Is Type 2 Diabetes Mellitus a Cause of Severe Erectile Dysfunction in Patients With Metabolic Syndrome?

OBJECTIVES To determine the effect of type 2 diabetes mellitus (T2DM) as a major risk factor for severe erectile dysfunction (ED) in patients with metabolic syndrome (MS). METHODS The study included 93 patients aged 30-70 years who had MS and ED. MS patients were divided into 2 groups: 37 patients with neither T2DM nor abnormal fasting glucose level (group 1) and 56 patients with T2DM (group 2). The severity of ED was determined according to the first 5-question version of the International Index of Erectile Function (IIEF-5). The MS was defined according to the 2005 International Diabetes Federation consensus definition. Logistic regression analysis, t test, and chi(2) tests were used to investigate the impact of T2DM on ED severity. RESULTS The mean age of the patients was 55.5 years (P = .313). Eleven patients in group 1 (29.7%) and 42 patients in group 2 (75%) had severe ED IIEF-5 score <= 7; P < .001). Abnormal blood pressure (BP), serum high-density lipoprotein (HDL), and serum triglyceride (TG) ratios were found to be 48.6%, 75.7%, and 86.5% in group 1 and 51.8%, 53.6% and 73.2% in group 2, respectively (P-BP = .933; P-HDL = .053; P-TG = .205). The IIEF-5 scores were higher in group 1 patients than in group 2 patients (12.6 vs. 7.5; PIIEF-5 < .001). Presence of T2DM was significantly associated with severe ED, and the relative risk was as high as 7.1 (P-T2DM < .0001). CONCLUSIONS In our study, the presence of T2DM was strongly associated with severe ED in patients with MS. We believe that components of MS should be taken into consideration in the diagnosis and treatment of ED. UROLOGY 74: 561-565, 2009. (C) 2009 Elsevier Inc.