Relationship Between Serum Uric Acid Level And Erectile Dysfunction

Background and ObjectiveA large number of epidemiological investigations and clinical researches suggest that there may be a potential association between serum uric acid(UA)and erectile dysfunction(ED),but controversies still exist among different studies.In order to explore whether serum UA level is a risk factor for ED,this study explored the relationship between UA and ED,diagnosed by the five index of international erectile function(IIEF-5),through the method of epidemiological cross-sectional study.Study design and Statistical MethodsThis cross-sectional study is based on the Fangchenggang area male health and examination survey(FAMHES)cohort study,in which recruited 5,988 male respondents from July to October 2011.The inclusion criteria for this study was men with health complete and effective information of the questionnaire,and with serum UA test results.Finally,the study was included 3,880 men aged 20-70 years.Data collection includes basic information such as the total score of the IEFF-5scale,demographic information,lifestyle,history of disease operations,and medication history.The ergonomic measurements were conducted by qualified professionals who have undergone uniform training,including body mass index(BMI),waist circumference,and blood pressure.Samples of fasting venous blood were collected from the survey subjects after 8 hours of fasting,and biochemical indicators,such as fasting blood glucose,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,total cholesterol,and triglycerides,were detected.The subjects were divided into hyperuricemia group and normal group according to serum UA level.Two independent samples t’test and χ2 test(or Fisher’s exact probability method)were used for comparison between two groups.In overall population and some groups of population with different characteristics,linear regression,log-binomial regression and multiple logistic regression were used to evaluate the association between serum UA level and IIEF-5 score,prevalence of ED and severity of ED,respectively.Log-binomial regression was used to analyze the association between serum UA levels and the risk of ED in people with different alcohol intakes,and to analyze whether the interaction between alcohol intake and serum UA levels impact on ED.Multiple logistic regression was used to analyze the association between the serum UA level and the severity of ED in people with excessive drinking and harmful drinking.In the above regression analyses,the unadjusted model did not adjust any factors.The adjusted model adjusted age,BMI,marital status,education,smoking status,drinking status,waist circumference,fasting blood glucose,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,total cholesterol,triglycerides,and blood pressure.All statistical analyses were performed by STATA version 12.0 software(Stata Corp LP,USA).All statistical tests were two-sided tests,and P value ≤ 0.05 was considered statistically significant.Results1.The study includs 3,880 male subjects,aged between 20 to 70 years.In all age groups,there are 2,206 males(56.9%)with ED.2.Among the overall population,the serum UA level is associated with ED.The higher serum UA level,the lower IIEF-5 score,and the higher risk of ED(especially mild ED),suggesting that high serum UA level is a risk of ED.Under the model adjusted for age,BMI,marital status,education,smoking,drinking,waist circumference,fasting blood glucose,low density lipoprotein cholesterol,high density lipoprotein cholesterol,total cholesterol,triglycerides,systolic blood pressure,diastolic blood pressure,linear regression analysis shows a negative correlation between UA level and IIEF-5 score(β=-0.40,95%CI=-0.78-0.03,P=0.034);log-binomial regression analysis shows that UA is a risk factor of ED(PRR=1.11,95% CI=1.01-1.23,P=0.030);multiple logistic regression analysis shows no association between UA and severity of ED.3.In the current drinking group,the association between UA and risk of ED is still present(PRR=1.18,95% CI=1.04-1.34,P =0.012).4.Log-binomial regression analysis for the association between UA and risk of ED among people with different alcohol intake is conducted,and it shows that among the men with excessive drinking behaviors(PRR=1.20,95% CI=1.01-1.42,P=0.041)or harmful drinking behavior(PRR=1.36,95% CI=1.01-1.85,P=0.049),UA level is associated with risk of ED.However,hyperuricemia is not associated with ED among these men.The interaction between alcohol intake and UA has no effect on ED.5.Multiple logistic regression analysis shows that the severity of ED of harmful drinkers may gradually increase with the increase of UA level(P-trend=0.046).ConclusionThe study suggest that high serum UA level may be a risk factor of ED.In the current drinking group,especially men with harmful drinking behavior(each alcohol intake ≥61 g),the association between UA and risk of ED still exists,and UA may be related to severity of ED.Further follow-up investigations are needed to conduct,and longitudinal cohort studies would provide stronger evidence support for revealing the association between UA and ED.