Differences in the prevalence of erectile dysfunction between novel subgroups of recent-onset diabetes,Diabetologia

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Differences in the prevalence of erectile dysfunction between novel subgroups of recent-onset diabetes
Diabetologia ( IF 8.4 ) Pub Date : 2021-11-20 , DOI: 10.1007/s00125-021-05607-z
Haifa Maalmi _{1,

2} , Christian Herder _{1,

2,

3} , Gidon J Bönhof _{1,

2,

3} , Klaus Strassburger _{2,

4} , Oana-Patricia Zaharia _{1,

2,

3} , Wolfgang Rathmann _{2,

4} , Volker Burkart _{1,

2} , Julia Szendroedi _{1,

2,

3} , Michael Roden _{1,

2,

3} , Dan Ziegler _{1,

2,

3} ,

Affiliation

Aims/hypothesis

In men with diabetes, the prevalence of erectile dysfunction increases with advanced age and longer diabetes duration and is substantially higher in men with type 2 diabetes than those with type 1 diabetes. This study aimed to evaluate the prevalence of erectile dysfunction among the five novel subgroups of recent-onset diabetes and determine the strength of associations between diabetes subgroups and erectile dysfunction.

Methods

A total of 351 men with recent-onset diabetes (<1 year) from the German Diabetes Study baseline cohort and 124 men without diabetes were included in this cross-sectional study. Erectile dysfunction was assessed with the International Index of Erectile Function (IIEF) questionnaire. Poisson regression models were used to estimate associations between diabetes subgroups (each subgroup tested against the four other subgroups as reference) and erectile dysfunction (dependent binary variable), adjusting for variables used to define diabetes subgroups, high-sensitivity C-reactive protein and depression.

Results

The prevalence of erectile dysfunction was markedly higher in men with diabetes than in men without diabetes (23% vs 11%, p = 0.004). Among men with diabetes, the prevalence of erectile dysfunction was highest in men with severe insulin-resistant diabetes (SIRD) (52%), lowest in men with severe autoimmune diabetes (SAID) (7%), and intermediate in men with severe insulin-deficient diabetes (SIDD), mild obesity-related diabetes (MOD) and mild age-related diabetes (MARD) (31%, 18% and 29%, respectively). Men with SIRD had an adjusted RR of 1.93 (95% CI 1.04, 3.58) for prevalent erectile dysfunction (p = 0.038). Similarly, men with SIDD had an adjusted RR of 3.27 (95% CI 1.18, 9.10) (p = 0.023). In contrast, men with SAID and those with MARD had unadjusted RRs of 0.26 (95% CI 0.11, 0.58) (p = 0.001) and 1.52 (95% CI 1.04, 2.22) (p = 0.027), respectively. However, these associations did not remain statistically significant after adjustment.

Conclusions/interpretation

The high RRs for erectile dysfunction in men with recent-onset SIRD and SIDD point to both insulin resistance and insulin deficiency as major contributing factors to this complication, suggesting different mechanisms underlying erectile dysfunction in these subgroups.

Graphical abstract

中文翻译：

新发糖尿病亚组之间勃起功能障碍患病率的差异

目标/假设

在患有糖尿病的男性中，勃起功能障碍的患病率随着年龄的增长和糖尿病病程的延长而增加，并且在患有 2 型糖尿病的男性中明显高于患有 1 型糖尿病的男性。本研究旨在评估新发糖尿病的五个新亚组中勃起功能障碍的患病率，并确定糖尿病亚组与勃起功能障碍之间的关联强度。

方法

这项横断面研究包括来自德国糖尿病研究基线队列的 351 名新近发病的糖尿病患者（<1 岁）和 124 名没有糖尿病的男性。使用国际勃起功能指数 (IIEF) 问卷评估勃起功能障碍。泊松回归模型用于估计糖尿病亚组（每个亚组与其他四个亚组作为参考进行测试）和勃起功能障碍（因二元变量）之间的关联，调整用于定义糖尿病亚组、高敏 C 反应蛋白和抑郁症的变量.

结果

患有糖尿病的男性勃起功能障碍的患病率明显高于非糖尿病男性（23% vs 11%，p = 0.004）。在患有糖尿病的男性中，勃起功能障碍的患病率在患有严重胰岛素抵抗性糖尿病 (SIRD) 的男性中最高 (52%)，在患有严重自身免疫性糖尿病 (SAID) 的男性中最低 (7%)，在患有严重胰岛素的男性中发病率居中-缺陷型糖尿病（SIDD）、轻度肥胖相关糖尿病（MOD）和轻度年龄相关糖尿病（MARD）（分别为31%、18%和29%）。患有 SIRD 的男性对普遍勃起功能障碍的调整 RR 为 1.93 (95% CI 1.04, 3.58) ( p = 0.038)。同样，患有 SIDD 的男性调整后的 RR 为 3.27 (95% CI 1.18, 9.10) ( p = 0.023)。相比之下，患有 SAID 和 MARD 的男性未经调整的 RR 分别为 0.26 (95% CI 0.11, 0.58) ( p = 0.001) 和 1.52 (95% CI 1.04, 2.22) ( p = 0.027)。然而，这些关联在调整后并没有保持统计显着性。