Background: The penis has been compared to a barometer of endothelial health, being erectile dysfunction (ED) an early sign of endothelial dysfunction. The aim of the study was to investigate the association between ED and endothelial dysfunction in patients with HIV infection on ART.
Methods: In this observational cross-sectional study we evaluated the prevalence and factors associated with ED in a cohort of 133 HIV-infected men. Evaluation tools included: the International Index of Erectile Function, ultrasound assessment of brachial artery flow mediated dilatation (FMD) and multi-slice computed tomography for coronary artery calcifications (CAC) as surrogates of endothelial dysfunction, the ATP III criteria to diagnose metabolic syndrome, plasma total testosterone (hypogonadism), and a visual analogue scale (VAS) of aesthetic satisfaction of the face and of the body (psychological distress associated with lipodystrophy).
Results: Thirty-nine (29.32%) patients had mild, 14 (10.52%) moderate and 26 (19.55%) severe ED. Prevalence of ED ranged from 45% to 65% respectively in patients less than 40 and more than 60 years old. Metabolic syndrome (MS) was present in 20 (25%) patients with ED and 13 (24%) without (P value=0.87). Prevalence of ED did not appear to be associated with MS as a single clinical pathological entity, nor with the numbers of its diagnostic components. FMD <7% was present in 25 (32%) patients with and 18 (33%) without ED (P value=0.83) and CAC >100 was present in 8 (10%) patients with and 5(9%) without ED (P value=0.87). A stepwise multivariable logistic regression analysis was used to find predictors of ED. Independent predictor were VAS face (OR=0.85, 95% CI 0.730.99, P=0.049) and age, per 10 years of increase (OR=1.73, 95% CI 1.022.94, P=0.04).
Conclusions: Age constituted the most important risk factor for ED, which was related with aesthetic dissatisfaction of the face leading to negative body image perception.
30 Apr - 04 May 2011
European Society of Endocrinology