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Insulin resistance is an independent predictor of severe lower urinary tract symptoms and of erectile dysfunction: results from a cross-sectional study.
J Sex Med 2014; 11(8):2074-82JS

Abstract

INTRODUCTION

Several studies have linked the association between lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and the presence of insulin resistance (IR) due to an underlined metabolic syndrome (MetS).

AIM

This study aims to determine the relationship between IR, sexual function, and LUTS and to demonstrate the ability of IR in predicting ED and severe LUTS.

METHODS

Between January 2008 to January 2013, 544 consecutive patients with benign prostatic hyperplasia-related LUTS were enrolled. LUTS and sexual function of the patients were evaluated by the International Index of Erectile Function (IIEF) and the International Prostate Symptom Score (IPSS). MetS was defined by the International Diabetes Federation. IR was defined as a homeostasis model assessment (HOMA) index of 3 or greater.

MAIN OUTCOME MEASURES

Uni- and multivariate logistic regression analysis was performed to assess significant predictors of severe LUTS (IPSS ≥ 20) and ED (IIEF-Erectile Function [IIEF-EF] <26), including MetS component, prostate volume, prostate-specific antigen, total testosterone, and HOMA index.

RESULTS

IR patients resulted in higher values of IPSS (19.0 vs. 15.0; P<0.01), IPSS-storage (6.0 vs. 5.0; P<0.01), IPSS-voiding (12.0 vs. 9.0; P<0.01), total prostate volume (54.8 vs. 36.5; P<0.01), and lower values of IIEF-EF (17.0 vs. 20.0; P<0.01), IIEF-Intercourse Satisfaction (3.0 vs. 10.0; P<0.01), IIEF-Orgasmic Function (8.0 vs. 9.0; P<0.01), IIEF-Overall Satisfaction (6.0 vs. 8.0; P<0.01), and total testosterone (3.83 vs. 4.44; P<0.01). IR was demonstrated to be a strong predictor of ED (IIEF-EF <26) (odds ratio [OR] =6.20, P<0.01) after adjusting for confounding factors. Finally, IR was also an independent predictor of severe LUTS (IPSS ≥ 20) (OR=2.0, P<0.01) after adjusting for confounding factors.

CONCLUSIONS

IR patients are at high risk of having severe LUTS and contemporary sexual dysfunctions. We strongly suggest to prevent LUTS and ED by reducing insulin resistance.

Authors+Show Affiliations

Department of Urology, University of Catania, Urology, Catania, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24836928

Citation

Russo, Giorgio Ivan, et al. "Insulin Resistance Is an Independent Predictor of Severe Lower Urinary Tract Symptoms and of Erectile Dysfunction: Results From a Cross-sectional Study." The Journal of Sexual Medicine, vol. 11, no. 8, 2014, pp. 2074-82.
Russo GI, Cimino S, Fragalà E, et al. Insulin resistance is an independent predictor of severe lower urinary tract symptoms and of erectile dysfunction: results from a cross-sectional study. J Sex Med. 2014;11(8):2074-82.
Russo, G. I., Cimino, S., Fragalà, E., Privitera, S., La Vignera, S., Condorelli, R., ... Morgia, G. (2014). Insulin resistance is an independent predictor of severe lower urinary tract symptoms and of erectile dysfunction: results from a cross-sectional study. The Journal of Sexual Medicine, 11(8), pp. 2074-82. doi:10.1111/jsm.12587.
Russo GI, et al. Insulin Resistance Is an Independent Predictor of Severe Lower Urinary Tract Symptoms and of Erectile Dysfunction: Results From a Cross-sectional Study. J Sex Med. 2014;11(8):2074-82. PubMed PMID: 24836928.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance is an independent predictor of severe lower urinary tract symptoms and of erectile dysfunction: results from a cross-sectional study. AU - Russo,Giorgio Ivan, AU - Cimino,Sebastiano, AU - Fragalà,Eugenia, AU - Privitera,Salvatore, AU - La Vignera,Sandro, AU - Condorelli,Rosita, AU - Calogero,Aldo E, AU - Castelli,Tommaso, AU - Favilla,Vincenzo, AU - Morgia,Giuseppe, Y1 - 2014/05/19/ PY - 2014/5/20/entrez PY - 2014/5/20/pubmed PY - 2014/10/24/medline KW - Erectile Dysfunction KW - HOMA KW - IPSS KW - Insulin Resistance KW - LUTS KW - Metabolic Syndrome SP - 2074 EP - 82 JF - The journal of sexual medicine JO - J Sex Med VL - 11 IS - 8 N2 - INTRODUCTION: Several studies have linked the association between lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and the presence of insulin resistance (IR) due to an underlined metabolic syndrome (MetS). AIM: This study aims to determine the relationship between IR, sexual function, and LUTS and to demonstrate the ability of IR in predicting ED and severe LUTS. METHODS: Between January 2008 to January 2013, 544 consecutive patients with benign prostatic hyperplasia-related LUTS were enrolled. LUTS and sexual function of the patients were evaluated by the International Index of Erectile Function (IIEF) and the International Prostate Symptom Score (IPSS). MetS was defined by the International Diabetes Federation. IR was defined as a homeostasis model assessment (HOMA) index of 3 or greater. MAIN OUTCOME MEASURES: Uni- and multivariate logistic regression analysis was performed to assess significant predictors of severe LUTS (IPSS ≥ 20) and ED (IIEF-Erectile Function [IIEF-EF] <26), including MetS component, prostate volume, prostate-specific antigen, total testosterone, and HOMA index. RESULTS: IR patients resulted in higher values of IPSS (19.0 vs. 15.0; P<0.01), IPSS-storage (6.0 vs. 5.0; P<0.01), IPSS-voiding (12.0 vs. 9.0; P<0.01), total prostate volume (54.8 vs. 36.5; P<0.01), and lower values of IIEF-EF (17.0 vs. 20.0; P<0.01), IIEF-Intercourse Satisfaction (3.0 vs. 10.0; P<0.01), IIEF-Orgasmic Function (8.0 vs. 9.0; P<0.01), IIEF-Overall Satisfaction (6.0 vs. 8.0; P<0.01), and total testosterone (3.83 vs. 4.44; P<0.01). IR was demonstrated to be a strong predictor of ED (IIEF-EF <26) (odds ratio [OR] =6.20, P<0.01) after adjusting for confounding factors. Finally, IR was also an independent predictor of severe LUTS (IPSS ≥ 20) (OR=2.0, P<0.01) after adjusting for confounding factors. CONCLUSIONS: IR patients are at high risk of having severe LUTS and contemporary sexual dysfunctions. We strongly suggest to prevent LUTS and ED by reducing insulin resistance. SN - 1743-6109 UR - https://www.unboundmedicine.com/medline/citation/24836928/Insulin_resistance_is_an_independent_predictor_of_severe_lower_urinary_tract_symptoms_and_of_erectile_dysfunction:_results_from_a_cross_sectional_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-6095(15)30101-6 DB - PRIME DP - Unbound Medicine ER -