe in 12.3%. A significant association was found between the existence of DM and a deprived response to intracorporeal injection (ICI), rising end-diastolic velocity (EDV), and reducing resistance index (RI) values. Comparing all diabetic groups according to HbA1c with controls, a significant relationship was found in; severity of IIEF-5 score, poor response to ICI, decreased peak systolic velocity (PSV) at 10min, increased EDV at 10, 20min and decreased RI at 10, 20min. A significant relationship was found between smoking, dyslipidaemia, and decreased PSV at 10, 20min and decreased increment ratio. However, a non-significant relationship was observed between age, type of DM and PPDU parameters. CONCLUSION Poor glycaemic control of DM is associated with an increase in EDV and decrease in RI, and PSV of PPDU.
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Affiliation(s)
- Emad Eldien Kamal
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Mohammed Essam M Ali
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | | | - Mona Soliman
- Department of Internal medicine and endocrinology, Faculty of Medicine, Assiut University, Egypt
| | - Reham I El-Mahdy
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt.
| | - Ahmed Elsayed
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Aya Y Badran
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
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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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Hui J, Chen S, Zhang H, Yang C, Wei A, He S. Effects of "metabolic memory" on erectile function in diabetic men: A retrospective case-control study. Andrology 2020; 9:288-296. [PMID: 33022887 DOI: 10.1111/andr.12919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/20/2020] [Accepted: 09/30/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study was performed to explore the effects of metabolic memory on diabetic erectile dysfunction (ED), especially the severity and response to treatment. METHODS Through medical records and follow-up by telephone, 67 patients meeting the criteria with a clinical diagnosis of ED and a diabetic history of more than 5 years were enrolled for erectile function analysis. They were divided into a glycemic control group, a glycemic non-control group and a metabolic memory group according to glycemic levels and treatments for diabetes in the past 5 years, and they were treated with phosphodiesterase type 5 (PDE5) inhibitors for 4 weeks. Erectile function and efficacy were assessed by the International Index for Erectile Function (IIEF), the Erection Hardness Score (EHS), and the Sexual Encounter Profile (SEP). RESULTS The patients in the glycemic control group performed better in erectile function than those in the other groups. The patients in the glycemic control group received a significantly greater score on both the EHS and the five domains of the IIEF than did the patients in the glycemic non-control group and the metabolic memory group (all P < .001). There were also statistically significant differences favoring the glycemic control group (P < .05) in SEP2 and SEP3 success rates. However, there were no significant differences between the metabolic memory group and the glycemic non-control group in these erectile function assessments (P > .05). Significant negative correlations were seen between HbA1c levels at the time of consultation and the scores on the IIEF-EF and the EHS (Pearson r-values of -0.338 with P = .005 and -0.273 with P = .025, respectively). HbA1c levels at the first diagnosis of diabetes mellitus (DM) were also significantly negatively correlated with scores on the IIEF-EF and the EHS with greater Pearson correlation coefficients (Pearson r-values of -0.478 with P < .001 and -0.392 with P = .001, respectively). Significant improvements on each of the erectile function assessments were observed among diabetic patients with ED, but no significant difference in efficacy was observed between each group. CONCLUSIONS The phenomenon of metabolic memory did have a significant influence on ED in men with diabetes, associated with the severity of ED but not the response to medical treatment. Early hyperglycemia exposure would have long-term disadvantageous effects on erectile function in diabetic patients with ED, which would be sustained even after the patients achieve better glycemic control. PATIENTS SUMMARY In this report, we looked at the erectile functions of 67 patients with a clinical diagnosis of ED and a diabetic history of more than 5 years. We found that early hyperglycemia exposure would have long-term disadvantageous effects on erectile function in diabetic patients with ED, which would be sustained even after the patients achieve better glycemic control. We further found that the effects were associated with the severity of ED but not the response to medical treatment in men with diabetes.
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Affiliation(s)
- Jialiang Hui
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Organ Transplant, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shisheng Chen
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haibo Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Changmou Yang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Anyang Wei
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuhua He
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Yilmaz M, Karaaslan M, Tonyali S, Celik M, Toprak T, Odabas O. Triglyceride-Glucose Index (TyG) is associated with erectile dysfunction: A cross-sectional study. Andrology 2020; 9:238-244. [PMID: 32936988 DOI: 10.1111/andr.12904] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/31/2020] [Accepted: 09/08/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is often associated with endocrine metabolic diseases such as metabolic syndrome (MetS) and diabetes mellitus (DM), in which insulin resistance (IR) plays a decisive role in pathology. Triglyceride-glucose index (TyG), a simple, inexpensive and easily accessible IR marker, is calculated by fasting serum glucose and triglyceride values. OBJECTIVES We aimed to reveal the relationship between TyG index and ED. MATERIALS AND METHODS Of 152 male patients, aged between 24-80 years, admitted to the urology outpatient clinic with complaining erectile insufficiency were evaluated. Liver function tests, complete blood count, fasting serum triglyceride, serum testosterone, fasting glucose, fasting insulin, and hemoglobinA1c (HbA1c) were analyzed. TyG index was calculated. All patients were requested to fill in the validated Turkish version of the 5-item International Index of Erectile Function (IIEF-5) survey. RESULTS A total of 142 patients were included the study. ED was detected in 91 (64.1%) of the patients. BMI, fasting insulin level, fasting glucose level, IR, GGT, HDL, HbA1c, Triglyceride, TyG, DM, HT, and MetS status of the patients in ED group were statistically significantly higher compared to non-ED group (all P < .05). It was found that the cutoff value of TyG index for ED was 8.88 (AUC = 0.739, sensitivity 67%, specificity = 68.6%). In multivariate logistic regression analysis, age (OR = 1.07, 95% CI = 1026-1115, P = .002) and TyG index above 8.88 (OR = 3.865, 95% CI = 1686-8859, P = .001) were found as independent predictors of ED after accounting for BMI, serum total T and IR. CONCLUSION TyG index might be useful in the diagnosis and follow-up of ED.
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Affiliation(s)
- Mehmet Yilmaz
- Department of Urology, Zile State Hospital, Tokat, Turkey
| | - Mustafa Karaaslan
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Senol Tonyali
- Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Mecit Celik
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Oner Odabas
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Bahar A, Elyasi F, Moosazadeh M, Afradi G, Kashi Z. Sexual dysfunction in men with type II diabetes. CASPIAN JOURNAL OF INTERNAL MEDICINE 2020; 11:295-303. [PMID: 32874437 PMCID: PMC7442469 DOI: 10.22088/cjim.11.3.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Diabetes mellitus (DM) is a chronic disease inducing short-term and long-term complications including sexual dysfunction (SD) which can consequently reduce patients’ quality of life. Given the limited literature on frequency of SD in men experiencing diabetes in northern Iran, the present study was conducted in the city of Sari in Mazandaran Province, with the aim of investigating SD in men with type II diabetes. Methods: Using a descriptive cross-sectional research design, a total number of 350 male patients suffering from type II diabetes referring to endocrinology clinics in the city of Sari in. The patients were requested to fill out the demographic questionnaire, depression, anxiety and stress scale-21 items (DASS-21) and the 15-question International Index of Erectile Function (IIEF). The data were analyzed using the IBM SPSS statistics software Results: The average period of time in which the patients were facing diabetes was 3.65±5.75 years. The IIEF mean score was equal to 16.98±43.79. Erectile dysfunction (ED) was also evident in 152 patients (62.2%). Moreover, increase in age had significantly decreased the IIEF scores (p<0.001). The chance of being affected with ED among diabetic patients above 50 was 11.21 times as much as those below 50 years of age (odds ratio (OR): 11.21, 95% confidence interval (CI): 6.40-19.62). Conclusion: Concerning the high prevalence rate of ED in men suffering from type II diabetes, doctors are required to directly ask them about sexual disorders in follow-up visits. Furthermore, using screening questionnaires can be helpful in identifying this problem.
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Affiliation(s)
- Adele Bahar
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Afradi
- Department of Internal Medicine, School Of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Kashi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Che D, Fang Z, Yan L, Du J, Li F, Xie J, Feng J, Yin P, Qi W, Yang Z, Ma J, Yang X, Gao G, Zhou T. Elevated pigment epithelium-derived factor induces diabetic erectile dysfunction via interruption of the Akt/Hsp90β/eNOS complex. Diabetologia 2020; 63:1857-1871. [PMID: 32377760 DOI: 10.1007/s00125-020-05147-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/09/2020] [Indexed: 11/24/2022]
Abstract
AIMS/HYPOTHESIS Diabetes mellitus erectile dysfunction (DMED) is a common complication of diabetes. The level of pigment epithelium-derived factor (PEDF) is significantly upregulated in the serum of individuals with obesity and diabetes. However, whether elevated PEDF levels contribute to DMED remains unknown. This study aimed to investigate the pathogenic role of PEDF and its related mechanism in DMED. METHODS We enrolled 65 men, of whom 20 were nondiabetic control participants, 21 participants with diabetes but without erectile dysfunction, and 24 with DMED. The International Index of Erectile Function (IIEF-5) questionnaire was administered to evaluate erectile function. Plasma PEDF in diabetic participants and streptozotocin (STZ)-induced diabetic animals was detected by ELISA. Erectile function was evaluated by measuring the intracavernous pressure (ICP) and the ICP/mean arterial pressure (MAP) ratio in STZ-induced diabetic rats treated with PEDF-neutralising antibody (PEDF-Ab), db/db mice treated with PEDF-Ab, and Pedf knockout mice with STZ-induced diabetes. The overexpression of PEDF was implemented by intraperitoneal injection of recombinant PEDF and intracavernous injection of PEDF-expressing adenovirus. A mechanistic study was performed by immunofluorescence staining, bimolecular fluorescence complementation (BiFC), immunoprecipitation and western blotting. RESULTS We found that the plasma level of PEDF was significantly higher in participants with DMED compared with diabetic counterparts without erectile dysfunction and nondiabetic controls. Interestingly, PEDF levels were negatively correlated with plasma nitrite/nitrate levels and erectile function in DMED patients and STZ-induced diabetic rats. Furthermore, overexpression of PEDF significantly suppressed ICP and endothelial nitric oxide synthase (eNOS) phosphorylation in control rats. In contrast, the PEDF-Ab and Pedf knockout ameliorated ICP and eNOS phosphorylation in diabetic rats and mice. Mechanistically, PEDF promoted the membrane translocation of Hsp90β and directly bound to the amino acid residues 341-724 of Hsp90β on the endothelial cell surface, subsequently blocking intracellular Hsp90β/Akt/eNOS complex formation and downregulating eNOS phosphorylation. CONCLUSIONS/INTERPRETATION These results indicate that elevated PEDF levels contribute to impaired erectile function by suppressing Hsp90β-mediated eNOS phosphorylation and that PEDF may represent a novel therapeutic target for diabetic erectile dysfunction. Graphical abstract.
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Affiliation(s)
- Di Che
- Program of Molecular Medicine, Affiliated Guangzhou Women and Children's Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Zhenzhen Fang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
| | - Li Yan
- Department of Endocrinology, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jieping Du
- Department of Endocrinology, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fangping Li
- Department of Endocrinology, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jinye Xie
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
| | - Juan Feng
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
| | - Ping Yin
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
| | - Weiwei Qi
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
| | - Zhonghan Yang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China
| | - Jianxing Ma
- Department of Physiology, University of Oklahoma, Health Sciences Center, Oklahoma City, OK, USA
| | - Xia Yang
- Program of Molecular Medicine, Affiliated Guangzhou Women and Children's Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China.
- Guangdong Engineering & Technology Research Center for Gene Manipulation and Biomacromolecular Products, Sun Yat-sen University, Guangzhou, China.
| | - Guoquan Gao
- Program of Molecular Medicine, Affiliated Guangzhou Women and Children's Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China.
- Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
| | - Ti Zhou
- Program of Molecular Medicine, Affiliated Guangzhou Women and Children's Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, 510080, China.
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Combined Transplantation of Adipose Tissue-Derived Stem Cells and Endothelial Progenitor Cells Improve Diabetic Erectile Dysfunction in a Rat Model. Stem Cells Int 2020; 2020:2154053. [PMID: 32714394 PMCID: PMC7354671 DOI: 10.1155/2020/2154053] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/31/2020] [Accepted: 02/25/2020] [Indexed: 12/24/2022] Open
Abstract
Erectile dysfunction (ED) is a common complication in men suffered with diabetic mellitus. Stem cell transplantation is a promising strategy for the treatment of diabetic ED (DED). In this study, we evaluated whether combined transplantation of adipose tissue-derived stem cells (ADSCs) and endothelial progenitor cells (EPCs) could improve the erectile function of the DED rat model. DED rats were induced via intraperitoneal injection of streptozotocin (50 mg/kg), and ED was screened by apomorphine (100 mg/kg). DED rats were divided into 4 groups (n = 14 each): DED, ADSC, EPC, and ADSC/EPC group. Another 14 age-matched male SD rats with normal erectile function were served as the normal group. The normal group and the DED group were received intracavernous injection with phosphate-buffered saline (PBS). And the other groups were received intracavernous injection with ADSCs (1 × 106), EPCs (1 × 106), and ADSCs/EPCs (0.5 × 106/0.5 × 106), respectively. The total intracavernous pressure (ICP) and mean arterial pressure (MAP) were recorded at day 28 after injection. The endothelium, smooth muscle, and penile dorsal nerves were assessed within cavernoursal tissue. On day 28 after injection, the ADSC/EPC group displayed more significantly enhanced ICP and ICP/MAP than the DED or ADSC or EPC group (p < 0.05). Immunofluorescent analysis and western blot demonstrated that the improvement of erectile function in the ADSC/EPC5 group was associated with increased expression of endothelial marker (CD31) and the correction of eNOS-cGMP-NO signaling. More 5-ethynyl-2′-deoxyuridine- (EdU-) positive EPCs could be found lining in the cavernous endothelial layer in the ADSC/EPC group than the EPC group, which was attributed to the paracrine of vascular endothelial growth factor (VEGF) and stromal-derived factor-1 (SDF-1) by ADSCs. Combined transplantation of ADSCs and EPCs has a synergic effect in repairing the endothelial function of DED rats, and the underlying mechanism might be the paracrine of VEGF and SDF-1 by ADSCs, which improves the recruitment and proliferation of EPCs in the cavernosum.
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Nutalapati S, Ghagane SC, Nerli RB, Jali MV, Dixit NS. Association of erectile dysfunction and type II diabetes mellitus at a tertiary care centre of south India. Diabetes Metab Syndr 2020; 14:649-653. [PMID: 32438327 DOI: 10.1016/j.dsx.2020.04.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Erectile Dysfunction (ED) is more common in diabetic men and, unfortunately, occurs at an earlier age in diabetic patients when compared with the general population. The study aims to evaluate the independent predictors of ED in adult men with type 2 diabetes mellitus (DM) at a tertiary care center of South India. METHODS A total of 720 men aged 30-70 years who had been diagnosed with type 2 DM were enrolled for the study from January 2017 to January 2020 from the outpatient diabetes clinic of the Hospital. All patients completed the abridged version of the International Index of Erectile Function (IIEF-5) questionnaire. RESULTS The mean age of the patients was (58.4 ± 7.8 years). 68.6% of subjects had varying degrees of erectile dysfunction, of which 54.6% had moderate to severe ED. 55.8% had poor glycemic control (HbA1c ≥ 7%). Subjects with ED had a longer duration of DM than those without ED (mean DM duration was 8.1 ± 4.9 years versus 4.4 ± 3.5 years; p < 0.001). Longer duration of DM, poor glycemic control, hypertension, peripheral arterial disease, testosterone deficiency were all independent predictors ED (p < 0.05). CONCLUSIONS A high incidence of erectile dysfunction was observed in type 2 DM patients attending the diabetic clinic, and over half of the people affected were of moderate-to-severe in intensity. Poor glycemic control, testosterone deficiency, peripheral arterial disease were the modifiable risk factors for ED in diabetic subjects. At the same time, a longer duration of type 2 DM was noticed as a glaring non-modifiable risk factor, according to our study.
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Affiliation(s)
- Sreeharsha Nutalapati
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Shridhar C Ghagane
- KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India; Urinary Biomarkers Research Centre, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - R B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India.
| | - M V Jali
- KLE Academy of Higher Education and Research (Deemed to Be University), Nehru Nagar, Belagavi, 590010, India; KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - Neeraj S Dixit
- Urinary Biomarkers Research Centre, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
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Akintunde JK, Akintola TE, Hammed MO, Amoo CO, Adegoke AM, Ajisafe LO. Naringin protects against Bisphenol-A induced oculopathy as implication of cataract in hypertensive rat model. Biomed Pharmacother 2020; 126:110043. [PMID: 32172062 DOI: 10.1016/j.biopha.2020.110043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/14/2020] [Accepted: 02/23/2020] [Indexed: 12/12/2022] Open
Abstract
People who have experienced high blood pressure are at greater risk of susceptibility to other health problems including oculopathy. The patients with these experiences do not have adequate treatment and those who do; spend much funds on the drug purchase. The study examines the protective effect of naringin (NRG) against ocular impairment in L-NAME induced hypertensive rat on exposure to a cellular disruptor. Fifty-six adult male albino rats were randomly distributed into eight (n = 7) groups. Group I: control animals, Group II was treated with Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME), Group III was treated with 50 mg/kg Bisphenol-A, Group IV was treated with L-NAME +50 mg/kg Bisphenol-A. Group V was administered with L-NAME +80 mg/kg NRG. Group VI was administered with 50 Mg/kg BPA + 80 mg/kg NRG. Group VII was administered with L-NAME+50 mg/kg Bisphenol-A +80 mg/kg NRG. Lastly, group VIII was treated with 80 mg/kg NRG alone for 14 days. Naringin prevented hypertension and ocular dysfunction by depleting the activities of angiotensin-converting enzymes, arginase, aldose-reductase and phosphodiesterase-51 (PDE-51) with corresponding down-regulation of inflammatory markers including TNF-α and IL-B. Moreover, ocular impairment was remarkably reduced by NRG as manifested by the decreased activities of AChE, BuChE, MAO-A and enzymes of ATP hydrolysis (ATPase, ADPase, AMPase) and adenosine deaminase with resultant increased NO level. Also, ocular expression of CD43 transcript, caspaace-9 and tumor suppressor P53 proteins were suppressed on treatment with NRG. This study corroborates the view that NRG may be a useful therapy in alleviating inflammatory markers, apoptosis and metabolic nucleotides disorders via the NOS/cGMP/PKG signaling pathways in hypertensive rat model on exposure to a cellular disruptor.
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Affiliation(s)
- J K Akintunde
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria.
| | - T E Akintola
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - M O Hammed
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - C O Amoo
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - A M Adegoke
- Cancer Research and Molecular Biology Laboratories, Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
| | - L O Ajisafe
- Cancer Research and Molecular Biology Laboratories, Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Nigeria
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Pharmacology and perspectives in erectile dysfunction in man. Pharmacol Ther 2020; 208:107493. [PMID: 31991196 DOI: 10.1016/j.pharmthera.2020.107493] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/05/2019] [Indexed: 12/15/2022]
Abstract
Penile erection is a perfect example of microcirculation modulated by psychological factors and hormonal status. It is the result of a complex neurovascular process that involves the integrative synchronized action of vascular endothelium; smooth muscle; and psychological, neuronal, and hormonal systems. Therefore, the fine coordination of these events is essential to maintain penile flaccidity or allow erection; an alteration of these events leads to erectile dysfunction (ED). ED is defined as the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual activity. A great boost to this research field was given by commercialization of phosphodiesterase-5 (PDE5) inhibitors. Indeed, following the discovery of sildenafil, research on the mechanisms underlying penile erection has had an enormous boost, and many preclinical and clinical papers have been published in the last 10 years. This review is structured to provide an overview of the mediators and peripheral mechanism(s) involved in penile function in men, the drugs used in therapy, and the future prospective in the management of ED. Indeed, 30% of patients affected by ED are classified as "nonresponders," and there is still an unmet need for therapeutic alternatives. A flowchart suggesting the guidelines for ED evaluation and the ED pharmacological treatment is also provided.
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Papazafiropoulou AK, Anagnostopoulou K, Petropoulou K, Melidonis A. Prevalence of erectile dysfunction among Greek men with type 2 diabetes mellitus. Ann Afr Med 2020; 19:73-74. [PMID: 32174620 PMCID: PMC7189876 DOI: 10.4103/aam.aam_32_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Athanasia K Papazafiropoulou
- First Department of Internal Medicine, Diabetes Centre, Tzaneio General Hospital of Piraeus, Piraeus, Greece , Greece
| | - Konstantina Anagnostopoulou
- First Department of Internal Medicine, Diabetes Centre, Tzaneio General Hospital of Piraeus, Piraeus, Greece , Greece
| | - Konstantina Petropoulou
- First Department of Internal Medicine, Diabetes Centre, Tzaneio General Hospital of Piraeus, Piraeus, Greece , Greece
| | - Andreas Melidonis
- First Department of Internal Medicine, Diabetes Centre, Tzaneio General Hospital of Piraeus, Piraeus, Greece , Greece
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Kumanan T, Sujanitha V, Rajeshkannan N, Nisahan B. Nocturnal systolic blood pressure pattern of type 2 diabetic hypertensive men with erectile dysfunction: a cross sectional study from Northern Sri Lanka. BMC Res Notes 2019; 12:696. [PMID: 31653261 PMCID: PMC6814983 DOI: 10.1186/s13104-019-4740-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/16/2019] [Indexed: 11/14/2022] Open
Abstract
Objective This small scale cross-sectional study was done to identify the common systolic blood pressure pattern (dipping or non-dipping) among type 2 diabetic men with coexisting hypertension and erectile dysfunction(ED). A recent study in the same setting showed that prevalence of ED was high among diabetic men and co-existing hypertension was identified as an independent risk factor. There was a postulation about an association between ED and non-dipping nocturnal blood pressure pattern. So ambulatory blood pressure measurements (ABPM) was obtained for participants to test this prediction. Data was analysed using SPSS 25 Version. Results Among 29 participants who underwent ABPM, 21 showed non-dipping pattern of nocturnal systolic blood pressure (72.4%; CI 54.3–86.3). Mean SBP of participants was 125.55 +_14.1 and Mean DBP was 81.5 + _12.82. There was no statistical difference observed in mean SBP and DBP between patients with dipping nocturnal SBP and non-dipping pattern (P > 0.05). Variability of SBP was high among the participants (Mean SD-11.96 +/_2.74) and DBP also showed relatively high variability (SD-9.28 +/_2.9). Mean dipping percentage of the SBP during sleep was 5.54 +/_6.66. A significant difference in heart rate (HR) between patients with non-dipping and dipping pattern was noted (P-0.034).
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Affiliation(s)
| | - Vathulan Sujanitha
- Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.
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Chen GT, Yang BB, Chen JH, Zhang Z, Zhu LL, Jiang HS, Yu W, Chen Y, Dai YT. Pancreatic kininogenase improves erectile function in streptozotocin-induced type 2 diabetic rats with erectile dysfunction. Asian J Androl 2019; 20:448-453. [PMID: 29676291 PMCID: PMC6116675 DOI: 10.4103/aja.aja_23_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Erectile dysfunction (ED) associated with type 2 diabetes is a severe problem that requires effective treatment. Pancreatic kininogenase (PK) has the potential to improve the erectile function of ED patients. This study aims to investigate the effect of PK on erectile function in streptozotocin-induced type 2 diabetic ED rats. To achieve this goal, we divided male Sprague-Dawley rats into five groups. One group was not treated, and the other four groups were treated with saline, sildenafil, PK or sildenafil, and PK, respectively, for 4 weeks after the induction of type 2 diabetic ED. Then, intracavernous pressure under cavernous nerve stimulation was measured, and penile tissue was collected for further study. Endothelial nitric oxide synthase levels, smooth muscle content, endothelium content, cyclic guanosine monophosphate (cGMP) levels in the corpus cavernosum, and neuronal nitric oxide synthase levels in the dorsal penile nerve were measured. Improved erectile function and endothelium and smooth muscle content in the corpus cavernosum were observed in diabetic ED rats. When treating diabetic ED rats with PK and sildenafil at the same time, a better therapeutic effect was achieved. These data demonstrate that intraperitoneal injection of PK can improve erectile function in a rat model of type 2 diabetic ED. With further research on specific mechanisms of erectile function improvement, PK may become a novel treatment for diabetic ED.
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Affiliation(s)
- Guo-Tao Chen
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Bai-Bing Yang
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Jian-Huai Chen
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Zheng Zhang
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Lei-Lei Zhu
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - He-Song Jiang
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Wen Yu
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Yun Chen
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Yu-Tian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
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Ugwumba FO, Okafor CI, Nnabugwu II, Udeh EI, Echetabu KN, Okoh AD, Okorie JC. Prevalence of, and risk factors for erectile dysfunction in male type 2 diabetic outpatient attendees in Enugu, South East Nigeria. Ann Afr Med 2019; 17:215-220. [PMID: 30588936 PMCID: PMC6330780 DOI: 10.4103/aam.aam_3_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Context: Erectile dysfunction (ED) is a strong predictor of poor quality of life in men with type 2 Diabetes mellitus (T2DM). Several studies evaluating ED in men with diabetes mellitus have been carried out, but few of these have been done in Nigeria. In Enugu, South East Nigeria, paucity of studies on this subject was observed. Aims: This study aims to determine the prevalence and predictors of ED in men with T2DM attending the diabetes clinics. Settings and Design: A descriptive cross-sectional study of men with T2DM in UNTH and Saint Mary's Hospital, Enugu, was carried out. The systematic sampling method was used to recruit participants. Subjects and Methods: Data collection from participants and their hospital records was done using semi-structured questionnaire. ED was assessed using the 5 items, international index of erectile function questionnaire. Statistical Analysis Used: Data analysis was done using SPSS version 20 and results presented as texts and tables. P value was set at <0.05. Results: A total of 325 participants with mean age of 57.8 ± 13.2 years were involved out of which 94.7% had ED. The proportion of participants with ED had increased with its severity. Predictors of ED included poor glycemic control, longer duration of diabetes, overweight/obesity, and older age. Poor ED health-seeking behavior and treatment were noted. Conclusions: The prevalence of ED is high. Lifestyle interventions targeted at improving glycemic control and weight loss may reduce the burden of this complication. We recommend objective ED screening using standard but brief instruments as part of routine evaluation of men with T2DM.
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Affiliation(s)
- Fred O Ugwumba
- Urology Unit, Department of Surgery, Faculty of Medical Sciences, University of Nigeria, Ituku Ozalla Campus; Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Christian I Okafor
- Endocrinology Unit, Department of Medicine, Faculty of Medical Sciences, University of Nigeria, Ituku Ozalla Campus; Endocrinology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Ikenna I Nnabugwu
- Urology Unit, Department of Surgery, Faculty of Medical Sciences, University of Nigeria, Ituku Ozalla Campus; Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Emeka I Udeh
- Urology Unit, Department of Surgery, Faculty of Medical Sciences, University of Nigeria, Ituku Ozalla Campus; Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Kevin N Echetabu
- Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Agharighom D Okoh
- Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - John C Okorie
- Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
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Ouyang B, Xie Y, Zhang C, Deng C, Lv L, Yao J, Zhang Y, Liu G, Deng J, Deng C. Extracellular Vesicles From Human Urine-Derived Stem Cells Ameliorate Erectile Dysfunction in a Diabetic Rat Model by Delivering Proangiogenic MicroRNA. Sex Med 2019; 7:241-250. [PMID: 30910509 PMCID: PMC6522949 DOI: 10.1016/j.esxm.2019.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/18/2019] [Accepted: 02/11/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Stem cell therapies represent a promising new frontier for the treatment of refractory diabetic erectile dysfunction (DED). The use of stem cell-derived extracellular vesicles (EVs) is a novel strategy for cell-free stem cell therapy. We have reported that urine-derived stem cells (USCs) can improve DED; however, the therapeutic effects of EVs secreted by USCs (USC-EVs) remain unknown. AIM To determine the therapeutic effects of USC-EVs on DED in a rat model. METHODS USC-EVs were isolated from conditioned medium by ultracentrifugation. DED was induced in male Sprague-Dawley rats via an intraperitoneal injection of streptozotocin. Sixteen DED rats were divided into phosphate-buffered saline (PBS) and USC-EV groups. Eight normal rats served as the normal control group. PBS or USC-EVs were transplanted into the corpora cavernosa in the corresponding groups. MAIN OUTCOME MEASURE Intracavernosal pressure (ICP), mean arterial pressure (MAP), expression of endothelial markers (CD31), endothelial nitric oxide synthase (eNOS), phospho-eNOS, and neural nitric oxide synthase (nNOS) were assessed in each group. Masson's trichrome staining was used to determine the collagen deposition and ratio of smooth muscle cells to collagen. The microRNA (miRNA) cargo of USC-EVs was characterized by high-throughput RNA sequencing. RESULTS Recovery of erectile function was observed in the USC-EV group, as represented by improved ICP and ICP/MAP ratio. CD31, eNOS, phospho-eNOS, and nNOS expression in the penis was significantly improved in the USC-EV group. In addition, the ratio of smooth muscle to collagen was significantly increased in the USC-EV group. RNA sequencing revealed that USC-EVs were enriched for distinct classes of miRNA (miR-21-5p, let-7 family, miR-10 family, miR-30 family, and miR-148a-3p) that promote angiogenesis. CONCLUSION USC-EV transplantation can ameliorate DED in rats. Its mechanism may involve the delivery of proangiogenic miRNA. Ouyang B, Xie Y, Zhang C, et al. Extracellular Vesicles From Human Urine-Derived Stem Cells Ameliorate Erectile Dysfunction in a Diabetic Rat Model by Delivering Proangiogenic MicroRNA. Sex Med 2019;7:241-250.
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Affiliation(s)
- Bin Ouyang
- Department of Andrology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Department of Andrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yun Xie
- Department of Andrology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chi Zhang
- Department of Andrology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cuncan Deng
- Reproductive Medicine Research Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Linyan Lv
- Reproductive Medicine Research Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiahui Yao
- Department of Andrology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuanyuan Zhang
- Department of Andrology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Department of Andrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Guihua Liu
- Reproductive Medicine Research Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Junhong Deng
- Department of Andrology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China; Department of Andrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Chunhua Deng
- Department of Andrology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Potential of phloroglucinol to improve erectile dysfunction associated with streptozotocin-induced diabetes in rats. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:282-287. [PMID: 31005601 DOI: 10.1016/j.joim.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/20/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Diabetes is a common metabolic disease with several complications in its patients. Often, people living with diabetes develop erectile dysfunction (ED). The primary aim of this work was to investigate the effect of phloroglucinol in diabetes-induced ED in rats. METHODS Male Wistar rats were given 52 mg/kg of streptozotocin, by intraperitoneal injection, to induce diabetes and ED. Subsequently, animals were grouped into three groups: group 1, diabetic control; group 2, low-dose phloroglucinol (150 mg/kg body weight); and group 3, high-dose phloroglucinol (250 mg/kg body weight). A group of six normal rats served as a normal control. The rats were treated with phloroglucinol for six weeks and then were assessed for treatment effects. Sexual behavior, glycosylated hemoglobin A1c (HbA1c) values, serum testosterone, serum nitric oxide (NO), blood pressure and sperm count were measured after the end of treatment. RESULTS After a 6-week treatment period, the high dose of phloroglucinol significantly decreased HbA1c values in diabetic rats. Rats treated with phloroglucinol had increased serum testosterone, NO and sperm count. Animals treated with 250 mg/kg phloroglucinol performed similar to normal rats in the sexual behavioral study, suggesting the reversal of complications of ED. Conversely, a decrease in the blood pressure in treated groups was observed. CONCLUSION The results highlight the protective effect of phloroglucinol in diabetes-induced ED in rats warranting further studies.
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Nisahan B, Kumanan T, Rajeshkannan N, Peranantharajah T, Aravinthan M. Erectile dysfunction and associated factors among men with diabetes mellitus from a tertiary diabetic center in Northern Sri Lanka. BMC Res Notes 2019; 12:210. [PMID: 30953562 PMCID: PMC6451292 DOI: 10.1186/s13104-019-4244-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/01/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Prevalence of erectile dysfunction (ED) in diabetic men is considerably high but it is often underdiagnosed and undermanaged. There were no data available about the prevalence and the risk factors of ED in our region. So a cross-sectional study was conducted to identify the prevalence and associated risk factors of ED in a tertiary care diabetic center in Northern Sri Lanka. RESULTS 326 diabetic male patients between ages 18-60 years were interviewed. Majority (62.9%; 95% CI 57.5-68.0%) of the diabetic patients suffered from ED and 22.4% (95% CI 17.8-26.8%) were found to have severe ED. Most of the patients (98.8%) were not screened or treated for ED. Bivariate analysis showed age above 40, duration of DM (> 5 years), type of diabetes (type 2), having micro-vascular complications, co-existing hypertension, BMI, consuming unsafe level of alcohol and taking beta-blockers were associated with ED at 5% level (P < 0.05). This study failed to show association with dyslipidemia, macro vascular complications such as coronary artery disease (CAD, P-0.052), glycemic control (P-0.082) and smoking. Regression analysis revealed age > 40 (AOR: 2.13; 95% CI 1.05-4.33), duration of diabetes (AOR: 2.90; 95% CI 1.67-5.01), co-existing hypertension (AOR: 1.8; 95% CI 1.06-3.06), and unsafe level alcohol intake (AOR: 3.14; 95% CI 1.76-5.59) were independent risk factors.
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Ojo OA, Ojo AB, Oyinloye BE, Ajiboye BO, Anifowose OO, Akawa A, Olaiya OE, Olasehinde OR, Kappo AP. Ocimum gratissimum Linn. Leaves reduce the key enzymes activities relevant to erectile dysfunction in isolated penile and testicular tissues of rats. Altern Ther Health Med 2019; 19:71. [PMID: 30890127 PMCID: PMC6425690 DOI: 10.1186/s12906-019-2481-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 03/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Ocimum gratissimum L. is a medicinal plant widely grown in tropical and subtropical regions with the leaf decoction usually taken in folk medicine to enhance erectile performance in men although the probable mechanism of actions remains undetermined. This study examined the inhibitory potentials of Ocimum gratissimum leaves on some key enzymes associated with erectile dysfunction in penile and testicular tissues of the rat. METHODS Inhibitory effect of aqueous extract (1:10 w/v) of O. gratissimum leaves on the activities of phosphodiesterase-5 (PDE-5), arginase, angiotensin I -converting enzyme (ACE), and acetylcholinesterase (AChE) in penile and testicular tissues were assessed. Also, the extract was investigated for ferric reducing antioxidant property(FRAP) and 1,1-diphenyl-2-picryl-hydrazil (DPPH) radical scavenging abilities. RESULTS The extract showed higher PDE-5 (IC50 = 43.19 μg/mL), ACE (IC50 = 44.23 μg/mL), AChE (IC50 = 55.51 μg/mL) and arginase (IC50 = 46.12 μg/mL) inhibitory activity in the penile tissue than PDE-5 (IC50 = 44.67 μg/mL), ACE (IC50 = 53.99 μg/mL), AChE (IC50 = 60.03 μg/mL) and arginase (IC50 = 49.12 μg/mL) inhibitory activity in the testicular tissue homogenate. Furthermore, the extract scavenged free radicals and in a dose-dependent manner. CONCLUSION The enzyme activities displayed might be associated with the bioactive compounds present in the extract which could possibly explain its use in the management of erectile dysfunction (ED).
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Azmi S, Petropoulos IN, Ferdousi M, Ponirakis G, Alam U, Malik RA. An update on the diagnosis and treatment of diabetic somatic and autonomic neuropathy. F1000Res 2019; 8. [PMID: 30828432 PMCID: PMC6381801 DOI: 10.12688/f1000research.17118.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2019] [Indexed: 12/30/2022] Open
Abstract
Diabetic peripheral neuropathy (DPN) is the most common chronic complication of diabetes. It poses a significant challenge for clinicians as it is often diagnosed late when patients present with advanced consequences such as foot ulceration. Autonomic neuropathy (AN) is also a frequent and under-diagnosed complication unless it is overtly symptomatic. Both somatic and autonomic neuropathy are associated with increased mortality. Multiple clinical trials have failed because of limited efficacy in advanced disease, inadequate trial duration, lack of effective surrogate end-points and a lack of deterioration in the placebo arm in clinical trials of DPN. Multifactorial risk factor reduction, targeting glycaemia, blood pressure and lipids can reduce the progression of DPN and AN. Treatment of painful DPN reduces painful symptoms by about 50% at best, but there is limited efficacy with any single agent. This reflects the complex aetiology of painful DPN and argues for improved clinical phenotyping with the use of targeted therapy, taking into account co-morbid conditions such as anxiety, depression and sleep disturbance.
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Affiliation(s)
- Shazli Azmi
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Manchester Diabetes Centre, Manchester University Foundation Trust, Manchester, UK
| | | | - Maryam Ferdousi
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Georgios Ponirakis
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Uazman Alam
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,Department of Diabetes and Endocrinology, Royal Liverpool and Broadgreen University NHS Hospital Trust, Liverpool, UK
| | - Rayaz A Malik
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
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Zhang H, Tong WT, Zhang CR, Li JL, Meng H, Yang HG, Chen M. Gross saponin of Tribulus terrestris improves erectile dysfunction in type 2 diabetic rats by repairing the endothelial function of the penile corpus cavernosum. Diabetes Metab Syndr Obes 2019; 12:1705-1716. [PMID: 31564938 PMCID: PMC6730548 DOI: 10.2147/dmso.s205722] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 08/09/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To investigate the effect of gross saponins of Tribulus terrestris (GSTT) on erectile function in rats resulting from type 2 diabetes mellitus (T2DMED). METHODS The T2DMED model was constructed by high-fat and high-sugar feeding and streptozotocin injection. After 4 weeks of GSTT intervention. Intracavernous pressure (ICP) and mean arterial pressure (MAP) were measured in each group. The level of nitric oxide (NO) in the cavernous tissue was detected using the nitrate reductase method. The production of reactive oxygen species (ROS) was detected using DHE fluorescent probe detection. Cyclic adenosine monophosphate (cGMP) level was detected by enzyme-linked immunosorbent assay, and endothelial nitric oxide synthase (eNOS) was detected using immunohistochemistry. Masson staining was used to detect the cavernosal smooth muscle/collagen ratio. Apoptosis in endothelial cells was measured using TUNEL. Western blotting method to detect the protein expression level of eNOS, TIMP-1, cleaved caspase 3, and cleaved caspase 9. RESULTS After treatment, the ICP and ICP/MAP values of the GSTT were significantly higher than those of the T2DMED group (P<0.05). Unlike the T2DMED group, the GSTT group showed significantly increased NO levels (P<0.05) and decreased ROS levels (P<0.05). There was no significant difference between the GSTT group and the sildenafil group in increasing cGMP levels (P>0.05), and the mixed group had higher levels than these two groups (P<0.05). Immunohistochemistry and Western blotting showed that the expression of eNOS in the GSTT was significantly higher than that in the T2DMED groups (P<0.05). Masson staining showed that the smooth muscle/collagen ratio of the GSTT group was significantly higher than that of the T2DMED groups (P<0.05), the expression of TIMP-1 was lower than that of T2DMED group (P<0.05). TUNEL assay showed that the apoptotic index and cleaved caspase 3 and cleaved caspase 9 expression level of GSTT group were lower than that of the T2DMED group (P<0.05). CONCLUSION GSTT can protect T2DMED rats' erectile function by improving penile endothelial function and inhibiting cavernosum fibrosis, inhibiting apoptosis, and is synergistic with sildenafil.
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Affiliation(s)
- Hui Zhang
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China
| | - Wen-Ting Tong
- Department of Pharmacy, The First Affiliated Hospital of Gannan Medical College, Ganzhou, Jiangxi, People’s Republic of China
| | - Chang-Rong Zhang
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China
| | - Jun-Long Li
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China
| | - Hao Meng
- Department of Andrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China
| | - Hai-Gan Yang
- Department of Andrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China
| | - Min Chen
- Department of Andrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China
- Correspondence: Min ChenDepartment of Andrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 12 Ji-chang Road, Guangzhou51000, Guangdong, People’s Republic of ChinaTel +86 203 659 1359Fax +86 203 659 1127Email
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Azmi S, Ferdousi M, Kalteniece A, Al-Muhannadi H, Al-Mohamedi A, Hadid NH, Mahmoud S, Bhat HA, Gad HYA, Khan A, Ponirakis G, Petropoulos IN, Alam U, Malik RA. Diagnosing and managing diabetic somatic and autonomic neuropathy. Ther Adv Endocrinol Metab 2019; 10:2042018819826890. [PMID: 30783521 PMCID: PMC6365998 DOI: 10.1177/2042018819826890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022] Open
Abstract
The diagnosis and management of diabetic neuropathy can be a major challenge. Late diagnosis contributes to significant morbidity in the form of painful diabetic neuropathy, foot ulceration, amputation, and increased mortality. Both hyperglycaemia and cardiovascular risk factors are implicated in the development of somatic and autonomic neuropathy and an improvement in these risk factors can reduce their rate of development and progression. There are currently no US Food and Drug Administration (FDA)-approved disease-modifying treatments for either somatic or autonomic neuropathy, as a consequence of multiple failed phase III clinical trials. While this may be partly attributed to premature translation, there are major shortcomings in trial design and outcome measures. There are a limited number of partially effective FDA-approved treatments for the symptomatic relief of painful diabetic neuropathy and autonomic neuropathy.
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Affiliation(s)
- Shazli Azmi
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester, UK
| | - Maryam Ferdousi
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester, UK
| | - Alise Kalteniece
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester, UK
| | | | | | | | - Salah Mahmoud
- Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
| | - Harun A. Bhat
- Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
| | - Hoda Y. A. Gad
- Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
| | - Adnan Khan
- Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
| | | | | | - Uazman Alam
- Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
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Azad AK, Setunge S, Selim S, Chowdhury SH, Rahaman MF, Chowdhury MAJ, de Courten B, Ilic D, Karim MN. Dyslipidaemia as a risk factor for erectile dysfunction in type 2 diabetes mellitus patients. Diabetes Metab Syndr 2019; 13:748-753. [PMID: 30641801 DOI: 10.1016/j.dsx.2018.11.052] [Citation(s) in RCA: 6] [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: 11/05/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite epidemiological studies worldwide have documented erectile dysfunction (ED) as a major complication of type 2 diabetes Mellitus (T2DM) in men, only limited research reported on determinants of ED in this population. The study aimed at examining the association of ED with dyslipidaemia in T2DM patients. METHODS The study enrolled 813 consecutive eligible adult male T2DM patients attending the endocrinology departments of a tertiary teaching hospital in Bangladesh. Sexual function was assessed using modified International Index of Erectile Function (IIEF) in face-to-face interview and collected along with sociodemographic information. Diabetes and lipid profile and treatment history were collected from patient's treatment records. Association of ED with dyslipidaemia was assessed using multivariable logistic regression adjusting for potential confounders. RESULT Prevalence of ED among the T2DM patients was very high (72.7%), of which around half had moderated-to-severe ED. Odds of having dyslipidaemia among T2DM patients with ED is 2.3 times higher than those without. The odds increased by approximately 3 fold for an abnormal High Density Lipoprotein level and by 2.7 fold for abnormal Low Density Lipoprotein. CONCLUSION Dyslipidaemia was associated with increased ED risk among T2DM. Abnormal lipoprotein level particularly were found to pose greater risk.
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Affiliation(s)
- Abul Kalam Azad
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sumudu Setunge
- Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
| | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | | | | | - Barbora de Courten
- Schools of Public Health and Preventive Medicine, Monash University, Australia
| | - Dragan Ilic
- Schools of Public Health and Preventive Medicine, Monash University, Australia
| | - Md Nazmul Karim
- Schools of Public Health and Preventive Medicine, Monash University, Australia.
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Elsaied MA, Masallat D, Abdel-Hamid IA. Correlation of Adiponectin With Testosterone in Patients With and Without Type 2 Diabetes and Erectile Dysfunction. Am J Mens Health 2019; 13:1557988318807049. [PMID: 30339037 PMCID: PMC6771219 DOI: 10.1177/1557988318807049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the levels of adiponectin in diabetic patients with and without erectile dysfunction (ED). In addition, the correlations of adiponectin with the scores of international index of erectile function (IIEF) and total testosterone levels were explored in diabetic and nondiabetic patients with ED. The study included three groups: Type 2 Diabetic patients (T2DM) with and without ED and a third nondiabetics with ED group, each of 29 patients. Fasting blood glucose (FBG), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR index), testosterone and adiponectin levels were evaluated. IIEF was applied to diabetic and nondiabetic patients with ED. The results showed that adiponectin was lower in diabetic patients with ED than in both nondiabetics with ED and diabetics without ED groups (5.23 ± 1.05 vs. 11.38 ± 10.08 and 6.5 ± 2.13; p = .003 and .006 respectively). Testosterone was lower in diabetic patients with ED than in diabetics without ED group (2.52 ± 1.15 vs. 4.1 ± 1.46; p = .024). Testosterone had a direct correlation with adiponectin ( r = .371; p = .001). Both adiponectin and testosterone levels did not correlate with IIEF. In conclusion, the decreased adiponectin and testosterone are associated with ED in T2DM. Testosterone has a direct correlation with circulating adiponectin while both have no correlation with IIEF.
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Affiliation(s)
- Moustafa A. Elsaied
- Division of Andrology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Doaa Masallat
- Department of Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Elkamshoushi AAM, Hassan EM, El Abd AM, Hassan SZ, Maher AA. Serum endocan as a predictive biomarker of cardiovascular risk in erectile dysfunction patients. Andrologia 2018; 50:e13113. [DOI: 10.1111/and.13113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Affiliation(s)
- Abdel Aal M. Elkamshoushi
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine; Alexandria University; Alexandria Egypt
| | - Eman M. Hassan
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine; Alexandria University; Alexandria Egypt
| | - Amr M. El Abd
- Department of Diagnostic & Interventional Radiology, Faculty of Medicine; Alexandria University; Alexandria Egypt
| | - Seham Z. Hassan
- Department of Medical Physiology, Faculty of Medicine; Alexandria University; Alexandria Egypt
| | - Amer A. Maher
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine; Alexandria University; Alexandria Egypt
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