Insulin resistance is an independent predictor of erectile dysfunction in patients with gout
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Background/Aims: Gout is associated with metabolic disorders that are important risk factors for cardiovascular disease and erectile dysfunction (ED). We aimed to identify independent predictors of ED in patients with gout. Methods: From August 2014 to August 2015, male outpatients who were being treated for gout in our rheumatology clinic and healthy males without any history of inflammatory disease (control group) were studied. ED was assessed in participants using the five-item version of the International Index of Erectile Function questionnaire. Insulin resistance (IR) was estimated using the homeostatic model assessment (HOMA-IR). Logistic regression analysis was performed to determine the effect of variables on ED risk in all of the study subjects and in patients with gout. Results: We analyzed 80 patients with gout and 70 healthy controls. The median age of patients with gout was 52 years and median disease duration was 120 months. Gout patients were more likely to have ED than controls (55.3% vs. 41.4%, p < 0.047). After adjustment for confounding factors, only HOMA-IR was significantly associated with ED (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.05 to 3.15). Gout patients with ED were more likely to be older (p < 0.001), have higher HOMA-IR (p = 0.048), and have lower glomerular filtration rate (p = 0.038) than those without ED. Multivariate logistic regression analysis showed that HOMAIR was an independent predictor for ED (OR, 1.62; 95% CI, 1.03 to 2.82) in gout patients. Conclusions: IR is an independent predictor of ED in patients with gout.
Abstract
Background/Aims: Gout is associated with metabolic disorders that are important risk factors for cardiovascular disease and erectile dysfunction (ED). We aimed to identify independent predictors of ED in patients with gout. Methods: From August 2014 to August 2015, male outpatients who were being treated for gout in our rheumatology clinic and healthy males without any history of inflammatory disease (control group) were studied. ED was assessed in participants using the five-item version of the International Index of Erectile Function questionnaire. Insulin resistance (IR) was estimated using the homeostatic model assessment (HOMA-IR). Logistic regression analysis was performed to determine the effect of variables on ED risk in all of the study subjects and in patients with gout. Results: We analyzed 80 patients with gout and 70 healthy controls. The median age of patients with gout was 52 years and median disease duration was 120 months. Gout patients were more likely to have ED than controls (55.3% vs. 41.4%, p < 0.047). After adjustment for confounding factors, only HOMA-IR was significantly associated with ED (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.05 to 3.15). Gout patients with ED were more likely to be older (p < 0.001), have higher HOMA-IR (p = 0.048), and have lower glomerular filtration rate (p = 0.038) than those without ED. Multivariate logistic regression analysis showed that HOMAIR was an independent predictor for ED (OR, 1.62; 95% CI, 1.03 to 2.82) in gout patients. Conclusions: IR is an independent predictor of ED in patients with gout.
참고문헌 (37)
- Richette P, "Gout", Lancet, 375, pp.318~328 (2010)
- Zhu Y, "Prevalence of gout and hyperuricemia in the US general population : the National Health and Nutrition Examination Survey 2007-2008", Arthritis Rheum, 63, pp.3136~3141 (2011)
- Fessel WJ, "Renal outcomes of gout and hyperuricemia", Am J Med, 67, pp.74~82 (1979)
- Takahashi S, "Increased concentrations of serum Lp(a)lipoprotein in patients with primary gout", Ann Rheum Dis, 54, pp.90~93 (1995)
- Grodzicki T, "Incidence of diabetes and gout in hypertensive patients during 8 years of follow-up. The General Practice Hypertension Study Group", J Hum Hypertens, 11, pp.583~585 (1997)
- Choi HK, "Prevalence of the metabolic syndrome in patients with gout : the Third National Health and Nutrition Examination Survey", Arthritis Rheum, 57, pp.109~115 (2007)
- Abbott RD, "Gout and coronary heart disease : the Framingham Study", J Clin Epidemiol, 41, pp.237~242 (1988)
- Choi HK, "Independent impact of gout on mortality and risk for coronary heart disease", Circulation, 116, pp.894~900 (2007)
- Zhang W, "EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)", Ann Rheum Dis, 65, pp.1312~1324 (2006)
- Zhang W, "EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)", Ann Rheum Dis, 65, pp.1301~1311 (2006)
- Hatzimouratidis K, "Guidelines on male sexual dysfunction : erectile dysfunction and premature ejaculation", Eur Urol, 57, pp.804~814 (2010)
- Kloner RA, "Erectile dysfunction in the cardiac patient", Curr Urol Rep, 4, pp.466~471 (2003)
- Hermann GG, "The influence of the level of lamina propria invasion and the prevalence of p53nuclear accumulation on survival in stage T1 transitional cell bladder cancer", J Urol, 159, pp.91~94 (1998)
- Feldman HA, "Erectile dysfunction and coronary risk factors : prospective results from the Massachusetts male aging study", Prev Med, 30, pp.328~338 (2000)
- Chiurlia E, "Subclinical coronary artery atherosclerosis in patients with erectile dysfunction", J Am Coll Cardiol, 46, pp.1503~1506 (2005)
- Heidler S, "Is the metabolic syndrome an independent risk factor for erectile dysfunction?", J Urol, 177, pp.651~654 (2007)
- Chen YF, "Gout and a subsequent increased risk of erectile dysfunction in men aged 64 and under : a nationwide cohort study in Taiwan", J Rheumatol, 42, pp.1898~1905 (2015)
- Hsu CY, "Gout is associated with organic and psychogenic erectile dysfunction", Eur J Intern Med, 26, pp.691~695 (2015)
- Schlesinger N, "Erectile dysfunction is common among patients with gout", J Rheumatol, 42, pp.1893~1897 (2015)
- Wallace SL, "Preliminary criteria for the classification of the acute arthritis of primary gout", Arthritis Rheum, 20, pp.895~900 (1977)
- Herrmann C, "International experiences with the Hospital Anxiety and Depression Scale : a review of validation data and clinical results", J Psychosom Res, 42, pp.17~41 (1997)
- Rosen RC, "The international index of erectile function(IIEF) : a multidimensional scale for assessment of erectile dysfunction", Urology, 49, pp.822~830 (1997)
- Salem S, "Serum uric acid as a risk predictor for erectile dysfunction", J Sex Med, 11, pp.1118~1124 (2014)
- Kanbay M, "The role of uric acid in the pathogenesis of human cardiovascular disease", Heart, 99, pp.759~766 (2013)
- Vlachopoulos C, "Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease", Eur Heart J, 27, pp.2640~2648 (2006)
- Yoo HG, "Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis", Rheumatol Int, 31, pp.485~491 (2011)
- Dessein PH, "Beneficial effects of weight loss associated with moderate calorie", carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout : a pilot study, 2000, pp.59, 539~543
- Lee J, "Uric acid and coronary heart disease risk: evidence for a role of uric acid in the obesity-insulin resistance syndrome. The Normative Aging Study", Am J Epidemiol, 142, pp.288~294 (1995)
- Rathmann W, "Relations of hyperuricemia with the various components of the insulin resistance syndrome in young black and white adults: the CARDIA study. Coronary Artery Risk Development in Young Adults", Ann Epidemiol, 8, pp.250~261 (1998)
- Choi HK, "Pathogenesis of gout", Ann Intern Med, 143, pp.499~516 (2005)
- Bornfeldt KE, "Insulin resistance, hyperglycemia, and atherosclerosis", Cell Metab, 14, pp.575~585 (2011)
- Karrowni W, "Insulin resistance is associated with significant clinical atherosclerosis in nondiabetic patients with acute myocardial infarction", Arterioscler Thromb Vasc Biol, 33, pp.2245~2251 (2013)
- Gandaglia G, "A systematic review of the association between erectile dysfunction and cardiovascular disease", Eur Urol, 65, pp.968~978 (2014)
- Blander DS, "Sex inventories:can questionnaires replace erectile dysfunction testing?", Urology, 54, pp.719~723 (1999)
- Deveci S, "Can the International Index of Erectile Function distinguish between organic and psychogenic erectile function?", BJU Int, 102, pp.354~356 (2008)
- Lithell HO, "Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism", Diabetes Care, 14, pp.203~209 (1991)
- Lue TF, "Erectile dysfunction", N Engl J Med, 342, pp.1802~1813 (2000)