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Year 2014, , 11 - 16, 01.04.2014

Ünal M

https://doi.org/10.18521/ktd.41922

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

References

  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel III)Third Report of the National Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult treatment Panel III) final report. Circulation 2002;106(25):3143-421.
  • Wheatcroft SB, Williams IL, Shah AM et al. Pathophysiological implications of insulin resistance on vasculer endohelial function. Diabet Med 2003;20(4):255-68.
  • Blumentals WA, Gomes-Caminero A, Joo S et al. Should erectile dysfunction be considered as a marker for acute myocardial infarction?. Int J Impot Res 2004;16(4):350-3.
  • Cappelleri JC, Siegel RL, Glasser DB et al. Relationship between patient self-assessment of erectile dysfunction and the sexual health inventory for men. Clin Ther 2001;23(10):1707-19.
  • Jordan A. 1st International Erectile dysfunction Meeting Plymouth, UK: Health Publication, Ltd 2000;711- 26.
  • Aytac I.A, McKinlay J.B, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 some possible policy consequences BJU Int 1999;84(1):50-6.
  • Goldstein I. The mutually reinforcing triad of depressive symptoms, cardiovascular disease and erectile dysfunction. Am J Cardiol 2000;86(2A):41-5.
  • Goldstein I. Screening for erectile dysfunction: Rationale Int J Impot Res 2000;12(4):147-54.
  • Virag R, Bouilly P, Frydman D. Is impotence an arterial disorder? A study of arteryal risk factors in 440 impotence men. Lancet 1985;1(8422):181-4.
  • Champion HC, Bivalacqua TJ, Hyman AL et al. Gene transfer of endothelial nitric oxide syntase to the penis augments erectile responses in the aged rat. Proc Natl Acad Sci USA 1999;96(20):11648-52.
  • Naylor AM. Endogenous neurotransmitters mediating penile erection. Br J Urol 1998;81(3):424-31.
  • Rajfer J, Aronson WJ, Bush PA et al. Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Engl J Med 1992;326(2):90-4.
  • Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 1980;288(5789):373-6.
  • Ganz P,Vita JA. Testing endothelial vasomotor function: Nitric oxide, a multipotent molecule. Circulation 2003;108(17):2049-53.
  • Behrendt D, Ganz P. Endothelial function: From vascular biology to clinical applications. Am J Cardiol 2002;90(10C):40-8.
  • Morley JE, Korenman SG, Kaiser FE et al. Relationship of penile brachial pressure index to myocardial infarction and cerebrovascular accidents in older men. Am J Med 1988;84(3 Pt 1):445-8.
  • Levine LA, Kloner RA. Impotence of asking questions about erectile dysfunction. Am J Cardiol 2000;86(11):1210-3.
  • Zambon JP, Mendonça RR, Wroclawski ML et al. Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study. Sao Paulo Med J. 2010;128(3):137-40.
  • Solomon H, Man J, Wierzbicki AS et al. Erectile dysfunction: cardiovascular risk and the role of the cardiologist. Int J Clin Pract 2003;57(2):96-9.
  • Jones RWA, Rees RW, Minhas S et all. Oxygen free radicals and the penis. Expert Opin Pharmacother 2002;3(7):889-97.
  • Bocchio M, Desideri G, Scarpelli P et al. Endothelial cell activation in men with erectile dysfunction without cardiovascular risk factors and overt vascular damage. J Urol 2004;171(4):1601-4.
  • Sullivan ME, Thompson CS, Daswood MR et al. Nitric oxide and penile erection: Is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res 1999;43(3):658-65.
  • Grundy SM. Obesity, metabolic syndrome and coronary atherosclerosis. Circulation 2002;105(23):2696-8.
  • Kupelian V, Shabsigh R, Araujo AB et al. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006;176(1):222-6.
  • Green AW: Sexual activity and the postmyocardial infarction patient. Am Heart J 1975;89(2):246-52.
  • Virag R, Bouilly P, Frydman I: Is impotence an arterial disorder? Lancet 1984;1(8422):181-4.
  • Kaplan SA, Meehan AG, Shah A. The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? Urol 2006;176(4 Pt 1):1524-7.
  • Laaksonen DE, Niskanen L, Punnonen K et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol 2003;149(6):601-8.
  • Seidell JC, Bjorntorp P, Sjostrom L et al. Visceral fat accumulation in men is positively associated with insulin, glucose, and c-peptide levels, but negatively with testosterone levels. Metabolism 1990;39(9):897- 901.
  • Brodsky IG, Balagopal P, Nair KS. Effects of testosterone replacement on muscle mass and muscle protein synthesis in hypogonadal men-a clinical research center study. J Clin Endocrinol Metab 1996;81(10):3469- 75.
  • Kaiser Dr, Billups K, Mason C et al: Impaired brachial artery endothelium-dependent and-independent vasodilatation in men with erectile dysfunction but no other clinical cardiovascular disease. J Am Coll Cardiol 2004;43(2):179-84.
  • Gorbachinsky I, Akpinar H, Assimos DG. Metabolic syndrome and urologic diseases. Rev Urol. 2010;12(4):157-80.

Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı

Year 2014, , 11 - 16, 01.04.2014

Ünal M

https://doi.org/10.18521/ktd.41922

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

References

  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel III)Third Report of the National Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult treatment Panel III) final report. Circulation 2002;106(25):3143-421.
  • Wheatcroft SB, Williams IL, Shah AM et al. Pathophysiological implications of insulin resistance on vasculer endohelial function. Diabet Med 2003;20(4):255-68.
  • Blumentals WA, Gomes-Caminero A, Joo S et al. Should erectile dysfunction be considered as a marker for acute myocardial infarction?. Int J Impot Res 2004;16(4):350-3.
  • Cappelleri JC, Siegel RL, Glasser DB et al. Relationship between patient self-assessment of erectile dysfunction and the sexual health inventory for men. Clin Ther 2001;23(10):1707-19.
  • Jordan A. 1st International Erectile dysfunction Meeting Plymouth, UK: Health Publication, Ltd 2000;711- 26.
  • Aytac I.A, McKinlay J.B, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 some possible policy consequences BJU Int 1999;84(1):50-6.
  • Goldstein I. The mutually reinforcing triad of depressive symptoms, cardiovascular disease and erectile dysfunction. Am J Cardiol 2000;86(2A):41-5.
  • Goldstein I. Screening for erectile dysfunction: Rationale Int J Impot Res 2000;12(4):147-54.
  • Virag R, Bouilly P, Frydman D. Is impotence an arterial disorder? A study of arteryal risk factors in 440 impotence men. Lancet 1985;1(8422):181-4.
  • Champion HC, Bivalacqua TJ, Hyman AL et al. Gene transfer of endothelial nitric oxide syntase to the penis augments erectile responses in the aged rat. Proc Natl Acad Sci USA 1999;96(20):11648-52.
  • Naylor AM. Endogenous neurotransmitters mediating penile erection. Br J Urol 1998;81(3):424-31.
  • Rajfer J, Aronson WJ, Bush PA et al. Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Engl J Med 1992;326(2):90-4.
  • Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 1980;288(5789):373-6.
  • Ganz P,Vita JA. Testing endothelial vasomotor function: Nitric oxide, a multipotent molecule. Circulation 2003;108(17):2049-53.
  • Behrendt D, Ganz P. Endothelial function: From vascular biology to clinical applications. Am J Cardiol 2002;90(10C):40-8.
  • Morley JE, Korenman SG, Kaiser FE et al. Relationship of penile brachial pressure index to myocardial infarction and cerebrovascular accidents in older men. Am J Med 1988;84(3 Pt 1):445-8.
  • Levine LA, Kloner RA. Impotence of asking questions about erectile dysfunction. Am J Cardiol 2000;86(11):1210-3.
  • Zambon JP, Mendonça RR, Wroclawski ML et al. Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study. Sao Paulo Med J. 2010;128(3):137-40.
  • Solomon H, Man J, Wierzbicki AS et al. Erectile dysfunction: cardiovascular risk and the role of the cardiologist. Int J Clin Pract 2003;57(2):96-9.
  • Jones RWA, Rees RW, Minhas S et all. Oxygen free radicals and the penis. Expert Opin Pharmacother 2002;3(7):889-97.
  • Bocchio M, Desideri G, Scarpelli P et al. Endothelial cell activation in men with erectile dysfunction without cardiovascular risk factors and overt vascular damage. J Urol 2004;171(4):1601-4.
  • Sullivan ME, Thompson CS, Daswood MR et al. Nitric oxide and penile erection: Is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res 1999;43(3):658-65.
  • Grundy SM. Obesity, metabolic syndrome and coronary atherosclerosis. Circulation 2002;105(23):2696-8.
  • Kupelian V, Shabsigh R, Araujo AB et al. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006;176(1):222-6.
  • Green AW: Sexual activity and the postmyocardial infarction patient. Am Heart J 1975;89(2):246-52.
  • Virag R, Bouilly P, Frydman I: Is impotence an arterial disorder? Lancet 1984;1(8422):181-4.
  • Kaplan SA, Meehan AG, Shah A. The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? Urol 2006;176(4 Pt 1):1524-7.
  • Laaksonen DE, Niskanen L, Punnonen K et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol 2003;149(6):601-8.
  • Seidell JC, Bjorntorp P, Sjostrom L et al. Visceral fat accumulation in men is positively associated with insulin, glucose, and c-peptide levels, but negatively with testosterone levels. Metabolism 1990;39(9):897- 901.
  • Brodsky IG, Balagopal P, Nair KS. Effects of testosterone replacement on muscle mass and muscle protein synthesis in hypogonadal men-a clinical research center study. J Clin Endocrinol Metab 1996;81(10):3469- 75.
  • Kaiser Dr, Billups K, Mason C et al: Impaired brachial artery endothelium-dependent and-independent vasodilatation in men with erectile dysfunction but no other clinical cardiovascular disease. J Am Coll Cardiol 2004;43(2):179-84.
  • Gorbachinsky I, Akpinar H, Assimos DG. Metabolic syndrome and urologic diseases. Rev Urol. 2010;12(4):157-80.
There are 32 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ünal M This is me

Publication Date April 1, 2014
Published in Issue Year 2014

Cite

APA M, Ü. (2014). Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı. Konuralp Medical Journal, 6(1), 11-16. https://doi.org/10.18521/ktd.41922
AMA M Ü. Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı. Konuralp Medical Journal. April 2014;6(1):11-16. doi:10.18521/ktd.41922
Chicago M, Ünal. “Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı”. Konuralp Medical Journal 6, no. 1 (April 2014): 11-16. https://doi.org/10.18521/ktd.41922.
EndNote M Ü (April 1, 2014) Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı. Konuralp Medical Journal 6 1 11–16.
IEEE Ü. M, “Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı”, Konuralp Medical Journal, vol. 6, no. 1, pp. 11–16, 2014, doi: 10.18521/ktd.41922.
ISNAD M, Ünal. “Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı”. Konuralp Medical Journal 6/1 (April 2014), 11-16. https://doi.org/10.18521/ktd.41922.
JAMA M Ü. Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı. Konuralp Medical Journal. 2014;6:11–16.
MLA M, Ünal. “Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı”. Konuralp Medical Journal, vol. 6, no. 1, 2014, pp. 11-16, doi:10.18521/ktd.41922.
Vancouver M Ü. Metabolik Sendrom Hastalarında Erektil Disfonksiyonun Sıklığı. Konuralp Medical Journal. 2014;6(1):11-6.