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Iqhrammullah M, Gusti N, Andika FF, Abdullah A. Association of serum vitamin D and the risk of cardiovascular diseases among diabetic patients: A systematic review and meta-analysis. Clin Nutr ESPEN 2024; 62:66-75. [PMID: 38901950 DOI: 10.1016/j.clnesp.2024.04.018] [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: 09/23/2023] [Revised: 03/27/2024] [Accepted: 04/22/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The emerging role of vitamin D has drawn the attention of researchers around the world, including its involvement in cardiovascular complications among individuals with diabetes. AIM This study aimed to obtain comprehensive evidence on the association between serum vitamin D level and the risk of cardiovascular disease among patients with diabetes. METHODS Systematic search was performed on July 1st, 2023, to identify and screen published literature reporting the association between vitamin D and cardiovascular disease among diabetic patients in six databases. Each eligible study was appraised for its quality using modified Newcastle Ottawa Scale for cross-sectional and cohort studies. Meta-analysis was performed using Dersimonian-Laird random effect model or fix-effect model. The heterogeneity and publication bias were judged based on percentage of I2 and the symmetry of Begg's funnel plot, respectively. RESULTS As many as 22 studies were found eligible for the systematic review. A meta-analysis from 13 studies comprising of 3850 and 1797 (control and exposure groups, respectively) revealed that serum vitamin D level was significantly lower in patients with diabetes and cardiovascular diseases (Z = 4.89; p-total<0.001; SMD = 0.68 [95%CI: 0.41-0.95]), yet the heterogeneity was high. Following the adjustment of removing the potential outliers, the same results were still observed (Z = 6.19; p-total<0.001; SMD = 0.35 [95%CI: 0.24-0.46]). Though decreased, high heterogeneity could not be resolved, resulting in moderate level of this evidence. Another pooled analysis of 7 studies with 4211 patients in control group and 2381 patients in exposure group revealed that lower level of serum vitamin D is a risk factor for cardiovascular disease incidence among diabetic patients (Z = 4.89; p-total<0.001; OR: 1.76 [95%CI: 1.4-2.2]). CONCLUSION Serum vitamin D level status is a risk factor for developing cardiovascular diseases among diabetic patients, hence should be carefully monitored and maintained. PROSPERO REGISTRATION CRD42023437698.
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Affiliation(s)
- Muhammad Iqhrammullah
- Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia; Faculty of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia.
| | - Naufal Gusti
- Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia; Faculty of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia.
| | - Fina Fitria Andika
- Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia; Faculty of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia.
| | - Asnawi Abdullah
- Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia; Faculty of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia.
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Taloyan M, Hjörleifdottir Steiner K, Östenson CG, Salminen H. Association between sexual dysfunction and vitamin D in Swedish primary health care patients born in the Middle East and Sweden. Sci Rep 2024; 14:594. [PMID: 38182624 PMCID: PMC10770125 DOI: 10.1038/s41598-023-50494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
The present study investigated primary care patients and compared self-reported sexual health in Swedes and Middle Easterners; analysed differences within and between the groups and analysed differences in 25-hydroxyvitamin D [25(OH)D] levels between the groups. 522 patients responded to a health questionnaire that included items on sexual health: 225 Middle Easterners from Iran, Iraq, and Turkey and 297 Swedes. Logistic regression was used to calculate the odds ratio (OR). Middle Easterners reported less sexual dysfunction than Swedes, and 75.8% of them and 18.9% of Swedes presented a 25(OH)D of < 50 nmol/L. The crude OR for reporting sexual dysfunction was 70% higher in Swedes compared to Middle Easterners (OR 1.70, 95% CI 1.15-2.50). This OR remained significant after adjustment for age, gender, waist circumference, and reported sexual desire. However, the significance disappeared after additional adjustment for 25(OH)D. In both groups, more females than males reported insufficient sexual desire. More female Middle Easterners reported sex life dissatisfaction. More female Swedes reported sexual dysfunction. Vitamin D could explain an association between gender and sex life dissatisfaction in Middle Easterners, and age could explain an association between gender and sexual dysfunction in Swedes. Age, waist circumference, and 25(OH)D levels were significant covariates in the logistic regression models. Results from the present study suggest that 25(OH)D variation partly explains differences in sexual dysfunction between the groups and between genders within the groups. Vitamin D therapy should be investigated to determine if these results are clinically useful.
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Affiliation(s)
- Marina Taloyan
- Division of Family Medicine and Primary Care, Department of Neurobiology, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Alfred Nobels allé 23, 14183, Stockholm, Sweden.
- Academic Primary Health Care Centre, Region Stockholm, Box 45436, SE-104 31, Stockholm, Sweden.
| | - Kristin Hjörleifdottir Steiner
- Division of Family Medicine and Primary Care, Department of Neurobiology, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Alfred Nobels allé 23, 14183, Stockholm, Sweden
| | - Claes-Göran Östenson
- Endocrine and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Helena Salminen
- Division of Family Medicine and Primary Care, Department of Neurobiology, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Alfred Nobels allé 23, 14183, Stockholm, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Box 45436, SE-104 31, Stockholm, Sweden
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Corona G, Cucinotta D, Di Lorenzo G, Ferlin A, Giagulli VA, Gnessi L, Isidori AM, Maiorino MI, Miserendino P, Murrone A, Pivonello R, Rochira V, Sangiorgi GM, Stagno G, Foresta C, Lenzi A, Maggi M, Jannini EA. The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction. J Endocrinol Invest 2023; 46:1241-1274. [PMID: 36698034 PMCID: PMC9876440 DOI: 10.1007/s40618-023-02015-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE Erectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized. METHODS The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. RESULTS Several evidence-based statements were released providing the necessary up-to-date guidance in the context of ED with organic and psychosexual comorbidities. Many of them were related to incorrect lifestyle habits suggesting how to associate pharmacotherapies and counseling, in a couple-centered approach. Having the oral therapy with phosphodiesterase type 5 inhibitors as the gold standard along with several other medical and surgical therapies, new therapeutic or controversial options were also discussed. CONCLUSIONS These are the first guidelines based on a multidisciplinary approach that involves the most important Societies related to the field of sexual medicine. This fruitful discussion allowed for a general agreement on several recommendations and suggestions to be reached, which can support all stakeholders in improving couple sexual satisfaction and overall general health.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
| | - D Cucinotta
- Chair of Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Di Lorenzo
- Section of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - V A Giagulli
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "Aldo Moro", Bari, Italy
- Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - L Gnessi
- Section of Food Science, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Section of Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M I Maiorino
- Division of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - P Miserendino
- Diabetology and Endocrinology Unit, ASP #, Caltanissetta, Italy
| | - A Murrone
- Cardiology Unit, Città di Castello and Gubbio-GualdoTadino Hospitals, Azienda Usl Umbria 1, Gubbio, Italy
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- Staff of UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - V Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G M Sangiorgi
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - G Stagno
- Diabetology Unit, ASP Reggio Calabria, Reggio Calabria, Italy
| | - C Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - A Lenzi
- Section of Food Science, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - E A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, E Tower South Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy.
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Crafa A, Cannarella R, Barbagallo F, Leanza C, Palazzolo R, Flores HA, La Vignera S, Condorelli RA, Calogero AE. Mechanisms Suggesting a Relationship between Vitamin D and Erectile Dysfunction: An Overview. Biomolecules 2023; 13:930. [PMID: 37371510 DOI: 10.3390/biom13060930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Vitamin D deficiency (VDD) and erectile dysfunction (ED) heavily burden the male population. The higher prevalence of both conditions in the elderly suggests a possible relationship between the two conditions. In addition, in vitro, animal, and human studies have revealed several mechanisms that may relate VDD to ED. The main mechanism by which vitamin D might exert its action on sexual function appears to be through the regulation of endothelial function. Indeed, VDD correlates with several markers of endothelial function. The action of vitamin D on the endothelium would be exercised both indirectly through its intervention in inflammatory processes and through the production of oxygen free radicals, and directly through the regulation of vascular stiffness, the production of nitric oxide, and the regulation of vessel permeability. Furthermore, the ubiquitous distribution of the vitamin D receptor in the human body means that this hormone can also exert a beneficial effect on erectile function by interfering with those comorbidities significantly associated with ED, such as hypertension, diabetes mellitus, hypercholesterolemia, chronic kidney disease, and hypogonadism. In this review, we thoroughly and carefully presented the evidence and mechanisms that would appear to relate vitamin D levels to erectile function. Furthermore, we have summarized the meta-analytic evidence for and against this association to provide a true representation of this topic. Data published to date suggest that low levels of vitamin D could contribute to worsening erectile function through several mechanisms. Therefore, vitamin D levels should be measured in patients with ED and maintained at adequate levels by specific supplementation in case of deficiency. However, the low quality and heterogeneity of clinical trials evaluating the effects of vitamin D administration on erectile function and ED-associated comorbidities do not allow for a univocal conclusion, and indicate the need for further studies to analyze these aspects.
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Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Claudia Leanza
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Roberto Palazzolo
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Hunter Ausley Flores
- Scott Department of Urology, Baylor College of Medicine in Houston, Houston, TX 77030, USA
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
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Wu X, Zhang Y, Zhang W, Liu G, Jiang H, Huang H, Zhang X. The relationship between serum 25‐hydroxy vitamin D and arteriogenic erectile dysfunction. Andrologia 2022; 54:e14568. [DOI: 10.1111/and.14568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Xu Wu
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Yuyang Zhang
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Wei Zhang
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Guodong Liu
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
| | - Hui Jiang
- Department of Urology Peking University First Hospital Beijing China
| | - Houbao Huang
- Department of Urology The first Affiliated Hospital of Wannan Medical College Wuhu China
| | - Xiansheng Zhang
- Department of Urology the First Affiliated Hospital of Anhui Medical University Anhui China
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