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Erectile dysfunction was significantly linked to arthritis and remained significant even after adjustment.
Patients with arthritis were significantly more likely to have erectile dysfunction (ED), according to data published in Frontiers in Endocrinology.1
“There is an urgent need to raise awareness and conduct additional research on the reasons behind this association in order to implement more scientific and rational treatment programs for patients with ED and arthritis,” wrote a group of Chinese investigators.
ED is a common condition affecting 46.1% of American men aged 40 – 70 years and between 42.1% – 52.5% of European men aged 40 – 70 years. Although the condition is not life-threatening, it greatly impacts a person’s quality of life. A variety of psychological, environmental, and lifestyle, and medical factors, such as diabetes and hypertension, have been identified as contributing influences to the development of the disorder.2
To evaluate any association between arthritis and ED, investigators employed weighted logistic regression and subgroup analyses using participant data from the 2001 – 2004 National Health and Nutrition Examination Survey (NHANES) database. These datasets were chosen because they were the only cycles with complete ED and arthritis data. Exclusionary criteria included females, male patients aged < 20 years, and patients with missing pertinent information.
The NHANES self-report questionnaire was used to label patients with ED and/or arthritis. Potential confounders that could influence the association between the conditions were identified using multivariate-adjusted models. These included body mass index (BMI), marital status, education level, exercise status, insurance status, age, race, smoking status, alcohol consumption, and a variety of relevant comorbidities.
In total, 3646 patients were included in the analyses. Of these patients 1012 (27.8%) had a history of ED and 795 (18.5%) had a history of arthritis. Patients with ED reported higher rates of arthritis (P <.001) and were more likely to be married, socioeconomically disadvantaged, less educated, older, and physical inactive. Similarly, patients with arthritis had higher rates of ED (P <.001), were married, socioeconomically disadvantaged, less educated, physically inactive, older, and were predominantly White.
ED was linked to arthritis (odds ratio [OR] = 4.00; 95% confidence interval [CI]: 3.20 – 4.99; P <.001), which remained significant after adjustment (OR = 1.42, 95% CI: 1.00 – 1.96; P <.001). After full adjustment, osteoarthritis continued to be significantly associated with ED (OR = 1.11; 95% CI: 1.03 – 1.20; P = .017); however, rheumatoid arthritis (OR = 1.03, 95% CI: 0.93 – 1.13; P = .5) and other types of arthritis (OR = 1.04, 95% CI: 0.98 – 1.11; P = .2) were not significantly linked to the disorder.
Subgroup analyses showed a consistent positive correlation between the conditions across the subgroups, further proving the robustness of results. Significance was sustained among White patients, those aged < 60 years, and those who did not report alcohol consumption (P <.05).
Investigators noted limitations of the study included the cross-sectional, observational study design. Further, as diagnoses were based on results of self-reported questionnaires, there is a possibility that the actual number of patients with ED and arthritis were misestimated. Lastly, results may not be generalizable to other countries and the analyses were only based on patients living in the US.
“Timely identification and treatment of ED in patients with arthritis can have a significant impact on their quality of life by avoiding the use of costly healthcare,” investigators concluded. “In the future, we hope that relevant research will be conducted on populations of more races. Further research is needed to investigate the underlying molecular mechanisms to take appropriate therapeutic measures for patients with arthritis and ED.”
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