Erectile dysfunction (ED), a condition closely related to cardiovascular morbidity and mortality, is frequently associated with obesity. In this study, we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young (18-49 years) nondiabetic obese (body mass index [BMI] ≥ 30 kg m-2) men from primary care. Erectile function (International Index of Erectile Function [IIEF-5] questionnaire), quality of life (Aging Males’ Symptoms [AMS scale]), and body composition analysis (Tanita MC-180MA) were determined. Total testosterone was determined using high-performance liquid chromatography-mass spectrometry. Multivariate logistic regression analysis was used to study the factors associated with ED. ED prevalence was 42.1%. Subjects with ED presented higher BMI, waist circumference, number of components of the metabolic syndrome, AMS score, insulin resistance, and a more unfavorable body composition than those without ED. Multivariate logistic regression analysis showed that a pathological AMS score (odds ratio [OR]: 4.238, P < 0.001), degree of obesity (BMI ≥ 40 kg m-2, OR: 2.602, P = 0.005, compared with BMI 30-34.9 kg m-2), high-density lipoprotein (HDL)-cholesterol levels (OR: 0.956, P = 0.004), and age (OR: 1.047, P = 0.016) were factors independently associated with ED. In conclusion, we demonstrate that, in a primary care-based cohort of nondiabetic young obese men, ED affected >40% of subjects. A pathological AMS score, the degree of obesity, and age were positively associated with ED, while elevated HDL-cholesterol levels were inversely associated with the odds of presenting ED. Further prospective studies are needed to evaluate the long-term consequences of ED in this population.

Asian journal of andrology. 2019 Oct 11 [Epub ahead of print]

MarIa Molina-Vega, Maite Asenjo-Plaza, María José Banderas-Donaire, María Dolores Hernández-Ollero, Silvia Rodríguez-Moreno, Juan J Álvarez-Millán, Pablo Cabezas-Sanchez, Fernando Cardona-Díaz, Juan Alcaide-Torres, Lourdes Garrido-Sánchez, Daniel Castellano-Castillo, Francisco J Tinahones, José C Fernández-García

Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain., Cruz de Humilladero Primary Care Center, Málaga 29010, Spain., Teatinos Primary Care Center, Málaga 29010, Spain., Chemical Sanitary Consulting (CQS Lab), Madrid 28003, Spain.