4.4 Article

Homocysteine levels correlate with velocimetric parameters in patients with erectile dysfunction undergoing penile duplex ultrasound

Journal

ANDROLOGY
Volume 10, Issue 4, Pages 733-739

Publisher

WILEY
DOI: 10.1111/andr.13169

Keywords

cardiovascular disease; homocysteine; sexual dysfunction

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Hyperhomocysteinemia is highly prevalent in patients with erectile dysfunction, and it correlates with velocimetric parameters assessed by basal penile duplex ultrasound.
Introduction Hyperhomocysteinemia may contribute to the development of endothelial dysfunction and, consequently, atherosclerosis, a systemic disease involving the vessels that may affect the cavernous arteries leading to vasculogenic erectile dysfunction. Our study aims therefore to explore the relationship between homocysteine levels and velocimetric parameters detected by basal penile duplex ultrasound such as peak systolic velocity and flaccid penile acceleration in patients with erectile dysfunction. Methods A cross-sectional study was conducted collecting clinical, metabolic, hormonal, and instrumental (basal penile duplex ultrasound) data in patients affected by vasculogenic erectile dysfunction. Results Data of 126 subjects affected by erectile dysfunction were collected. Mean age was 52.1 +/- 12.6 years, whereas mean body mass index was 25.6 +/- 4.0 kg/m(2). Basal penile duplex ultrasound showed peak systolic velocity values of 13.1 +/- 2.9 cm/s and mean flaccid penile acceleration of 2.28 +/- 0.70 m/s(2), with a strong correlation among these two parameters (r = 0.690; p < 0.001). Frankly pathological values of peak systolic velocity and flaccid penile acceleration were detected in 39.7% and 4.8% of the subjects examined, respectively. Mean homocysteine levels were 14.9 +/- 9.5 mu mol/l. Homocysteine values >15 mu mol/l were found in 26% of the subjects with erectile dysfunction. Peak systolic velocity values and homocysteine levels showed an inverse correlation (r = -0.213; p = 0.03). Similarly, flaccid penile acceleration values were inversely correlated to homocysteine levels (r = -0.199; p = 0.05). In addition, an inverse correlation was found between both peak systolic velocity and flaccid penile acceleration and body mass index, atherogenic lipid pattern, and age. Homocysteine and metabolic parameters showed no significant correlations. Conclusion Hyperhomocysteinemia is highly prevalent in erectile dysfunction patients. The results of our study show that homocysteine levels correlate with velocimetric parameters assessed by basal penile duplex ultrasound, confirming the role of hyperhomocysteinemia in the genesis of erectile dysfunction of arterial origin.

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