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Dilixiati D, Kadier K, Lu JD, Xie S, Azhati B, Xilifu R, Rexiati M. Causal associations between prostate diseases, renal diseases, renal function, and erectile dysfunction risk: a 2-sample Mendelian randomization study. Sex Med 2024; 12:qfae002. [PMID: 38348104 PMCID: PMC10859556 DOI: 10.1093/sexmed/qfae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/17/2023] [Accepted: 12/28/2023] [Indexed: 02/15/2024] Open
Abstract
Background Previous observational studies have found a potential link between prostate disease, particularly prostate cancer (PCa), and kidney disease, specifically chronic renal disease (CKD), in relation to erectile dysfunction (ED), yet the causal relationship between these factors remains uncertain. Aim The study sought to explore the potential causal association between prostate diseases, renal diseases, renal function, and risk of ED. Methods In this study, 5 analytical approaches were employed to explore the causal relationships between various prostate diseases (PCa and benign prostatic hyperplasia), renal diseases (CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, and kidney ureter calculi), as well as 8 renal function parameters, with regard to ED. All data pertaining to exposure and outcome factors were acquired from publicly accessible genome-wide association studies. The methods used encompassed inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode residual sum and outlier techniques. The MR-Egger intercept test was utilized to assess pleiotropy, while Cochran's Q statistic was employed to measure heterogeneity. Outcomes We employed inverse variance weighting MR as the primary statistical method to assess the causal relationship between exposure factors and ED. Results Genetically predicted PCa demonstrated a causal association with an elevated risk of ED (odds ratio, 1.125; 95% confidence interval, 1.066-1.186; P < .0001). However, no compelling evidence was found to support associations between genetically determined benign prostatic hyperplasia, CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, kidney ureter calculi, and the renal function parameters investigated, and the risk of ED. Clinical Implications The risk of ED is considerably amplified in patients diagnosed with PCa, thereby highlighting the importance of addressing ED as a significant concern for clinicians treating individuals with PCa. Strengths and Limitations This study's strength lies in validating the PCa-ED association using genetic analysis, while its limitation is the heterogeneity in study results. Conclusion The results of this study suggest a potential link between PCa and a higher risk of ED.
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Affiliation(s)
- Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Kaisaierjiang Kadier
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Jian-De Lu
- Department of General Surgery, Children's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830010, China
| | - Shiping Xie
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Baihetiya Azhati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Reyihan Xilifu
- Department of Nephrology, Children's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Mulati Rexiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
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Katsimardou A, Patoulias D, Zografou I, Tegou Z, Imprialos K, Stavropoulos K, Toumpourleka M, Karagiannis A, Petidis K, Doumas M. The Associations between Kidney Function and Sexual Dysfunction among Males and Females with Type 2 Diabetes Mellitus. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050969. [PMID: 37241201 DOI: 10.3390/medicina59050969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/04/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Diabetic kidney disease (DKD), expressed either as albuminuria, low estimated glomerular filtration rate (eGFR) or both, and sexual dysfunction (SD), are common complications among type 2 diabetes mellitus (T2DM) patients. This study aims to assess whether an association exists between DKD and SD, erectile dysfunction (ED) or female sexual dysfunction (FSD) in a T2DM population. Materials and Methods: A cross-sectional study was designed and conducted among T2DM patients. The presence of SD was assessed using the International Index of Erectile Function and the Female Sexual Function Index questionnaires for males and females, respectively, and patients were evaluated for DKD. Results: Overall, 80 patients, 50 males and 30 females, agreed to participate. Sexual dysfunction was present in 80% of the study population. Among the participants, 45% had DKD, 38.5% had albuminuria and/or proteinuria and 24.1% had an eGFR below 60 mL/min/1.73 m2. The eGFR was associated with SD, ED and FSD. Moreover, SD and ED were proven as significant determinants for lower eGFR values in multiple linear regression analyses. DKD was associated with lower lubrication scores and eGFR was associated with lower desire, arousal, lubrication and total scores; however, the multivariate linear regression analyses showed no significant associations between them. Older age resulted in significantly lower arousal, lubrication, orgasm and total FSFI scores. Conclusions: SD is commonly encountered in older T2DM patients and DKD affects almost half of them. The eGFR has been significantly associated with SD, ED and FSD, while SD and ED were proven to be significant determinants for the eGFR levels.
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Affiliation(s)
- Alexandra Katsimardou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Dimitrios Patoulias
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Ioanna Zografou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Zoi Tegou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Konstantinos Imprialos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Konstantinos Stavropoulos
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Maria Toumpourleka
- 3rd Department of Cardiology, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Asterios Karagiannis
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Konstantinos Petidis
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
| | - Michael Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece
- Veterans Affairs Medical Center, George Washington University, Washington, DC 20422, USA
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Koopman ADM, Beulens JW, Dijkstra T, Pouwer F, Bremmer MA, van Straten A, Rutters F. Prevalence of Insomnia (Symptoms) in T2D and Association With Metabolic Parameters and Glycemic Control: Meta-Analysis. J Clin Endocrinol Metab 2020; 105:5585878. [PMID: 31603475 PMCID: PMC7110921 DOI: 10.1210/clinem/dgz065] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/23/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We aimed to determine the prevalence of insomnia and insomnia symptoms and its association with metabolic parameters and glycemic control in people with type 2 diabetes (T2D) in a systematic review and meta-analysis. DATA SOURCES A systematic literature search was conducted in PubMed/Embase until March 2018. STUDY SELECTION Included studies described prevalence of insomnia or insomnia symptoms and/or its association with metabolic parameters or glycemic control in adults with T2D. DATA EXTRACTION Data extraction was performed independently by 2 reviewers, on a standardized, prepiloted form. An adaptation of Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included studies. DATA SYNTHESIS When possible, results were meta-analyzed using random-effects analysis and rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS A total of 11 329 titles/abstracts were screened and 224 were read full text in duplicate, of which 78 studies were included. The pooled prevalence of insomnia (symptoms) in people with T2D was 39% (95% confidence interval, 34-44) with I2 statistic of 100% (P < 0.00001), with a very low GRADE of evidence. Sensitivity analyses identified no clear sources of heterogeneity. Meta-analyses showed that in people with T2D, insomnia (symptoms) were associated with higher hemoglobin A1c levels (mean difference, 0.23% [0.1-0.4]) and higher fasting glucose levels (mean difference, 0.40 mmol/L [0.2-0.7]), with a low GRADE of evidence. The relative low methodological quality and high heterogeneity of the studies included in this meta-analysis complicate the interpretation of our results. CONCLUSIONS The prevalence of insomnia (symptoms) is 39% (95% confidence interval, 34-44) in the T2D population and may be associated with deleterious glycemic control.
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Affiliation(s)
- Anitra D M Koopman
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
- Correspondence and Reprint Requests: Femke Rutters, Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands, De Boelelaan 1089a, 1081 HV Amsterdam, the Netherlands. E-mail:
| | - Joline W Beulens
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, GA Utrecht, the Netherlands
| | - Tine Dijkstra
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
| | - Frans Pouwer
- University of Southern Denmark, Department of Psychology, Odense, Denmark
- Deakin University, School of Psychology, Geelong, Australia
- STENO Diabetes Center Odense, Odense, Denmark
| | - Marijke A Bremmer
- Amsterdam UMC, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
| | - Annemieke van Straten
- Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit, HV Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
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Abootalebi M, Kargar M, Aminsharifi A. Assessment of the validity and reliability of a questionnaire on knowledge and attitude of general practitioners about andropause. Aging Male 2017; 20:60-64. [PMID: 27929734 DOI: 10.1080/13685538.2016.1188067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Andropause is one of the clinical and biochemical syndromes in aging men associated with the decrease in serum testosterone levels. With the increase in aging male population, life span in Iran, and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. General practitioners, as the first level of health care providers, are in the best position to assess their knowledge and attitude about andropause period, so a structured instrument is necessary to assess them. This study aimed at the assessment of the validity and reliability of the self-made questionnaire on knowledge and attitude of general practitioners about andropause. METHOD This is a descriptive study done on 402 general physicians working in public and private sectors. The instrument used was a self-administered questionnaire that was developed based on the literature review and recourses available on andropause and was designed to find out the level of knowledge and attitude of andropause. In order to determine the content and face validity of the questionnaire, judgments of experts were used. Cronbach's coefficient was used to determine the reliability of the questionnaire. SPSS 18 (SPSS Inc, Chicago, IL) was used to analyze the data. RESULTS Content and face validity of the questionnaire was confirmed by experts. The reliability was confirmed by Cronbach's alpha of (0).895 for the part on knowledge and (0).839 for the part on attitude. CONCLUSION Based on the results of the study, this questionnaire had appropriate validity and reliability to assess the knowledge and attitude of general practitioners about andropause.
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Affiliation(s)
- Maliheh Abootalebi
- a Department of Community Health Nursing , School of Nursing and Midwifery, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Marzieh Kargar
- b Department of Pediatric Nursing , School of Nursing and Midwifery, Shiraz University of Medical Sciences , Shiraz , Iran , and
| | - Alireza Aminsharifi
- c Department of Urology , School of Medicine, Shiraz University of Medical Sciences , Shiraz , Iran
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Rabijewski M, Papierska L, Kuczerowski R, Piątkiewicz P. Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes. Clin Interv Aging 2015; 10:1381-91. [PMID: 26316733 PMCID: PMC4548738 DOI: 10.2147/cia.s88499] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Andropausal and depressive symptoms are common in aging males and may be associated with hormone deficiency. We investigated the severity of andropausal and depressive symptoms, as well as their hormonal determinants, in 196 middle-aged and elderly men (age range: 40-80 years) with prediabetes (PD) and in 184 healthy peers. PD was diagnosed according to the definition of the American Diabetes Association. The severity of andropausal and depressive symptoms was assessed using the Aging Males' Symptoms Rating Scale and the Self-Rating Depression Scale. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured. The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively). In men with PD aged 40-59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60-80 years), only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar. The higher prevalence of andropausal symptoms was independently associated with cFT and IGF-1 in middle-aged men and with TT and DHEAS in elderly men with PD. The more severe depression symptoms were associated with low TT and DHEAS in middle-aged men and with low cFT and DHEAS in elderly men with PD. In conclusion, the prevalence of andropausal symptoms, especially psychological, was higher in prediabetic patients as compared to healthy men, while the severity of depressive symptoms was higher only in middle-aged men with PD. Hormonal determinants of andropausal and depressive symptoms are different in middle-aged and elderly patients, but endocrine tests are necessary in all men with PD.
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Affiliation(s)
- Michał Rabijewski
- Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Poland
| | - Lucyna Papierska
- Department of Endocrinology, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - Roman Kuczerowski
- Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Poland
| | - Paweł Piątkiewicz
- Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Poland
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Rabijewski M, Papierska L, Kuczerowski R, Piątkiewicz P. Hormonal determinants of erectile dysfunction and lower urinary tract symptoms in middle-aged and elderly men with prediabetes. Aging Male 2015; 18:256-64. [PMID: 26444448 DOI: 10.3109/13685538.2015.1083972] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) are common in diabetic men. The aim of this study was to investigate hormonal determinants, the prevalence and severity of ED and LUTS in middle-aged and elderly men with prediabetes (PD). METHODS We investigated 176 men with PD and 184 healthy peers. PD was defined according American Diabetes Association. ED according IIEF scale and LUTS according IPSS scale were assessed. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) were measured. RESULTS The prevalence of ED in patients with PD was higher than in control group (30 versus 24%) as well as the prevalence and severity of ED and LUTS in elderly (60-80 years) and middle-aged (40-59 years) men with PD was higher than in healthy peers. In middle-aged pre-diabetic men, the more severe LUTS symptoms were associated with low TT and DHEAS, while in elderly men with low cFT and DHEAS. The higher prevalence of ED in middle-aged men with PD was associated with cFT and DHEAS, while in elderly pre-diabetic men with TT and IGF-1. CONCLUSIONS The prevalence and severity of LUTS and ED symptoms were higher in pre-diabetic men than in healthy peers. Hormonal determinants of these symptoms are different in middle-aged and elderly patients with PD.
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Affiliation(s)
- Michał Rabijewski
- a Department of Internal Diseases , Diabetology and Endocrinology, Medical University of Warsaw Poland and
| | - Lucyna Papierska
- b Department of Endocrinology , Medical Centre for Postgraduate Education , Warsaw , Poland
| | - Roman Kuczerowski
- a Department of Internal Diseases , Diabetology and Endocrinology, Medical University of Warsaw Poland and
| | - Paweł Piątkiewicz
- a Department of Internal Diseases , Diabetology and Endocrinology, Medical University of Warsaw Poland and
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Asadollahi A, Saberi LF, Faraji N. Validity and reliability of male andropause symptoms self-assessment questionnaire among elderly males in Khuzestan province of Iran. J Midlife Health 2014; 4:233-7. [PMID: 24381466 PMCID: PMC3872671 DOI: 10.4103/0976-7800.122258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Andropause is a condition of decreasing testosterone in men that usually begins to occur at about 40 years of age. Many men find it difficult to acknowledge there may be a problem by refusing to even talk about the symptoms. Aims: The study was conducted to the standards of MASSQ (2012) within male older adults to introduce a relevant criterion. Materials and Methods: About 382 men with age range of 50-80 and with the mean age of 65.3 ± 2.32 were sampled with the cluster-ratio sampling method from the eight cities of Khuzestan province in southwestern Iran. The aged samples replied to the 25 items of MASSQ. Results: Coefficients of Cronbach's alpha (α = 0.89), split-half (0.91), convergent validity (0.72), divergent validity (−0.32), and criterion validity (0.67) were estimated, which were significant at P < 0.01. The exploratory factor analysis demonstrated that the 25-items of MASSQ for aged samples are organized into four factors (sexual, somatic, psychic, and behavioral) which clarify 79% of the scale's variance. Second-order confirmatory factor analysis pointed out that the factors are well-matched up onto a principal factor. Consequently, the four-factor model was well appropriate for the data by the fit index techniques for adjusting the scale [adjusted goodness of fit index = 0.92, goodness-of-fit statistic = 0.91, root mean square error of approximation = 0.006, incremental fit index = 0.94, normed fit index = 0.91, comparative fit index = 0.97]. Conclusions: The results pointed to the well-adjusted reliability and validity of MASSQ and its usefulness for the relevant studies as well.
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Affiliation(s)
- Abdolrahim Asadollahi
- Social Gerontology, Australian Centre on Quality of Life, Deakin University, Melbourne, Australia ; Department of Community Health, Faculty of Nursing and Midwifery, Mazandaran University of Medical Siences, Sari, Iran
| | - Laleh Fani Saberi
- Department of Community Health, Faculty of Nursing and Midwifery, Mazandaran University of Medical Siences, Sari, Iran
| | - Nasrin Faraji
- Aging Care Department, Bureau of Prevention and Rehabilitation, Ahwaz, Iran
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