Research Article
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Could High-Density Lipoprotein (HDL) Alone be a Predictive Biomarker for Patients with Erectile Dysfunction?

Year 2024, , 1 - 10, 28.03.2024
https://doi.org/10.58770/joinihp.1435248

Abstract

This study aimed to assess High-Density Lipoprotein (HDL) levels as a predictor of ED in 105 men aged 20-60, to determine whether HDL levels alone could indicate Erectile Dysfunction (ED) risk independently of other factors. Despite the numerous cardiovascular risk factors associated with ED, this study uniquely focused on the predictive value of HDL levels, aiming to highlight its standalone significance in ED risk assessment. The study analyzed the interaction of HDL levels with variables such as BMI and smoking status to improve understanding of lipid profiles in assessing and managing ED Logistic regression was conducted to assess the link between low HDL levels (<40 mg/dL) and ED, while adjusting for confounding factors like age, BMI, smoking, and hypertension. The ROC curve analysis determined the optimal cutoff point for predicting ED using HDL levels. Patients with ED had significantly lower mean high-density lipoprotein (HDL) levels at 32.0 ± 10.9 mg/dL compared to the normal population’s 48.3 ± 12.1 mg/dL (p = 0.043). In the ED group, 66.67% of patients had HDL levels below 40 mg/dL, which was higher than the 41.39% observed in the normal population (p = 0.023). Additionally, the ED population had a higher mean BMI of 27.4 ± 4.6 kg/m² compared to 24.0 ± 5.2 kg/m² in the normal population (p = 0.011). Smoking was also more prevalent among ED patients, with 53.33% being current smokers compared to 35.23% in the normal population (p = 0.037). Subgroup analyses revealed an interaction between low HDL and smoking (B = 0.45, β = 0.30, p = 0.001), as well as between low HDL and BMI (B = 0.50, β = 0.35, p = 0.001), indicating that these combinations exacerbated ED risk more than any individual factor. Our research suggests that HDL could function as a useful predictive biomarker for ED. Clinicians should consider evaluating the HDL levels of patients with ED and potentially managing low HDL levels to alleviate ED symptoms.

Ethical Statement

This study was approved by the Ethics Institution of Gazi Yaşargil Training and Research Hospital (dated 30.09.2022 and numbered 190).

References

  • [1] C. Eaton, Y. Liu, M. Mittleman, M. Miner, D. Glasser, E.B. Rimm. "A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men," International journal of impotence research, vol. 19, no. 2, pp. 218-25, 2007.
  • [2] M. Li, Z. Ma, X.L. Zhang, L.Q. Guo, M.Z Yuan. "Significance of blood lipid parameters as effective markers for arteriogenic erectile dysfunction," Andrology, vol. 8, no. 5, pp. 1086-94, 2020.
  • [3] M.G. Culha, L. Canat, R.B. Degirmentepe, A.T. Albayrak, H.A. Atalay, E. Merder, et al. "The correlation between atherogenic indexes and erectile dysfunction," The Aging Male, vol. 23, no. 5, pp. 1232-6, 2020.
  • [4] Z. Liao, Y. Tang, X. Li, D. Li. "The relationship between hematologic parameters and erectile dysfunction," Sexual Medicine. vol. 9, no. 4, pp. 100401, 2021.
  • [5] E. Ermis, S. Ozbay Ozyilmaz, E. Salabas, C. Senol, M. Cengiz, S. Allahverdiyev, H. Ucar. "The relationship between erectile dysfunction and the Atherogenic Index of Plasma," International Journal of Impotence Research, vol. 32, no. 4, pp. 462-8, 2020.
  • [6] M. Sambel, A. Erdogan, V. Caglayan, S. Avci, S. Kilic, H.E. Yildiz, E. Keskin. "Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction?" Sexual Medicine, vol. 11, no. 6, pp. qfad069, 2023.
  • [7] J. Kovac, C. Labbate, R. Ramasamy, D. Tang, L. Lipshultz. "Effects of cigarette smoking on erectile dysfunction," Andrologia, vol. 47, no. 10, pp. 1087-92, 2015.
  • [8] B. Zhao, Z. Hong, Y. Wei, D. Yu, J. Xu, W. Zhang. "Erectile dysfunction predicts cardiovascular events as an independent risk factor: a systematic review and meta-analysis," Journal of Sexual Medicine, vol. 16, no. 7, pp. 1005-17, 2019.
  • [9] W. Guo, C. Liao, Y. Zou, F. Li, T. Li, Q. Zhou, et al. "Erectile dysfunction and risk of clinical cardiovascular events: a meta-analysis of seven cohort studies," Journal of Sexual Medicine, vol. 7, no. 8, pp. 2805-16, 2010.
  • [10] G. Gandaglia, A. Briganti, G. Jackson, R.A. Kloner, F. Montorsi, P. Montorsi, C. Vlachopoulos." A systematic review of the association between erectile dysfunction and cardiovascular disease," European urology, vol. 65, no. 5, pp. 968-78, 2014.
  • [11] H. Besiroglu, A. Otunctemur, E. Ozbek. "The relationship between metabolic syndrome, its components, and erectile dysfunction: a systematic review and a meta-analysis of observational studies," Journal of Sexual Medicine, vol. 12, no. 6, pp. 1309-18, 2015.

Yüksek Yoğunluklu Lipoprotein (HDL) Tek Başına Ereksiyon Bozukluğu Olan Hastalar İçin Bir Öngörücü Belirteç Olabilir mi?

Year 2024, , 1 - 10, 28.03.2024
https://doi.org/10.58770/joinihp.1435248

Abstract

Bu çalışma, 20-60 yaş arası 105 erkekte erektil disfonksiyonun (ED) bir öngörücüsü olarak High-Density Lipoprotein (HDL) düzeylerini değerlendirmeyi ve HDL düzeylerinin tek başına diğer faktörlerden bağımsız olarak ED riskini gösterebileceğini belirlemeyi amaçlamıştır. ED ile ilişkili birçok kardiyovasküler risk faktörüne rağmen, bu çalışma özellikle HDL seviyelerinin öngörü değerine odaklanmakta ve ED risk değerlendirmesindeki bağımsız önemini vurgulamayı amaçlamaktadır. Çalışma, lipid profillerinin ED değerlendirilmesi ve yönetimindeki anlayışı geliştirmek için HDL düzeylerinin BMI ve sigara içme durumu gibi değişkenlerle etkileşimini analiz etmiştir. ED ile düşük HDL düzeyleri (<40 mg/dL) arasındaki bağlantıyı değerlendirmek için yaş, BMI, sigara içme ve hipertansiyon gibi karıştırıcı faktörler dikkate alınarak lojistik regresyon yapılmıştır. ROC eğrisi analizi, HDL düzeylerini kullanarak ED'yi öngörmek için optimal kesme noktasını belirlemiştir. ED'li hastaların ortalama yüksek yoğunluklu lipoprotein (HDL) düzeyleri, normal popülasyonun 48.3 ± 12.1 mg/dL'ye kıyasla 32.0 ± 10.9 mg/dL olarak belirgin şekilde daha düşük bulunmuştur (p = 0.043). ED grubunda, hastaların %66.67'sinin HDL düzeyleri 40 mg/dL'nin altında olup bu oran, normal popülasyonda gözlemlenen %41.39'dan daha yüksekti (p = 0.023). Ayrıca, ED popülasyonunun ortalama BMI değeri normal popülasyonun 24.0 ± 5.2 kg/m²'sine kıyasla 27.4 ± 4.6 kg/m² olarak daha yüksekti (p = 0.011). Sigara içme de ED hastaları arasında daha yaygın olup, %53.33'ü şu an sigara içen kişiler iken normal popülasyonda bu oran %35.23 idi (p = 0.037). Alt grup analizleri, düşük HDL ile sigara içme (B = 0.45, β = 0.30, p = 0.001) ve düşük HDL ile BMI (B = 0.50, β = 0.35, p = 0.001) arasında bir etkileşim olduğunu ortaya koymuş ve bu kombinasyonların herhangi bir bireysel faktörden daha fazla ED riskini artırdığını göstermiştir. Araştırmamız, HDL'nin ED için yararlı bir öngörücü biyomarkır olarak işlev görebileceğini önermektedir. Klinisyenler, ED'li hastaların HDL düzeylerini değerlendirmeyi ve potansiyel olarak düşük HDL düzeylerini yöneterek ED semptomlarını hafifletmeyi hedeflemelidirler.

References

  • [1] C. Eaton, Y. Liu, M. Mittleman, M. Miner, D. Glasser, E.B. Rimm. "A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men," International journal of impotence research, vol. 19, no. 2, pp. 218-25, 2007.
  • [2] M. Li, Z. Ma, X.L. Zhang, L.Q. Guo, M.Z Yuan. "Significance of blood lipid parameters as effective markers for arteriogenic erectile dysfunction," Andrology, vol. 8, no. 5, pp. 1086-94, 2020.
  • [3] M.G. Culha, L. Canat, R.B. Degirmentepe, A.T. Albayrak, H.A. Atalay, E. Merder, et al. "The correlation between atherogenic indexes and erectile dysfunction," The Aging Male, vol. 23, no. 5, pp. 1232-6, 2020.
  • [4] Z. Liao, Y. Tang, X. Li, D. Li. "The relationship between hematologic parameters and erectile dysfunction," Sexual Medicine. vol. 9, no. 4, pp. 100401, 2021.
  • [5] E. Ermis, S. Ozbay Ozyilmaz, E. Salabas, C. Senol, M. Cengiz, S. Allahverdiyev, H. Ucar. "The relationship between erectile dysfunction and the Atherogenic Index of Plasma," International Journal of Impotence Research, vol. 32, no. 4, pp. 462-8, 2020.
  • [6] M. Sambel, A. Erdogan, V. Caglayan, S. Avci, S. Kilic, H.E. Yildiz, E. Keskin. "Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction?" Sexual Medicine, vol. 11, no. 6, pp. qfad069, 2023.
  • [7] J. Kovac, C. Labbate, R. Ramasamy, D. Tang, L. Lipshultz. "Effects of cigarette smoking on erectile dysfunction," Andrologia, vol. 47, no. 10, pp. 1087-92, 2015.
  • [8] B. Zhao, Z. Hong, Y. Wei, D. Yu, J. Xu, W. Zhang. "Erectile dysfunction predicts cardiovascular events as an independent risk factor: a systematic review and meta-analysis," Journal of Sexual Medicine, vol. 16, no. 7, pp. 1005-17, 2019.
  • [9] W. Guo, C. Liao, Y. Zou, F. Li, T. Li, Q. Zhou, et al. "Erectile dysfunction and risk of clinical cardiovascular events: a meta-analysis of seven cohort studies," Journal of Sexual Medicine, vol. 7, no. 8, pp. 2805-16, 2010.
  • [10] G. Gandaglia, A. Briganti, G. Jackson, R.A. Kloner, F. Montorsi, P. Montorsi, C. Vlachopoulos." A systematic review of the association between erectile dysfunction and cardiovascular disease," European urology, vol. 65, no. 5, pp. 968-78, 2014.
  • [11] H. Besiroglu, A. Otunctemur, E. Ozbek. "The relationship between metabolic syndrome, its components, and erectile dysfunction: a systematic review and a meta-analysis of observational studies," Journal of Sexual Medicine, vol. 12, no. 6, pp. 1309-18, 2015.
There are 11 citations in total.

Details

Primary Language English
Subjects Primary Health Care
Journal Section Research Articles
Authors

Abdullah Akkurt 0000-0002-6437-981X

Ercan Kazan 0000-0002-8707-1244

Cemal Nas 0000-0002-5616-8625

Publication Date March 28, 2024
Submission Date February 11, 2024
Acceptance Date March 19, 2024
Published in Issue Year 2024

Cite

IEEE A. Akkurt, E. Kazan, and C. Nas, “Could High-Density Lipoprotein (HDL) Alone be a Predictive Biomarker for Patients with Erectile Dysfunction?”, Journal of Innovative Healthcare Practices, vol. 5, no. 1, pp. 1–10, 2024, doi: 10.58770/joinihp.1435248.