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Abstract

Purpose: Metabolic syndrome (MS) is the most important clinical situation which predisposes the endotelial dysfunction and atherosclerosis. Nitric oxid (NO) loss is an important finding in the early stages of endothelial dysfunction. NO deficiency results erectile dysfunction (ED) signs and symptoms. We aim in this study to assess the frequency of the ED in MS patients. Method: This study includes 43 MS patients who fullfill NCEP-ATP III criteria and 29 healthy subjects. A signed permission form was taken from all of the participants. Biochemical and hormonal parameters such as fasting bood glucose (FBG), postprandial glucose (PPG), total testosterone (TT), insulin, high sensitive CRP, total cholesterol (TC), triglyceride (Tg), low density lipoprotein (LDL), high density liporotein (HDL) were measured from the blood which was taken after 12 hours fasting period. ED was evaluated by the questionnaire of International Index of Erectile Function–5 (IIEF–5) which was answered by the included subjects. Insulin resistance was calculated by HOMA-IR method by the formula of FBGxinsulin/405. Results: ED was detected in 65% of the MS group and in 13,8% of the control group. ED was divided into subgroups according to the severity. In MS patients; 18,6% had mild ED, 14% had mild-moderate ED, 14% had moderate ED and 14% had severe ED but in control group only 13,8% of them had mild ED. Although HOMA-IR value was 3,56 ± 3,45 in MS patients with ED, it was 2,23±1,72 in patients without ED (p=0,034). In MS patients with and without ED testosterone levels were measured as 4,5±1 and 6,1±1,56, respectively (p<0,001). Conclusion: ED is highly prevelant in patients with MS and MS patients with ED have low testosterone levels and high HOMA-IR levels which shows insulin resistance

Keywords

• Metabolic Syndrome, Erectile Dysfunction, İnsulin Resistance

Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı

Abstract

Amaç: Metabolik sendrom (MS) endotel disfonksiyon ve ateroskleroz gelişimine zemin hazırlayan en önemli bir klinik tablodur. Endotel disfonksiyonun erken döneminde Nitrik oksit (NO) kaybı önemli bir klinik durumdur. NO eksikliğinde erektil disfonksiyon (ED) bulguları da ortaya çıkmaktadır. Bu çalışmada MS hastalarında ED sıklığını ortaya koymayı amaçladık. Metod: Çalışmaya International Diabetes Federation (IDF) metabolik sendrom tanı kriterlerine uyan 43 hastada ve 29 sağlıklı kişide gönüllü olur formu alındıktan sonra yapıldı. Biyokimyasal tetkikleri 12 saatlik açlık sonrası alınan kanlarından AKŞ, TKŞ, total testosteron, insülin, hs-CRP, total kolesterol, trigliserid, LDL, HDL çalışıldı. Erektil fonksiyon sorgulaması, ED değerlendirilmesinde kullanılan, ‘Uluslararası Erektil Fonksiyon İndeksinde’ (IIEF-5, International Index of Erectile Function) soruların kişiler tarafından yanıtlanmasıyla belirlendi. Bulgular: MS grubunda gözlemlerin %61,5 ED izlenirken, bu oran kontrol grubunda %13,8 olarak bulunmuştur. Vaka grubunda %18,6’ sı hafif ED, %14’ü hafif-orta ED, %14’ü orta ED ve %14’ünde ciddi ED saptanırken, kontrol grubunda olguların %13,8’i hafif ED saptandı. ED pozitif olan grubun ortalama HOMA-IR düzeyi 3,56±3,45 iken, ED negatif olan grubun ortalama HOMA-IR düzeyi 2,23±1,72 olarak saptandı (p=0,034). ED pozitif olan grubun ortalama testosteron düzeyi 4,5±1,38 iken, ED negatif olan grubun ortalama testosteron düzeyi 6,1±1,56 idi (p<0,001). Sonuç: Erektil disfonksiyon MS hastalarında oldukça sık izlenmekte olup bu kişilerde insulin direnci göstergesi olan HOMA-IR seviyesi yüksek ve testosterone seviyesi düşük olduğu gözlenmiştir

Keywords

• Metabolik Sendrom, Erektil Disfonksiyon, İnsulin Direnci

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