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Hu Z, Chen K, Dai H, Lv Z, Li J, Yu P, Feng J, Abdulkarem AM, Wu H, He R, Li G. ROUX-en-Y gastric bypass surgery improves metabolic syndrome-related erectile dysfunction in mice via the IRS-1/PI3K/AKT/eNOS pathway. Sex Med 2024; 12:qfae029. [PMID: 38817951 PMCID: PMC11134102 DOI: 10.1093/sexmed/qfae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 04/10/2024] [Accepted: 05/05/2024] [Indexed: 06/01/2024] Open
Abstract
Objective Although many clinical studies have shown that ROUX-en-Y gastric bypass (RYGB) surgery significantly improves metabolic syndrome-related erectile dysfunction (MED), the role and mechanism are unclear. Aim In this study we used a mouse model to explore how RYGB improves MED induced by a high-fat diet (HFD). Methods We established a mouse model of metabolic syndrome by feeding an HFD for 16 weeks. The mice were randomly assigned to the standard chow diet (SCD), HFD, or RYGB groups. Body weight, fasting blood glucose, plasma insulin, and total plasma cholesterol were analyzed. Erectile responses were evaluated by determining the mean systolic blood pressure and the intracavernosal pressure (ICP). Penile histologic examination (Masson's trichrome and immunohistochemical stain) and Western blot were performed. Result Compared with the SCD group, the ICP in the sham group was significantly lower, and the ICP of the RYGB was significantly increased. Masson's trichrome and immunohistochemical staining showed that the content of endothelium and smooth muscle in the corpus cavernosum of mice with MED was significantly reduced. Western blot analysis showed a significant decrease in α-smooth muscle actin and a significant increase in osteopontin in penile tissue in the sham group, which was improved by RYGB surgery. Furthermore, RYGB significantly increased IRS-1/PI3K/Akt/eNOS phosphorylation. Clinical Translation In this study we explored the mechanism of bariatric surgery to improve erectile dysfunction associated with metabolic syndrome and provided a theoretical basis for clinical research. Strengths and Limitations First, we did not investigate the mechanism by which RYGB affects the IRS-1/PI3K/Akt/eNOS signaling pathway. Second, the effect of the IRS-1/PI3K/Akt/eNOS signaling pathway on the function of corpus cavernosum endothelial cells and smooth muscle cells remains to be investigated in cellular studies. Conclusion This study demonstrated that RYGB may not only improve metabolic parameters but also restore erectile function in MED patients. The mechanism of the therapeutic effect of RYGB may be reactivation of the IRS-1/PI3K/Akt/eNOS pathway.
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Affiliation(s)
- Zhenxing Hu
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
- Department of Urology, The First Affiliated Hospital of Yangtze University, Jingzhuo 434000, People’s Republic of China
| | - Keming Chen
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Haitao Dai
- Department of Urology, The First Affiliated Hospital of Yangtze University, Jingzhuo 434000, People’s Republic of China
| | - Zhiyong Lv
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Jian Li
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Puguang Yu
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Jiajing Feng
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Alqaisi Mohammed Abdulkarem
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Haifeng Wu
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
| | - Rui He
- Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan 750000, People’s Republic of China
| | - Guangyong Li
- Department of Urology, General Hospital of Ningxia Medical University, Ningxia Medical University, Xingqing District, Yinchuan 750000, People’s Republic of China
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Habous M, Khattak A, Farag M, Binsaleh S, Ralph D, Aziz M, Bettocchi C, Muir G. Investigating the risk factors of penile arterial insufficiency and veno-occlusive dysfunction in patients with erectile dysfunction. BJUI COMPASS 2024; 5:34-41. [PMID: 38179020 PMCID: PMC10764169 DOI: 10.1002/bco2.275] [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: 01/25/2023] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 01/06/2024] Open
Abstract
Objective To investigate the risk factors for penile arterial insufficiency (PAI), which is a known cause of erectile dysfunction (ED). Methods Patients who attended our urology clinic complaining of ED for more than 6 months were prospectively enrolled in this study over 1-year period. Patient consent was taken and ethical committee approval. Complete medical history and thorough general and local examination including body mass index (BMI), Peyronie's disease (PD) and penile size measurements (length and girth) were done for all of them. Laboratory tests included testosterone, lipid profile and glycated haemoglobin (HA1c). A penile duplex ultrasound study (PDU) was done for all patients after intracavernosal injection (ICI) with alprostadil. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured after 15 min. Statistical analysis was done using SPSS. Results A total of 440 patients were enrolled in this analysis. The mean age was 48(23-81), and the mean BMI was 30 (18-51). Older patients had lower PSV (r = -0.361, P = 0.000) and higher EDV (r = 0.174, P = 0.001), and both correlations were highly statistically significant. Diabetics had lower PSV (r = -0.318, P = 0.000) and higher EDV (r = 0.139, P = 0.008), which were also highly statistically significant. Smokers had lower PSV (r = -0.140, P = 0.008) and higher EDV (r = 0.178, P = 0.001), which were highly statistically significant. Men with larger penises measured skin to tip had lower EDV (r = -0.119, P = 0.024), which was less significant. Interestingly, there was neither a significant correlation between BMI and PSV (0.16, P = 0.745) nor a significant correlation between testosterone and PSV (0.029, P = 0.552). Also, there was no correlation between PSV and both dyslipidaemia and penile PD. Conclusions Ageing, tobacco consumption, DM and hypertension seem to have a negative impact on penile haemodynamics, which was statistically significant. In our patients, there was no statistically significant effect on penile haemodynamics in patients with increased BMI, low testosterone or PD or according to the size of the penis.
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Affiliation(s)
| | | | - Mohammed Farag
- Urology DepartmentAzhar University, Assiut BranchAssiutEgypt
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of MedicineKing Saud UniversityRiyadhSaudi Arabia
| | - David Ralph
- St. Peters Institute of Andrology, UCLHLondonUK
| | - Mohammed Aziz
- Urology DepartmentMenofia UniversityShibin Al KawmEgypt
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Cho KH, Kim JE, Nam HS, Baek SH, Bahuguna A. Consumption of Policosanol (Raydel ®) Improves Hepatic, Renal, and Reproductive Functions in Zebrafish: In Vivo Comparison Study among Cuban, Chinese, and American Policosanol. Pharmaceuticals (Basel) 2023; 17:66. [PMID: 38256899 PMCID: PMC10818973 DOI: 10.3390/ph17010066] [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: 11/23/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
The current study compared three policosanols from Cuba (sugarcane, Raydel®, policosanol (1), China (rice bran, Shaanxi, policosanol (2), and the USA (sugarcane, Lesstanol®, policosanol (3) in the treatment of dyslipidemia and protection of the liver, ovary, and testis in hypercholesterolemic zebrafish. After twelve weeks of supplementation of each policosanol (PCO, final 0.1% in diet, w/w) with a high cholesterol diet (HCD, final 4%, w/w), the Raydel policosanol (PCO1) group showed the highest survivability, approximately 89%. In contrast, Shaanxi policosanol (PCO2) and Lesstanol policosanol (PCO3) produced 73% and 87% survivability, respectively, while the HCD alone group showed 75% survivability. In the 12th week, the PCO1 group demonstrated the most modest increase in body weight along with significantly lower levels of total cholesterol (TC) and triglycerides (TG) in comparison to the HCD control group. Additionally, the PCO1 group exhibited the highest proportion of high-density lipoprotein (HDL)-cholesterol within TC. Notably, the PCO1 group displayed the lowest level of aspartate aminotransferase and alanine aminotransferase, minimal infiltration of inflammatory cells, reduced interleukin (IL)-6 production in the liver, a notable decline in reactive oxygen species (ROS) generation and mitigated fatty liver changes. HCD supplementation induced impairment of kidney morphology with the greatest extent of ROS production and apoptosis. On the other hand, the PCO 1 group showed a remarkably improved morphology with the least ROS generation and apoptosis. Within the ovarian context, the PCO1 group exhibited the most substantial presence of mature vitellogenic oocytes, accompanied by minimal levels of ROS and apoptosis. Similarly, in the testicular domain, the PCO1 group showcased optimal morphology for spermatogenesis, characterized by the least interstitial area and diminished production of ROS in testicular cells. At week 8, the PCO1 group showed the highest egg-laying ability, with around 244 eggs produced per mating. In contrast, the HCD alone, PCO2, and PCO3 groups showed significantly lower egg-laying ability (49, 59, and 86 eggs, respectively). The embryos from the PCO1 group exhibited the highest survivability with the fastest swimming ability and developmental speed. These results suggest that PCO1 consumption significantly enhanced the reproduction system, egg-laying ability, and embryo survivability. In conclusion, among the three policosanols, Cuban (Raydel®) policosanol had the strongest effect on survivability, improving dyslipidemia, liver protection, kidney, ovary, and testis with a restoration of the cell morphology, and the least ROS production and apoptosis-induced by HCD supplementation.
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Affiliation(s)
- Kyung-Hyun Cho
- Raydel Research Institute, Medical Innovation Complex, Dong-gu, Daegu 41061, Republic of Korea; (J.-E.K.); (H.-S.N.); (S.-H.B.); (A.B.)
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Mphasha MH, Mothiba TM, Skaal L. Daily living activities' performance by male diabetics with sexual dysfunction in South Africa. Afr J Prim Health Care Fam Med 2023; 15:e1-e6. [PMID: 37526558 PMCID: PMC10476452 DOI: 10.4102/phcfm.v15i1.3885] [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: 10/20/2022] [Revised: 12/11/2022] [Accepted: 01/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Sexual dysfunction (SD) is a common complication among men living with diabetes (MLWD), which adds to stresses induced by medical condition. Effect of stress on their daily living activities has been only poorly described. AIM This study aimed to explore the behaviour and challenges of MLWD experiencing SD in respect of daily living activities. SETTING Five clinics in Senwabarwana in Limpopo province. METHODS Qualitative approach and phenomenological exploratory design were adopted to collect data from 15 male participants selected from five clinics using purposive homogeneous sampling. One-on-one interviews were conducted using voice recorders, and field notes were taken of non-verbal cues. Unstructured interview guide with principal question enabled instructive probing to be conducted. Data were analysed using eight steps of Tesch's inductive, descriptive and open coding technique. RESULTS Participants reported stressful experiences, difficulty coping with diabetes and its accompanying complication of SD that led to fear of losing their wives. They indicated that as a result of stress and difficulty in coping with the condition, they were engaged in less physical activity than before their diagnosis. CONCLUSION Sexual dysfunction is prevalent among male diabetics and often feel stressed and worried about losing their wives. They struggle to cope with conditions to the point where they are less capable of performing tasks than they were before diagnosis. These outcomes are critical issues that should be addressed in any diabetes treatment strategy.Contribution: Support-based collaboration of healthcare providers with spouses and revision of South African diabetes management strategy to incorporate healthy coping strategies are recommended.
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Affiliation(s)
- Mabitsela H Mphasha
- Department of Public Health, Faculty of Healthcare Sciences, University of Limpopo, Polokwane.
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5
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Warli SM, Alamsyah MT, Nasution AT, Kadar DD, Siregar GP, Prapiska FF. The Assessment of Male Erectile Dysfunction Characteristics in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis and Hemodialysis Using the International Index of Erectile Function (IIEF-5) Combined with Hospital Anxiety and Depression Scales. Int J Nephrol Renovasc Dis 2023; 16:155-161. [PMID: 37180487 PMCID: PMC10167996 DOI: 10.2147/ijnrd.s402540] [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: 02/01/2023] [Accepted: 04/27/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose To determine the differences in mean scores of erectile dysfunctions (EDs) assessed by the International Index of Erectile Function (IIEF-5) questionnaire between patients with chronic kidney disease (CKD) undergoing hemodialysis and patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods This is an analytic observational study with a cross-sectional design that was conducted from June to December 2022 at the Urology Center of Haji Adam Malik General Hospital and Rasyida Kidney Specialized Hospital. The sample of this study were male CKD-patients who underwent regular hemodialysis (HD) and who underwent CAPD, and met the inclusion and exclusion criteria. Psychological disorders experienced during therapy session are considered as risk factors and assessed via the Hospital Anxiety and Depression Scale (HADS). These disorders assessment was used to evaluate the severity of the patients' anxiety and depressive symptoms. Statistical data analysis was carried out. Results Both groups had HADS-A and HADS-D scores with an average <7, classified as normal anxiety and depression. Most of the patients in the HD group had mild-to-moderate ED (28.6%), while in the CAPD group had mild severity of ED (38.1%). There were no significant differences in severity of ED between patients undergoing HD and CAPD (p > 0.05). However, there was a significant difference in ED scores (IIEF-5) between patients undergoing HD and those with CAPD (p < 0.05), in which patients in the CAPD group had a higher IIEF-5 score. In addition, there was a significant positive correlation with moderate strength (p<0.001; r=0.494) between anxiety disorders and ED disorders in patients undergoing HD and CAPD, whereas there is no significant correlation between depressive disorders and ED conditions (p > 0.05). Conclusion There was a significant difference in IIEF-5 scores between patients undergoing HD and CAPD.
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Affiliation(s)
- Syah Mirsya Warli
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara – Haji Adam Malik General Hospital, Medan, Indonesia
- Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia
| | - Mohammad Taufiq Alamsyah
- Department of Urology, Faculty of Medicine, Universitas Indonesia - Haji Adam Malik General Hospital, Medan, Indonesia
| | - Alwi Thamrin Nasution
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara – Haji Adam Malik General Hospital, Medan, Indonesia
| | - Dhirajaya Dharma Kadar
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara – Haji Adam Malik General Hospital, Medan, Indonesia
| | - Ginanda Putra Siregar
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara – Haji Adam Malik General Hospital, Medan, Indonesia
| | - Fauriski Febrian Prapiska
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara – Haji Adam Malik General Hospital, Medan, Indonesia
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6
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Shigehara K, Kato Y, Konaka H, Kawaguchi S, Nohara T, Izumi K, Kadono Y, Namiki M, Mizokami A. The correlation between erectile function and adiponectin levels in men with late-onset hypogonadism. Aging Male 2022; 25:249-254. [PMID: 36190764 DOI: 10.1080/13685538.2022.2119955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Aim: This study investigated the relationship between erectile dysfunction (ED) and adiponectin levels in hypogonadal men.Methods: In this study, 218 patients with hypogonadism (mean age: 65.1 ± 8.3 years) were enrolled. All patients underwent physical examinations, with measurement of body mass index, body fat ratio, and waist circumference. The erectile function was assessed using the sexual health inventory for men (SHIM) scoring system. Blood biochemical profiles such as free testosterone, fasting blood glucose, and lipid profile including adiponectin levels were measured. All patients were divided into two groups based on their SHIM score: normal to moderate ED (SHIM score ≥ 12) and severe ED (SHIM score < 12), and the factors associated with severe ED were determined. Patients with severe ED were divided into two groups based on adiponectin levels (cutoff value of 7.0 μg/mL), and their basic characteristics were compared between these two groups.Results: The severe ED group was older and had higher adiponectin levels. In patients with severe ED, various metabolic parameters were significantly worse in the low adiponectin groups than in the non-low adiponectin group.Conclusions: The risk of developing cardiovascular diseases is extremely high in hypogonadal men with severe ED who had lower serum adiponectin levels.
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Affiliation(s)
- Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yuki Kato
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hiroyuki Konaka
- Department of Urology, Kanazawa Red Cross Hospital, Kanazawa, Japan
| | - Shohei Kawaguchi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Takahiro Nohara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yoshifumi Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Mikio Namiki
- Department of Urology, Hasegawa Hospital, Toyama, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Martínez-Giner G, Giménez-De Llano E, Romero-Rubio D, Abad-Pérez MJ, Sánchez-Martínez V. Sexual dysfunction in people treated with long-acting injectable antipsychotics in monotherapy or polypharmacy: a naturalistic study. Int J Ment Health Nurs 2022; 31:576-590. [PMID: 34973049 DOI: 10.1111/inm.12973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/22/2021] [Accepted: 12/12/2021] [Indexed: 01/28/2023]
Abstract
Sexual dysfunction, psychosis, and antipsychotics are known to be related, but the precise association between them is still unknown. Most evidence about the prevalence of sexual dysfunction in people treated with antipsychotic drugs comes from studies with restrictive samples. That is why our main objective was to determine the prevalence of sexual dysfunction in a real-life sample of outpatients treated with antipsychotics, considering gender. A cross-sectional naturalistic study was developed, including people treated with long-acting injectable antipsychotics, with or without other psychotropic drugs. Participants were interviewed to assess sexual satisfaction through a Likert scale (0 to 10) and the presence of sexual dysfunction (the Psychotropic-Related Sexual Dysfunction Questionnaire, PRSexDQ-SALSEX). The participants also had a blood test to determine prolactin (men and women) and testosterone levels (men only). A total of 131 people participated in the study (90 men and 41 women). Some extent of sexual dysfunction was found in 62.2% of men and 51.2% of women. The most frequent sexual dysfunction symptom for both genders was the loss of libido (45%). Hyperprolactinemia was present in 56% of men and 61% of women. The presence of sexual dysfunction was associated with higher doses of antipsychotics, hyperprolactinemia, and smoking in men and with smoking and hyperprolactinemia in postmenopausal women. This study provides real-life evidence of sexual dysfunction and hyperprolactinemia in persons treated with long-acting injectable antipsychotics segregated by gender. The high rates of sexual dysfunction and hyperprolactinemia detected corroborate the need to consider these aspects in clinical practice.
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Das J, Yadav S. Comorbidities of male patients with sexual dysfunction in a psychiatry clinic: A study on industrial employees. Ind Psychiatry J 2022; 31:81-88. [PMID: 35800853 PMCID: PMC9255625 DOI: 10.4103/ipj.ipj_116_20] [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: 06/13/2020] [Revised: 10/27/2020] [Accepted: 07/21/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Previous studies assessed the association of sexual dysfunction (SD) in cases of specific organic and psychiatric disorders separately as risk factors of SD, but the extent of association of various disorders in cases of SD was rarely evaluated. This study was conducted to assess almost all types of comorbidities to find out their effects on SD in male patients and to make complete diagnoses. MATERIALS AND METHODS All male patients aged between 18 and 60 years reporting with sexual problems to the psychiatry outpatient department were evaluated with Arizona sexual experiences scale (ASEX) for males. Their assessment included detailed medical and psychiatric history including medicine intake, physical and mental status examination. Relevant biochemical investigations were done including sex hormone assessment. RESULTS Among 104 males diagnosed as cases of SD according to the ASEX scale in 1 year period only 75 patients completed all the biochemical and hormonal assessments. It was observed that 38.67% were diagnosed as SD without any comorbidity, 25.33% had biochemical or hormonal or physical comorbidities, 21.33% had psychiatric comorbidities and 14.67% had psychiatric as well as biochemical or hormonal or physical comorbidities (n = 75). The severity of SD was higher in the patients with comorbidity and the age of the patients predicted its severity. CONCLUSION All cases of SD should be assessed in detail for physical, biochemical, hormonal, and psychiatric comorbidities to treat them holistically. Psychiatrists should play a key role in assessing, diagnosing, treating, and referring them to the appropriate treatment provider.
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Affiliation(s)
- Jnanamay Das
- Department of Psychiatry, ESIC Model Hospital, Noida, Uttar Pradesh, India
| | - Shailly Yadav
- Department of Psychiatry, ESIC Model Hospital, Gurugram, Haryana, India
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9
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Li T, Bai Y, Jiang Y, Jiang K, Tian Y, Wang Z, Ban Y, Liang X, Luo G, Sun F. Potential Effect of the Circadian Clock on Erectile Dysfunction. Aging Dis 2022; 13:8-23. [PMID: 35111358 PMCID: PMC8782551 DOI: 10.14336/ad.2021.0728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
The circadian rhythm is an internal timing system, which is generated by circadian clock genes. Because the circadian rhythm regulates numerous cellular, behavioral, and physiological processes, organisms have evolved with intrinsic biological rhythms to adapt the daily environmental changes. A variety of pathological events occur at specific times, while disturbed rhythms can lead to metabolic syndrome, vascular dysfunction, inflammatory disorders, and cancer. Therefore, the circadian clock is considered closely related to various diseases. Recently, accumulated data have shown that the penis is regulated by the circadian clock, while erectile function is impaired by an altered sleep-wake cycle. The circadian rhythm appears to be a novel therapeutic target for preventing and managing erectile dysfunction (ED), although research is still progressing. In this review, we briefly summarize the superficial interactions between the circadian clock and erectile function, while focusing on how disturbed rhythms contribute to risk factors of ED. These risk factors include NO/cGMP pathway, atherosclerosis, diabetes mellitus, lipid abnormalities, testosterone deficiency, as well as dysfunction of endothelial and smooth muscle cells. On the basis of recent findings, we discuss the potential role of the circadian clock for future therapeutic strategies on ED, although further relevant research needs to be performed.
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Affiliation(s)
- Tao Li
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Yunjin Bai
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Yiting Jiang
- Department of Otorhinolaryngology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Ye Tian
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Zhen Wang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Yong Ban
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Xiangyi Liang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Guangheng Luo
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
- Correspondence should be addressed to: Dr. Fa Sun, Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China. .
| | - Fa Sun
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
- Correspondence should be addressed to: Dr. Fa Sun, Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China. .
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10
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Gerbild H, Areskoug Josefsson K, Marie Larsen C, Schantz Laursen B. Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation. Scand J Caring Sci 2021; 36:839-851. [PMID: 34288023 DOI: 10.1111/scs.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES An Institutional Data Protection Agency approved the study. METHODS An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit & Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
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11
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Imprialos K, Koutsampasopoulos K, Manolis A, Doumas M. Erectile Dysfunction as a Cardiovascular Risk Factor: Time to Step Up? Curr Vasc Pharmacol 2021; 19:301-312. [PMID: 32286949 DOI: 10.2174/1570161118666200414102556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Erectile dysfunction (ED) is a major health problem that affects a significant proportion of the general population, and its prevalence is even higher in patients with CV risk factors and/or disease. ED and cardiovascular (CV) disease share several common pathophysiological mechanisms, and thus, the potential role of ED as a predictor of CV events has emerged as a significant research aspect. OBJECTIVE The purpose of this review is to present and critically discuss data assessing the relation between ED and CV disease and the potential predictive value of ED for CV events. METHODS A comprehensive review of the literature has been performed to identify studies evaluating the association between ED and CV disease. RESULTS Several cross-sectional and prospective studies have examined the association between ED and CV disease and found an increased prevalence of ED in patients with CV disease. ED was shown to independently predict future CV events. Importantly, ED was found to precede the development of overt coronary artery disease (CAD) by 3 to 5 years, offering a "time window" to properly manage these patients before the clinical manifestation of CAD. Phosphodiesterase type 5 inhibitors are the first-line treatment option for ED and were shown to be safe in terms of CV events in patients with and without CV disease. CONCLUSION Accumulating evidence supports a strong predictive role of ED for CV events. Early identification of ED could allow for the optimal management of these patients to reduce the risk for a CV event to occur.
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Affiliation(s)
- Konstantinos Imprialos
- Second Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Konstantinos Koutsampasopoulos
- Second Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | | | - Michael Doumas
- Second Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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12
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Alomar AO, Shaheen MF, Almaneea AS, Althaqeb EK, Alshahrani ZM, Jarman YA, Alhabdan S. The Effect of Bariatric Surgery on Metabolic Syndrome: A Three-center Experience in Saudi Arabia. Obes Surg 2021; 31:3630-3636. [PMID: 34046824 DOI: 10.1007/s11695-021-05461-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/24/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The prevalence of metabolic syndrome (MetS) increases in parallel with the increasing incidence of obesity. Hence, bariatric surgery is potentially curative in obese patients with MetS. We aim to measure the effect of bariatric surgery as well as the potential factors leading to MetS resolution in the Saudi population. METHODS A retrospective review of three tertiary care centers in Saudi Arabia was done. We identified 386 patients who have MetS and underwent bariatric surgery during the period between January 2016 and December 2018. After exclusion of patients with insufficient follow-up, data from 275 patients was analyzed. MetS diagnosis, persistence, and resolution were determined using the International Diabetes Federation consensus worldwide definition. RESULTS MetS resolution was achieved in 78%, 79%, 73%, and 82% at 1, 2, 3, and 4 years after bariatric surgery, respectively. Accumulatively, 80% achieved MetS resolution with an average follow-up period of two and a half years. Patients who experienced resolution had younger age, lower BMI, lower systolic blood pressure, lower triglycerides, lower fasting plasma glucose, and lower HbA1c preoperatively in addition to a higher percentage of excess weight loss after bariatric surgery when compared to those who had persistence of MetS. CONCLUSION More than three fourths of patients with MetS achieved resolution after bariatric surgery. Certain patient characteristics, such as young age and higher excess weight loss postoperatively, were associated with a higher chance of MetS resolution.
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Affiliation(s)
- Abdulrahman O Alomar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed F Shaheen
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. .,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. .,Organ Transplant Center and Hepatobiliary Sciences Department, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.
| | - Abdallh S Almaneea
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Eyad K Althaqeb
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ziyad M Alshahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yazeed A Jarman
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sultan Alhabdan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of Surgery, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
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13
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Gur S, Alzweri L, Yilmaz-Oral D, Kaya-Sezginer E, Abdel-Mageed AB, Sikka SC, Hellstrom WJG. Ivabradine, the hyperpolarization-activated cyclic nucleotide-gated channel blocker, elicits relaxation of the human corpus cavernosum: a potential option for erectile dysfunction treatment. Aging Male 2020; 23:1088-1097. [PMID: 31741421 DOI: 10.1080/13685538.2019.1678125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the effect of the If channel inhibitor, ivabradine on human corpus cavernosum (HCC) smooth muscle tone. METHODS HCC samples were obtained from erectile dysfunction(ED) patients (n = 12) undergoing penile prosthesis surgery. Concentration-response curves for ivabradine were exposed to various inhibitory and stimulatory agents. The relaxant and contractile responses to electrical field stimulation (EFS, 10 Hz and 80 Hz) were examined in the presence or absence of ivabradine (10 μM). HCN3 and HCN4 channel expression and localization were determined by Western blot and immunohistochemical analyses of HCC tissues. RESULTS Increasing ivabradine concentrations dependently reduced the maximal contractile responses of isolated HCC strips induced by KCl (59.5 ± 2.5%) and phenylephrine (84.0 ± 9.8%), which was not affected by nitric oxide synthase and soluble guanylyl cyclase inhibitors after phenylephrine-induced contraction. Nifedipine and tetraethylammonium inhibited the maximum relaxation to ivabradine by 75% and 39.3%, respectively. Fasudil and sildenafil increased the relaxation response to ivabradine without altering the maximum response. Pre-incubation with ivabradine significantly increased relaxant responses to EFS (p < 0.01) and reduced the contractile tension evoked by EFS (72.3%) (p < 0.001). Ivabradine incubation did not affect the expression and localization of HCN3 and HCN4 channels in the HCC smooth muscle cells. CONCLUSIONS Ivabradine exhibits a relaxant effect on HCC tissues, which is likely to be attributed to the blocking of L-type Ca2+ channels and the opening of K+ channels, independent of changes in the activation of the nitric oxide/cyclic guanosine monophosphate system. Inhibition of HCN channels localized in cavernosal smooth muscle cells may offer pharmacological benefits for patients with cardiovascular risk factors.
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Affiliation(s)
- Serap Gur
- Departments of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
- Department of Pharmacology and Biochemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Laith Alzweri
- Departments of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
| | - Didem Yilmaz-Oral
- Department of Pharmacology, Faculty of Pharmacy, Cukurova University, Adana, Turkey
| | - Ecem Kaya-Sezginer
- Department of Pharmacology and Biochemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Asim B Abdel-Mageed
- Departments of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
| | - Suresh C Sikka
- Departments of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
| | - Wayne J G Hellstrom
- Departments of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
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14
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Yahia H, Hassan A, El-Ansary MR, Al-Shorbagy MY, El-Yamany MF. IL-6/STAT3 and adipokine modulation using tocilizumab in rats with fructose-induced metabolic syndrome. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2020; 393:2279-2292. [PMID: 32651660 DOI: 10.1007/s00210-020-01940-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022]
Abstract
Metabolic syndrome (MetS) is a low-grade inflammation state that results from an interplay between genetic and environmental factors. The incidence of MetS among individuals with insulin resistance, dyslipidemia, elevated blood pressure, and obesity, which constitute the syndrome, is 40% in the Middle East. The absence of an approved therapeutic agent for MetS is one reason to investigate tocilizumab (TCZ), which might be effective in the treatment of MetS. Results have implicated interleukin 6 (IL-6) in the development of MetS, identifying inflammation as a critical factor in its etiology and offering hope for new therapeutic approaches development. Here, we evaluate whether tocilizumab can be used for metabolic syndrome treatment. We assigned rats to three groups, 8 rats each: a negative-control group, provided with standard rodent chow and water; a fructose-fed group, provided with standard rodent chow and 10% fructose in drinking water for 22 weeks; and a treatment group, fed as per the metabolic syndrome group but treated with tocilizumab (5 mg/kg/week, intraperitoneal) for the final 5 weeks. Treatment with TCZ successfully ameliorated the damaging effects of fructose by stabilizing body weight gain and through the normalization of serum biochemical parameters and histopathological examination. Significant differences in adipokine levels were perceived, resulting in a significant decline in serum leptin and interleukin 6 (IL-6) levels concurrent with adiponectin normalization. Tocilizumab might be an effective agent for the treatment of metabolic syndrome. However, further investigations on human subjects are needed before the clinical application of tocilizumab for this indication.
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Affiliation(s)
- Haneen Yahia
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Modern University for Technology and Information, Al-Mokattam, Cairo, Egypt.
| | - Azza Hassan
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
| | - Mona R El-Ansary
- Department of Biochemistry, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Muhammad Y Al-Shorbagy
- School of Pharmacy, Newgiza University, Giza, Egypt
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mohamed F El-Yamany
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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15
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Sebastianelli A, Morselli S, Spatafora P, Liaci A, Gemma L, Zaccaro C, Vignozzi L, Maggi M, McVary KT, Kaplan SA, Chapple C, Gravas S, Serni S, Gacci M. Outcomes of combination therapy with daily tadalafil 5 mg plus tamsulosin 0.4 mg to treat lower urinary tract symptoms and erectile dysfunction in men with or without metabolic syndrome. Minerva Urol Nephrol 2020; 73:836-844. [PMID: 33200905 DOI: 10.23736/s2724-6051.20.04099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to assess the impact of tadalafil 5 mg/die plus tamsulosin 0.4 mg/die combination therapy on lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), according to presence vs. absence of metabolic syndrome (MetS). METHODS Seventy-five consecutive men presenting with ED and LUTS were enrolled. Patients were divided into two groups according to MetS presence. All subjects were treated with combination therapy for 12 weeks. Patients were re-evaluated after treatment with uroflowmetry and post-void residual volume (PVR), International Prostate Symptoms Score (IPSS), IPSS Quality of Life (QoL), overactive bladder questionnaire (OAB-q) and International Index Erectile Function-5 (IIEF-5) Score. RESULTS After enrollment, 50 patients were included: 31 (62.0%) with MetS and 19 (38.0%) without MetS. At baseline, patients without MetS showed a significantly better IPSS, IIEF and OAB-q, as compared to those with MetS. After 12 weeks of combination therapy LUTS, ED and flowmetry significantly improved in both groups (P<0.001). The improvement after 12 weeks was similar between groups in all parameters (P>0.05), except for ∆OAB-q that was significantly better for patients with MetS (P=0.028). Nevertheless, total IPSS, all IPSS subscores and OAB-q were significantly better at 12 weeks in men without MetS (P<0.05). Despite IIEF-5 was significantly different at baseline, after 12 weeks of combination therapy, erectile function was similar in men with or without METS: 16.3±3.8 vs. 17.7±4.7 (P=0.238). No serious adverse event (AE) was reported, and complications were comparable between groups (P>0.05). CONCLUSIONS Patients with MetS have worse LUTS and ED profiles. However, tadalafil plus tamsulosin combination treatment provided them a similar ED profile and a greater relief of overactive bladder (OAB) symptoms at the end of the trial. Combination therapy had the same safety profile in men besides MetS. Further randomized controlled trials are needed.
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Affiliation(s)
- Arcangelo Sebastianelli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Simone Morselli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy -
| | - Pietro Spatafora
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Liaci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Luca Gemma
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Claudia Zaccaro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | - Kevin T McVary
- Stritch School of Medicine, Department of Urology, Center for Male Health, Loyola University Medical Center, Maywood, IL, USA
| | - Steven A Kaplan
- Icahn School of Medicine at Mount Sinai, Department of Urology, New York, NY, USA
| | - Christopher Chapple
- Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Stavros Gravas
- Department of Urology, University of Thessaly, Larissa, Greece
| | - Sergio Serni
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Mauro Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
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16
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Diniz AFA, Ferreira RC, de Souza ILL, da Silva BA. Ionic Channels as Potential Therapeutic Targets for Erectile Dysfunction: A Review. Front Pharmacol 2020; 11:1120. [PMID: 32848741 PMCID: PMC7396897 DOI: 10.3389/fphar.2020.01120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/10/2020] [Indexed: 12/12/2022] Open
Abstract
Erectile dysfunction (ED) is a prevalent condition, especially in men over 40 years old, characterized by the inability to obtain and/or maintain penile erection sufficient for satisfactory sexual intercourse. Several psychological and/or organic factors are involved in the etiopathogenesis of ED. In this context, we gathered evidence of the involvement of Large-conductance, Ca2+-activated K+ channels (BKCa), Small-conductance, Ca2+-activated K+ channels (SKCa), KCNQ-encoded voltage-dependent K+ channels (KV7), Transient Receptor Potential channels (TRP), and Calcium-activated Chloride channels (CaCC) dysfunctions on ED. In addition, the use of modulating agents of these channels are involved in relaxation of the cavernous smooth muscle cell and, consequent penile erection, suggesting that these channels are promising therapeutic targets for the treatment of erectile dysfunction.
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Affiliation(s)
- Anderson Fellyp Avelino Diniz
- Programa de Pós-Graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Rafael Carlos Ferreira
- Programa de Pós-Graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Iara Leão Luna de Souza
- Departamento de Ciências Biológicas e da Saúde, Universidade Estadual de Roraima, Boa Vista, Brazil
| | - Bagnólia Araújo da Silva
- Programa de Pós-Graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil
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17
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Capogrosso P, Ventimiglia E, Boeri L, Cazzaniga W, Chierigo F, Pederzoli F, Frego N, Abbate C, Dehò F, Montorsi F, Salonia A. Age at First Presentation for Erectile Dysfunction: Analysis of Changes over a 12-yr Period. Eur Urol Focus 2019; 5:899-905. [DOI: 10.1016/j.euf.2018.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 01/29/2018] [Accepted: 02/20/2018] [Indexed: 01/05/2023]
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18
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Eren H, Horsanali MO. The independent association of non-alcoholic fatty liver disease with lower urinary tract symptoms/benign prostatic hyperplasia and erectile function scores. BJU Int 2019; 124:329-335. [DOI: 10.1111/bju.14753] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Huseyin Eren
- Department of Urology; Faculty of Medicine; Recep Tayyip Erdogan University; Rize Turkey
| | - Mustafa O. Horsanali
- Department of Urology; Faculty of Medicine; Recep Tayyip Erdogan University; Rize Turkey
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19
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Abstract
OBJECTIVES To evaluate the association between handgrip strength and erectile dysfunction (ED) in community-dwelling older men. METHODS This cross-sectional study included 1771 participants of the Dong-gu Study. Handgrip strength was measured with a handheld dynamometer. ED was assessed with the Korean version of the International Index of Erectile Function (IIEF). ED was categorized as none to mild (IIEF-EF scores of 13-30) and moderate to severe (IIEF-EF scores of 0-12). Multivariable logistic regression was conducted with adjustment for potential confounders. RESULTS The proportion of men with moderate to severe ED was 48.8%. The age-adjusted ED score increased with increasing quartile of handgrip strength (11.0, 12.4, 13.4, and 14.0 in the lowest, second, third, and highest quartiles, respectively). After adjustment for potential confounders, greater handgrip strength was associated with a lower risk of ED (odds ratio (OR): 0.82 per 5 kg; 95% confidence interval (CI): 0.74-0.90). In addition, a high level of moderate to vigorous physical activity was associated with a lower risk of ED (OR: 0.75; 95% CI: 0.61-0.93). CONCLUSION In this study, aging men with greater handgrip strength had a lower risk of ED. This result suggests that reduced physical functioning may contribute to ED.
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Affiliation(s)
- Ho Seok Chung
- a Department of Urology , Chonnam National University Medical School , Gwangju , Republic of Korea
| | - Min-Ho Shin
- b Department of Preventive Medicine , Chonnam National University Medical School , Gwangju , Republic of Korea
| | - Kwangsung Park
- a Department of Urology , Chonnam National University Medical School , Gwangju , Republic of Korea
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20
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Dimopoulou C, Goulis DG, Corona G, Maggi M. The complex association between metabolic syndrome and male hypogonadism. Metabolism 2018; 86:61-68. [PMID: 29656047 DOI: 10.1016/j.metabol.2018.03.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND The complex association between metabolic syndrome (MetS) and male hypogonadism is well established. A number of observational studies show that low testosterone is associated with insulin resistance and an increased risk for diabetes mellitus and MetS in men. AIMS To elucidate the association between MetS and male hypogonadism, present epidemiological data on the co-existence of the two comorbidities, enlighten the underlying pathophysiology and appraise the effects of testosterone supplementation therapy (TTh) and lifestyle modifications on MetS and body composition in men. MATERIALS AND METHODS Systematic search to PubMed and Medline databases for publications reporting data on association between MetS and male hypogonadism. RESULTS Both MetS and male hypogonadism have a high prevalence in the general population and are frequently co-existing e.g. in males with diabetes. Accumulating evidence from animal and human studies suggests that MetS is involved in the pathogenesis of hypogonadism in males as well as the other way around. On the other hand, there is evidence for a favorable effect of testosterone supplementation in testosterone deficient men with MetS and/or diabetes mellitus. CONCLUSIONS Studies with superior methodological characteristics are needed in order to establish a role for testosterone supplementation in men with MetS and/or diabetes mellitus.
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Affiliation(s)
- Christina Dimopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore Hospital, Bologna, Italy
| | - Mario Maggi
- Andrology and Sexual Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
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21
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Moon KH, Park SY, Kim YW. Obesity and Erectile Dysfunction: From Bench to Clinical Implication. World J Mens Health 2018; 37:138-147. [PMID: 30079640 PMCID: PMC6479091 DOI: 10.5534/wjmh.180026] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/17/2018] [Accepted: 05/23/2018] [Indexed: 12/25/2022] Open
Abstract
Obesity is a major public health issue worldwide and is frequently associated with erectile dysfunction (ED). Both conditions may share an internal pathologic environment, also known as common soil. Their main pathophysiologic processes are oxidative stress, inflammation, and resultant insulin and leptin resistance. Moreover, the severity of ED is correlated with comorbid medical conditions, including obesity. Therefore, amelioration of these comorbidities may increase the efficacy of ED treatment with phosphodiesterase 5 inhibitors, the first-line medication for patients with ED. Although metformin was originally developed as an insulin sensitizer six decades ago, it has also been shown to improve leptin resistance. In addition, metformin has been reported to reduce oxidative stress, inflammatory response, and body weight, as well as improve ED, in animal and human studies. Moreover, administration of a combination of metformin and phosphodiesterase 5 inhibitors improves erectile function in patients with ED who have a poor response to sildenafil and are insulin resistant. Thus, concomitant treatment of metabolic derangements associated with obesity in patients with ED who are obese would improve the efficacy and reduce the refractory response to penile vasodilators. In this review, we discuss the connecting factors between obesity and ED and the possible combined treatment modalities.
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Affiliation(s)
- Ki Hak Moon
- Department of Urology, Yeungnam University College of Medicine, Daegu, Korea
| | - So Young Park
- Department of Physiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Yong Woon Kim
- Department of Physiology, Yeungnam University College of Medicine, Daegu, Korea.
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22
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Yang YJ, Chien WC, Chung CH, Hong KT, Yu YL, Hueng DY, Chen YH, Ma HI, Chang HA, Kao YC, Yeh HW, Tzeng NS. Risk of Erectile Dysfunction After Traumatic Brain Injury: A Nationwide Population-Based Cohort study in Taiwan. Am J Mens Health 2018; 12:913-925. [PMID: 29325484 PMCID: PMC6131467 DOI: 10.1177/1557988317750970] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction: In our study, we aimed to investigate the association between a traumatic
brain injury (TBI) and subsequent erectile dysfunction (ED). This is a
population-based study using the claims dataset from The National Health
Insurance Research Database. Methods: We included 72,642 patients with TBI aged over 20 years, retrospectively,
selected from the longitudinal health insurance database during 2000–2010,
according to the ICD-9-CM. The control group consisted of 217,872 patients
without TBI that were randomly chosen from the database at a ratio of 1:3,
with age- and index year matched. Cox proportional hazards analysis was used
to estimate the association between the TBI and subsequent ED. Results: After a 10-year follow-up, the incidence rate of ED was higher in the TBI
patients when compared with the non-TBI control group (24.66 and 19.07 per
100,000, respectively). Patients with TBI had a higher risk of developing ED
than the non-TBI cohort after the adjustment of the confounding factors,
such as age, comorbidity, residence of urbanization and locations, seasons,
level of care, and insured premiums (adjusted hazard ratio (HR) = 2.569, 95%
CI [1.890, 3.492], p < .001). Conclusion: This is the first study using a comprehensive nationwide database to analyze
the association of ED and TBI in the Asian population. After adjusted the
confounding factors, patients with TBI have a significantly higher risk of
developing ED, especially organic ED, than the general population. This
finding might remind clinicians that it’s crucial in early identification
and treatment of ED in post-TBI patients.
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Affiliation(s)
- Yun-Ju Yang
- 1 Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- 2 Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,3 School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- 2 Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,3 School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,4 Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC
| | - Kun-Ting Hong
- 1 Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yi-Lin Yu
- 1 Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Dueng-Yuan Hueng
- 1 Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yuan-Hao Chen
- 1 Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hsin-I Ma
- 1 Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hsin-An Chang
- 5 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,6 Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yu-Chen Kao
- 5 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,7 Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hui-Wen Yeh
- 5 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,8 Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsin-Chu, Taiwan, ROC.,9 Department of Nursing, Tri-Service General Hospital, and School of Nursing, National Defense Medical Center, Taipei, Taiwan, ROC.,10 Department of Nursing, Kang Ning University (Taipei Campus), Taipei, Taiwan, ROC
| | - Nian-Sheng Tzeng
- 5 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,6 Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC
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Guo H, Gao X, Ma R, Liu J, Ding Y, Zhang M, Zhang J, Mu L, He J, Yan Y, Ma J, Guo S, Wei S. Prevalence of Metabolic Syndrome and its Associated Factors among Multi-ethnic Adults in Rural Areas in Xinjiang, China. Sci Rep 2017; 7:17643. [PMID: 29247195 PMCID: PMC5732195 DOI: 10.1038/s41598-017-17870-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/01/2017] [Indexed: 11/09/2022] Open
Abstract
Metabolic syndrome (MetS) has become a global public health problem affecting all nations and races. Few studies on the epidemic of metabolic syndrome (MetS) examined multi-ethnic adults in rural areas in Xinjiang, China. We thus investigated the prevalence and risk factors of MetS there. A cross-sectional study was performed in a representative sample of 15020 rural multi-ethnic adults from 2009 to 2010. Four widely used criteria (ATPIII\IDF\JIS\CDS) were used to measure the prevalence of MetS. Multiple logistic regression analysis was used to explore the risk factors of MetS. The age-adjusted prevalence of MetS was 14.43%, 21.33%, 26.50%, and 19.89% based on the ATP III, IDF, JIS and CDS criterion, respectively. The prevalence of MetS was higher in women and increased with age. According to JIS criterion, the prevalence of components in MetS was 57.75% for abdominal obesity, 44.05% for elevated blood pressure, 40.98% for reduced HDL-cholesterol, 23.33% for elevated triglycerides, 18.95% for raised fasting plasma glucose. Lower consumption of vegetables, milk, and higher consumption of red meat were associated with higher likelihood of having MetS. The prevalence of MetS in Xinjiang rural multi-ethnic adults was high. Diet factors were associated with the prevalence of MetS.
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Affiliation(s)
- Heng Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University 109 Chandlee Lab, University Park, PA, 16801, USA
| | - Rulin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jiaming Liu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Yusong Ding
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Mei Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jingyu Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Lati Mu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Yizhong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jiaolong Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Shuxia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China.
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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Metabolic syndrome in rats is associated with erectile dysfunction by impairing PI3K/Akt/eNOS activity. Sci Rep 2017; 7:13464. [PMID: 29044143 PMCID: PMC5647376 DOI: 10.1038/s41598-017-12907-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 09/12/2017] [Indexed: 12/04/2022] Open
Abstract
Metabolic syndrome (MetS) is a risk factor for erectile dysfunction (ED), but the underlying mechanisms are unclear. The aims of this study were to determine the underlying mechanisms of metabolic syndrome-related ED (MED). Sprague Dawley (SD) rats were fed a high-fat diet for 6 months, and metabolic parameters were then assessed. An apomorphine test was conducted to confirm MED. Only rats with MED were administered an intracavernosal injection of either epidermal growth factor (EGF) or vehicle for 4 weeks. Erectile responses were evaluated by determining the mean arterial blood pressure (MAP) and intracavernosal pressure (ICP). Levels of protein expression were examined by western blotting and immunohistochemistry. Body weight, fasting blood glucose, plasma insulin and plasma total cholesterol were increased in the MetS rats compared with those in control rats (each p < 0.05). The maximum ICP/MAP, total ICP/MAP and concentration of cyclic guanosine mono-phosphate (cGMP) were significantly decreased in MED rats (each p < 0.05). The expression levels of p110α, p-Akt1 (Tyr308)/Akt1 and p-eNOS (Ser1177)/eNOS were reduced in MED rats (each p < 0.05). Activation of the PI3K/Akt/eNOS signaling cascade (intracavernosal injection of EGF) reversed these changes (each p < 0.05). The present study demonstrates that downregulation of the PI3K/Akt/eNOS signaling pathway is involved in MED.
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Dayar E, Kara E, Yetik-Anacak G, Hocaoglu N, Bozkurt O, Gidener S, Durmus N. Do penile haemodynamics change in the presence of hydrogen sulphide (H2S) donor in metabolic syndrome-induced erectile dysfunction? Andrologia 2017; 50. [DOI: 10.1111/and.12885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 12/30/2022] Open
Affiliation(s)
- E. Dayar
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - E. Kara
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - G. Yetik-Anacak
- Department of Pharmacology; Faculty of Medicine; Ege University; Izmir Turkey
| | - N. Hocaoglu
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - O. Bozkurt
- Department of Urology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - S. Gidener
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - N. Durmus
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
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26
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Medical treatment of erectile dysfunction: too many medical prescriptions? Urologia 2017; 84:121-129. [PMID: 28708203 DOI: 10.5301/uj.5000250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 12/21/2022]
Abstract
Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs). However, available data on treatment-utilization patterns and medical prescriptions of PDE5is showed a range of as wide as 22-78% of patients reporting to purchase PDE5is even without a proper medical prescription. Moreover, an increase in the recreational use of PDE5is among young men has been observed in the last decades, with a worrisome diffusion of potential health-risky behaviours associated with this habit. Indeed, treatment of ED should carefully follow internationally based clinical guidelines to avoid inappropriate drug prescriptions, which may eventually expose treated patients to drug-related side effects. Thereof, a careful assessment of the so-called modifiable and reversible ED risk factors along with a patient-tailored screening for potential contraindications to the treatment itself should be performed in every case. Lastly, although conclusive data still lack, the potential association between life-risky PDE5is side effects (i.e. cardiovascular adverse events, melanoma skin cancer and worsening of prostate cancer outcomes) should be carefully taken into account when counselling patients for ED treatment.
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De Nunzio C, Lombardo R, Gacci M, Nacchia A, Presicce F, Alkhatatbeh H, Serni S, Tubaro A. Metabolic Syndrome Does Not Increase the Risk of Ejaculatory Dysfunction in Patients With Lower Urinary Tract Symptoms and Benign Prostatic Enlargement: An Italian Single-center Cohort Study. Urology 2017; 105:85-90. [DOI: 10.1016/j.urology.2017.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/21/2017] [Accepted: 04/05/2017] [Indexed: 01/02/2023]
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Hasanain AFA, Mahdy RE, Mahran AMAR, Safwat ASM, Mohamed AO, Abdel-Aal SM. Erectile dysfunction in patients with nonalcoholic fatty liver disease. Arab J Gastroenterol 2017; 18:21-24. [PMID: 28325476 DOI: 10.1016/j.ajg.2017.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 07/17/2016] [Accepted: 12/20/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS There is a lack of studies on erectile dysfunction (ED) in patients diagnosed with nonalcoholic fatty liver disease (NAFLD). The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients. PATIENTS AND METHODS We conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide. RESULTS The mean age of the study population was 42.4±7.7years (79.1%≥40years). Of the 192 patients with NAFLD, 88 (45.8%) had ED, 28 (14.6%) had metabolic syndrome, 25 (13%) had type-2 diabetes mellitus (DM), and 131 (68.2%) had insulin resistance (IR). The mean level of serum testosterone was 3.17±2.94ng/mL, while the mean insulin resistance index was 2.9±1.7. Mild ED (38.6%) was the most frequent grade of ED. Age≥40years (odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7-24.1; p- 0.006), IR (OR 5.9; 95% CI 1.7-20.6; p- 0.005), and low serum testosterone (OR 5.1; 95% CI 1.5-17.1; p- 0.009) were the predictors of ED. CONCLUSIONS ED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis.
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Affiliation(s)
| | - Reem Ezzat Mahdy
- Department of Internal Medicine (Gastroenterology Unit), Faculty of Medicine, Assiut University, Egypt
| | | | | | - Asmaa Omar Mohamed
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt
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Sexual Dysfunction in Type 2 Diabetes at Diagnosis: Progression over Time and Drug and Non-Drug Correlated Factors. PLoS One 2016; 11:e0157915. [PMID: 27706160 PMCID: PMC5051725 DOI: 10.1371/journal.pone.0157915] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 06/07/2016] [Indexed: 01/10/2023] Open
Abstract
Aims To present the longitudinal data of the SUBITO-DE study, a prospective survey involving male patients with new or recently diagnosed type 2 diabetes mellitus (T2DM) (<24 months). Materials and Methods Sexual function was assessed in male patients with T2DM at baseline (phase 1) and after a mean follow-up of 18 months (phase 2). Standard metabolic parameters and sexual and depressive symptoms were evaluated. Results Six of the 499 enrolled patients died of different causes during phase 1. Of the 493 surviving men invited to participate in phase 2, 450 (mean age 59.0±9.0 years) (90.2%) accepted and 43 (8.2%) were lost to follow-up. As compared to baseline, the proportion of the men who reported improvement in erectile dysfunction (ED) at follow-up was nearly double that of the men who reported worsening of ED (22.6% vs. 12.8%). The increase in frequency of sexual activity the men reported at follow-up assessment indicates that many never treated before baseline were taking an ED drug during the study period (106 subjects). Phosphodiesterase type 5 inhibitors (PDE5i) were the ED drugs most commonly taken at both baseline and follow-up. An overall improvement over baseline values was observed in metabolic targets for T2DM and depressive symptoms. Conversely, no change in lifestyle behaviors was recorded during the study. Conclusions Sexual dysfunction is a major concern in men with T2DM. The SUBITO-DE study demonstrates that, when combined with adequate counseling and tailored PDE5i therapy, an integrated approach to achieving metabolic targets in men with T2DM can improve sexual function as well as depressive symptoms.
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Shabsigh R, Mattern A. REVITALISE: A Large Observational Study Assessing the Safety and Effectiveness of Vardenafil in Men With Erectile Dysfunction and Metabolic Syndrome. Sex Med 2016; 4:e135-44. [PMID: 27151768 PMCID: PMC5005302 DOI: 10.1016/j.esxm.2016.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/24/2016] [Accepted: 03/15/2016] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is prevalent in men with metabolic syndrome (MetS); therefore, it is important to characterize ED treatments in this population. AIMS To investigate the safety and effectiveness of vardenafil in men with ED and MetS in a clinical setting. METHODS REVITALISE is an international, prospective, single-arm, observational study in men with ED and MetS newly prescribed vardenafil. Vardenafil was prescribed at the discretion of the treating physician in line with the marketing authorization. Treatment effectiveness (International Index of Erectile Function [IIEF]) and health-related quality of life (Aging Males' Symptoms Scale) were assessed at treatment initiation, at an optional dose adjustment visit after approximately 4 weeks, and at the end of the observation period (approximately 12 weeks). MAIN OUTCOME MEASURES The primary outcome was an intraindividual improvement in erectile function (EF), defined as an increase of at least four points in the EF domain of the IIEF. Secondary outcomes included assessing normal EF (IIEF-EF score ≥ 26), mild ED (IIEF-EF score = 22-25), and health-related quality of life. Treatment-emergent adverse events were monitored. RESULTS In the intent-to-treat population (n = 1,832, mean age = 54.0 years, mean body mass index = 31.82 kg/m(2), Asian 36.8%, white 49.9%, 20.4% with severe ED, 75.6% with mild or moderate ED, 4.0% without ED), 82.4% reported an increase of at least four points in IIEF-EF score. Median IIEF-EF score increased from 15.0 (baseline) to 25.0 at 12 weeks (P < .0001). After treatment, 45.4% and 29.4% (intent-to-treat population) had normal EF and mild ED, respectively. Improvements in the sexual, psychological, and somatic subscales of the Aging Males' Symptoms Scale were found (P < .0001). Treatment-emergent adverse events were reported by 7.19% of patients; there were no serious adverse events related to vardenafil. CONCLUSION In a clinical setting, men with ED and MetS treated with vardenafil reported improvements in EF and health-related quality of life; and the safety profile of vardenafil was acceptable. REVITALISE demonstrates that vardenafil represents a good treatment option for men with ED and MetS.
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Affiliation(s)
- Ridwan Shabsigh
- Chairman, Department of Surgery, SBH Health System, Bronx, NY; Professor of Clinical Urology, Cornell University, Ithaca, NY, USA.
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DeLay KJ, Haney N, Hellstrom WJ. Modifying Risk Factors in the Management of Erectile Dysfunction: A Review. World J Mens Health 2016; 34:89-100. [PMID: 27574592 PMCID: PMC4999494 DOI: 10.5534/wjmh.2016.34.2.89] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 12/16/2022] Open
Abstract
Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process.
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Affiliation(s)
- Kenneth J DeLay
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nora Haney
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Wayne Jg Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Abstract
MicroRNAs (miRNAs) are highly conserved, small, 18-25 nucleotide, non-coding RNAs that regulate gene expression at the post-transcriptional level. Each miRNA can regulate hundreds of target genes, and vice versa each target gene can be regulated by numerous miRNAs, suggesting a very complex network and explaining how miRNAs play pivotal roles in fine-tuning essentially all biological processes in all cell types in the liver. Here, we summarize the current knowledge on the role of miRNAs in the pathogenesis and diagnosis of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) with an outlook to the broader aspects of metabolic syndrome. Furthermore, we discuss the role of miRNAs as potential biomarkers and therapeutic targets in NAFLD/NASH.
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Affiliation(s)
- Gyongyi Szabo
- Department of Medicine, University of Massachusetts Medical School, LRB215, 364 Plantation Street, Worcester, MA, 01605, USA.
| | - Timea Csak
- Department of Medicine, University of Massachusetts Medical School, LRB215, 364 Plantation Street, Worcester, MA, 01605, USA
- Brookdale University Hospital and Medical Center, 1 Brookdale Plaza, Brooklyn, NY, 11212, USA
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Jepps TA, Olesen SP, Greenwood IA, Dalsgaard T. Molecular and functional characterization of Kv 7 channels in penile arteries and corpus cavernosum of healthy and metabolic syndrome rats. Br J Pharmacol 2016; 173:1478-90. [PMID: 26802314 DOI: 10.1111/bph.13444] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND PURPOSE KCNQ-encoded voltage-dependent potassium channels (Kv 7) are involved in the regulation of vascular tone. In this study we evaluated the influence of Kv 7 channel activation on smooth muscle relaxation in rat penile arteries and corpus cavernosum from normal and spontaneously hypertensive, heart failure-prone (SHHF) rats - a rat model of human metabolic syndrome. EXPERIMENTAL APPROACH Quantitative PCR and immunohistochemistry were used to determine the expression of KCNQ isoforms in penile tissue. Isometric tension was measured in intracavernous arterial rings and corpus cavernosum strips isolated from normal and SHHF rats. KEY RESULTS Transcripts for KCNQ3, KCNQ4 and KCNQ5 were detected in penile arteries and corpus cavernosum. KCNQ1 was only found in corpus cavernosum. Immunofluorescence signals to Kv 7.4 and Kv 7.5 were found in penile arteries, penile veins and corpus cavernosum. The Kv 7.2-7.5 activators, ML213 and BMS204352, relaxed pre-contracted penile arteries and corpus cavernosum independently of nitric oxide synthase or endothelium-derived hyperpolarization. Relaxations to sildenafil, a PDE5 inhibitor, and sodium nitroprusside (SNP), an nitric oxide donor, were reduced by blocking Kv 7 channels with linopirdine in penile arteries and corpus cavernosum. In SHHF rat penile arteries and corpus cavernosum, relaxations to ML213 and BMS204352 were attenuated, and the blocking effect of linopirdine on sildenafil-induced and SNP-induced relaxations reduced. KCNQ3, KCNQ4 and KCNQ5 were down-regulated, and KCNQ1 was up-regulated in corpus cavernosum from SHHF rats. KCNQ1-5 transcripts remained unchanged in penile arteries from SHHF rats. CONCLUSIONS AND IMPLICATIONS These data suggest that Kv 7 channels play a role in erectile function and contribute to the pathophysiology of erectile dysfunction, an early indicator of cardiovascular disease.
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Affiliation(s)
- T A Jepps
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S P Olesen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I A Greenwood
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,The Vascular Biology Research Centre, Institute of Cardiovascular and Cell Sciences, St George's, London, UK
| | - T Dalsgaard
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Guo H, Liu J, Zhang J, Ma R, Ding Y, Zhang M, He J, Xu S, Li S, Yan Y, Mu L, Rui D, Niu Q, Guo S. The Prevalence of Metabolic Syndrome Using Three Different Diagnostic Criteria among Low Earning Nomadic Kazakhs in the Far Northwest of China: New Cut-Off Points of Waist Circumference to Diagnose MetS and Its Implications. PLoS One 2016; 11:e0148976. [PMID: 26901035 PMCID: PMC4763161 DOI: 10.1371/journal.pone.0148976] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 01/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background Although the epidemic of metabolic syndrome (MetS) has aroused wide public concern, most studies on MetS tend to examine urban and high income settings, and few studies cover nomadic areas and low earning populations. This research aims to investigate the prevalence of MetS and explore the cut-off point of waist circumference in a nomadic minority typical of low income populations in the remote northwest region of China. Methods A cross-sectional study was performed in a representative sample of 3900 Kazakh adults aged 18–84 years from 2009–2010. Three widely used criteria (ATP III\IDF\JIS) were employed to estimate the prevalence of MetS in Kazakhs to compare them with other populations. Receiver operator characteristic (ROC) curve analysis was used to explore the optimal cut-off values of waist circumference. Results The age-adjusted prevalence of MetS was 13.8%, 20.9%, and 24.8% based on the ATP III, IDF, and JIS criteria, respectively. The prevalence of MetS was higher in women and increased with age. Except for reduced HDL-cholesterol, the risk of other components of MetS increased with waist circumference enlargement. The cut-off point of waist circumference in screening at least two other components of MetS was 88 cm in men (Sensitivity = 61.1%, Specificity = 62.1%, ROC Curve Distance = 0.54) and 83 cm in women (Sensitivity = 60.0%, Specificity = 59.6%, ROC Curve Distance = 0.57). Conclusion The prevalence of MetS in Kazakhs is higher than the national level of China and falls in between the Euro-American and Asia levels, as their cut-off points of waist circumference differ from that recommended for Chinese. We suggest a cost-effective strategy to screen for MetS and prevent cardiovascular disease using new cut-off points of waist circumference in low earning nomadic Kazakhs.
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Affiliation(s)
- Heng Guo
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Jiaming Liu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Jingyu Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Rulin Ma
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Yusong Ding
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Mei Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Jia He
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Shangzhi Xu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Shugang Li
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Yizhong Yan
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Lati Mu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Dongsheng Rui
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Qiang Niu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Shuxia Guo
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
- * E-mail:
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Barbalho SM, Bechara MD, Quesada K, Gabaldi MR, Goulart RDA, Tofano RJ, Gasparini RG. Síndrome metabólica, aterosclerose e inflamação: tríade indissociável? J Vasc Bras 2015. [DOI: 10.1590/1677-5449.04315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Observa-se, nas populações mundiais, aumento do sedentarismo e aumento do consumo de gorduras e açúcares, sendo estes vinculados normalmente aos alimentos industrializados. A consequência disso rapidamente se manifestou no aumento do sobrepeso/obesidade e na instalação de alterações fisiológicas e metabólicas, como a Síndrome Metabólica, que é representada por alterações na glicemia, nos lipídeos e na pressão arterial. Há evidências de ligação estreita entre estas alterações e os processos inflamatórios, que também podem estar associados ao estresse oxidativo. Estas condições levam à patogênese das alterações vasculares ou intensificam os processos metabólicos que acompanham a Síndrome Metabólica. O objetivo desta revisão foi comparar as inúmeras referências literárias que mostram correlação entre os componentes da Síndrome Metabólica e o aumento dos mediadores de inflamação. Para isso, utilizou-se Pubmed, Scopus, Lilacs e Scielo como base de dados, sendo que os artigos selecionados dataram principalmente dos últimos cinco anos.
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Affiliation(s)
- Sandra Maria Barbalho
- Universidade de Marília, Brasil; Faculdade de Tecnologia de Alimentos de Marília, Brasil
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Defeudis G, Gianfrilli D, Di Emidio C, Pofi R, Tuccinardi D, Palermo A, Lenzi A, Pozzilli P. Erectile dysfunction and its management in patients with diabetes mellitus. Rev Endocr Metab Disord 2015; 16:10.1007/s11154-015-9321-4. [PMID: 26497842 DOI: 10.1007/s11154-015-9321-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diabetes can be described as a syndrome of multiple closely related conditions induced by a chronic state of hyperglycaemia resulting from defective insulin secretion, insulin action or both. Chronic complications associated with diabetes (including neuropathy, vascular disease, nephropathy and retinopathy) are common, and of these, erectile dysfunction (ED) deserves special attention. ED and its correlation with cardiovascular disease require careful evaluation and appropriate treatment. PDE5 inhibitors (PDE5is) are an important tool for the treatment of ED, with new drugs coming onto the market since the late 90s. This review offers an overview of PDE5is and their use in treating ED in diabetes. We underline the differences between different types of PDE5i, focusing on available doses, duration of action, T ½, side effects and selectivity profiles in relation to patients with diabetes. We also discuss the link between diabetes and ED in presence of various associated cofactors (obesity, hypertension and its pharmacological treatments, atherosclerosis, hyperhomocysteinaemia, neuropathy, nephropathy, hypogonadism and depression). Finally a number of past and ongoing clinical trials on the use of PDE5is in patients with diabetes are presented to offer an overview of the appropriate treatment of ED in this condition.
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Affiliation(s)
- Giuseppe Defeudis
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Chiara Di Emidio
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
| | - Riccardo Pofi
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Dario Tuccinardi
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
| | - Andrea Palermo
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy.
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Rosenblatt A, Faintuch J, Cecconello I. Abnormalities of Reproductive Function in Male Obesity Before and After Bariatric Surgery—A Comprehensive Review. Obes Surg 2015; 25:1281-92. [DOI: 10.1007/s11695-015-1663-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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