Hormonal associations and sexual dysfunctions in patients with impaired fasting glucose
G. Rastrelli1, G. Corona1,2, G. Balercia3, F. Lotti1, A. Sforza2, M. Monami1, G. Forti1, E. Mannucci1 & M. Maggi1
Introduction: The category of impaired fasting glucose (IFG) denotes a state of non-diabetic hyperglycemia, considered a risk factor of the further development of diabetes mellitus (DM) and cardiovascular (CV) diseases.
Aim: The aim of the present study is to evaluate the impact of IFG on sexual health in men. In addition its effect on CV morbidity and mortality will also be addressed.
Methods: A consecutive series of 3451 men (mean age 57.3±10.1 years) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (n=1687) was enrolled in a longitudinal study.
Main outcome measures: Several clinical, biochemical (including testosterone) and instrumental (penile color doppler ultrasound; PCDU) factors were evaluated. IFG was defined by fasting glucose concentrations between 5.6 and 6.9 mmol/l (100125 mg/dl). A higher threshold (6.16.9 mmol/l, 110125 mg/dl) was also considered.
Results: Among the patients studied, 747 (21.7%) had DM. In addition, 659 (19.1%) subjects were classified as IFG. Patients with IFG, however defined, more often had severe ED, reduced penile blood flow and overt hypogonadism when compared to patients with normal glucose levels. In addition, men with ED and IFG showed poorer blood pressure and lipid profile with an overall increase in CV risk. Unadjusted incidence of major adverse CV events was significantly associated with baseline DM whereas there was a trend toward higher risk also for IFG, but this did not reach statistical significance. Conversely, both IFG and DM were significantly associated with a higher risk of fatal and non fatal cerebral events.
Conclusions: Checking glucose and testosterone levels is mandatory in subjects with ED, because testosterone substitution in impotent IFG subjects might not only ameliorate their sexual life but also their overall health.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.