The Study Of Vascular Factors In The Pathogenesis Of Diabetic Erectile Dysfunction Of Man

[Objective] To observe the changes of Ultrastructural in Diabetic Erectile dysfunction (DED) patient's skeletal muscular capillary basement membrane, to study dependability appreciation and application value between the changes of capillary vessel Ultrastructural in Diabetic Erectile dysfunction patient muscular skeletal capillary basement membrane and clinical laboratory index. To study whether the vascular factors play a role in the pathogenesis of dabetic erectile dysfunction of man.[Methods]The subjects from the endocrinology department of in-patients and out-patients of the first hospital affiliated to Guang Xi Medical University from June 2006 to September 2007. 28 subjects were Diabetic Erectile dysfunction group(DED). The criteria of DM from WHO(1999), the criteria of erectile dysfunction accorded with National Institutes of Health: International Index of Erectile Function-5, and the course of ED bypass half of year. In the same time, we collected 10 case for DM group and 10 case for normal group. The criteria of the DM group is according to WHO(1999), but without ED. The DED group and DM group were diagnose diabetic microvascularpathy with DN or DR group. To observe muscular skeletal capillary basement membrane microtome section in the diabetes mellitus patient with erectile dysfunction patients,the diabetes mellitus patients without erectile dysfunction and the normal patients by utilizing transmission electron microscope, and calculate the capillary basement membrane index(CBMI). Then, BMI, FPG, 2hPG, TC, TG, HDL, LDL, Testosterone, 24hUALB, HbA1c, optic- fundi were determined in all subjects.[Results]①The age, BMI and TG are no significance difference among normal group, DM group and DED group. In the three groups, the course of DM,FPG,HbA1c,24hUALB,HDL,T and the incidence rate of DMVP are significance differences in each two group(P<0.05). To compare their CBMI, the DED group is 10.5±1.1,the DM group is 30.4±1.1,the normal group is 50.4±1.6, with a significance difference among the three groups (P<0.01). To compare the scores of IIEF-5 : The DED group is 24,the DM group is 23,the normal group is 12, with a significance difference between The DED group and the normal group (P<0.01); with a significance difference between the DED group and the DM group (P<0.05); the normal group and the DM group have no distinction (P>0.05).②The relationship was found relatively between CBMI and the scores of IIEF-5 with the course of the DM,HbA1c,T,FPG,2hPG,24hUALB,TC,HDL,LDL, (P<0.05). CBMI and the scores of IIEF-5 show a inverse correlation.③In a multiple regression model, the course of the DM,HDL,IIEF-5,24hUALB and HbA1c remained significantly and independently related to the CBMI, The HDL and the scores of IIEF-5 show a inverse correlation with CBMI; The course of DM,24hUALB and HbA1c show a positive correlation with CBMI. And the course of the DM,HDL,the CBMI,HbA1c,testosterone remained significantly and independently related to the scores of IIEF-5 level, The course of DM,CBMI and HbA1c show a inverse correlation with the scores of IIEF-5; The HDL and testosterone show a positive correlation with the scores of IIEF-5[Conclusion] 1. It existenced the change of muscular skeletal capillary basement membrane of Diabetic Erectile dysfunction of man. Controlling other factor, the changes were even related with ercetion function. It hint the Vascular Factors play a important role in the pathogeneses of Diabetic Erectile dysfunction of man. 2. In the multiple regression model the scores of IIEF-5 that reflect DED and the course of the DM,CBMI,HbA1c,HDL,T, showed the course of the DM and CBMI,HbA1c were the risk factors of erectile function , T,HDL were the protective factor. The ED were accounted to the abnormality of serum glucose and the serum lipide of DM resulting in the dysfunction of micrangium. 3. The case of DED may reflect status of DN and DR in some degrees.