International Urology and Nephrology

, Volume 30, Issue 2, pp 185–191 | Cite as

Is apolipoprotein-(a) an important indicator of vasculogenic erectile dysfunction?

  • Ö. Atahan
  • Ö. Kayigil
  • N. Hizel
  • A. Metin
Article

Abstract

We aimed to investigate whether high peripheral and cavernosal plasma levels of apolipoprotein-(a) [Lp (a)] is an indicator for vasculogenic erectile dysfunction. We determined Lp (a), total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL) levels in peripheral and cavernosal blood in 39 patients with erectile dysfunction. Thirty-nine impotent patients have been divided into two groups: vasculogenic erectile dysfunction (VED) and nonvasculogenic erectile dysfunction (NVED), according to colour Doppler ultrasonic flowmetry, dynamic infusion cavernosometry, and the pressure difference between the brachial arterial systolic pressure and cavernosal arterial systolic pressure measurements. Biochemical values were compared in both groups. Lp (a) and TC levels were higher in both peripheral and cavernosal samples of VED group than in NVED group, with no differences between peripheral and cavernosal blood levels within the same groups. There were no significant changes in TG and HDL levels in either group. The detection of more than 31 mg/dl in Lp (a) level solely shows the vascular origin with a sensitivity and specificity of 95 and 82.3%, respectively. High Lp (a) levels can be considered an indicator of vasculogenic erectile dysfunction.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kostner, G. M.: The role of lipoprotein-(a) in atherogenesis.Klin. Lab., 38, 5 (1992).Google Scholar
  2. 2.
    Lue, T. F., Tanagho, E. A.: Physiology of erection and pharmacological management of impotence.J. Urol. 137, 829 (1987).PubMedGoogle Scholar
  3. 3.
    Virag, R., Bouilly, P., Frydman, D.: Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men.Lancet, 1, 181 (1985).PubMedCrossRefGoogle Scholar
  4. 4.
    Shabsigh, R., Fishman, I. J., Schum, C., Dunn, J. K.: Cigarette smoking and other vascular risk factors in vasculogenic impotence.Urology, 38, 227 (1991).PubMedCrossRefGoogle Scholar
  5. 5.
    Azadzoi, K. M., de Tejada, I. S.: Hypercholesterolemia impairs endothelium-dependent relaxation of rabbit corpus cavernosum smooth muscle.J. Urol., 146, 238 (1991).PubMedGoogle Scholar
  6. 6.
    Kim, J. H., Klyachkin, M. L., Svendsen, E., Davies, M. G., Hagen, P., Carson III, C. C.: Experimental hypercholesterolemia in rabbits induces cavernosal atherosclerosis with endothelial and smooth muscle cell dysfunction.J. Urol., 151, 198 (1994).PubMedGoogle Scholar
  7. 7.
    Panza, J. A., Quyyumi, A. A., Brush, J. E., Jr.: Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension.N. Engl. J. Med., 323, 22 (1990).PubMedCrossRefGoogle Scholar
  8. 8.
    Jünemann, K.-P., Aufenanger, J., Konrad, T., Pill, J., Berle, B., Persson-Jünemann, C., Alken, P.: The effect of impaired lipid metabolism on the smooth muscle cells of rabbits.Urol. Res., 19, 271 (1991).PubMedCrossRefGoogle Scholar
  9. 9.
    Utermann, G.: The mysteries of lipoprotein-(a).Science, 246, 904 (1989).PubMedCrossRefGoogle Scholar
  10. 10.
    Kayigil, Ö., Atahan, Ö., Mein, A.: Dynamic infusion cavernosometry and cavernosography in diagnosing and classifying venoocclusive dysfunction.Int. Urol. Nephrol., 27, 615 (1995).PubMedGoogle Scholar
  11. 11.
    Penson, D. F., Seftel, A. D., Krane, R. J., Frohrib, D., Goldstein, I.: The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis.J. Urol., 148, 1171 (1992).PubMedGoogle Scholar
  12. 12.
    Padma-Nathan, H.: Dynamic infusion cavernosometry and cavernosography and the cavernosal artery systolic occlusion pressure gradient: A complete evaluation of the hemodynamic events of a penile erection. Postgraduate course 64. Presented at the Annual Meeting of the American Urological Association, May 10–14, Washington 1992.Google Scholar
  13. 13.
    Michal, V.: Arterial disease as a cause of impotence.Clin. Endocrinol. Metab., 11, 725 (1982).PubMedCrossRefGoogle Scholar
  14. 14.
    Krane, R. J., Goldstein, I., Saenz, D. T.: Impotence.N. Engl. J. Med., 321, 1648 (1989).PubMedCrossRefGoogle Scholar
  15. 15.
    Mc Gill, H. C.: The pathogenesis of atherosclerosis.Clin. Chem., 34, 33 (1988).Google Scholar
  16. 16.
    Orem, A., Deger, O., Kulan, K., Onder, E., Kiran, E., Uzunosmanoĝlu, D.: Evaluation of lipoprotein-(a) as a risk factor for coronary artery disease in the Turkish population.Clin. Biochem., 28, 171 (1995).PubMedCrossRefGoogle Scholar
  17. 17.
    Wei, M., Macera, C. A., Davis, D. R., Hornung, C. A., Nankin, H. R., Blair, S. N.: Total cholesterol and high density lipoprotein cholesterol as important predictors of erectile dysfunction.Am. J. Epidemiol., 140, 930 (1994).PubMedGoogle Scholar
  18. 18.
    Adams, M. R., Kaplan, J. R., Koritnik, D. R., Weaver, D. S., Bond, M. G.: Erectile failure in cynomolgus monkeys with atherosclerosis of the arteries supplying the penis.J. Urol., 131, 571 (1984).PubMedGoogle Scholar
  19. 19.
    Wespes, E., Goes, P. M., Schiffmann, S., Depierreux, M., Vanderhaeghen, J. J., Schulman, C. C.: Computerized analysis of smooth muscle fibers in potent and impotent patients.J. Urol., 146, 1015 (1991).PubMedGoogle Scholar
  20. 20.
    Pickard, R. S., King, P., Zar, M. A., Powell, P. H.: Corpus cavernosal relaxation in impotent men.Br. J. Urol., 74, 485 (1994).PubMedCrossRefGoogle Scholar

Copyright information

© Akadémiai Kiadó 1998

Authors and Affiliations

  • Ö. Atahan
    • 1
  • Ö. Kayigil
    • 1
  • N. Hizel
    • 2
  • A. Metin
    • 1
  1. 1.Urologic Clinics of TCDD Ankara HospitalAnkaraTurkey
  2. 2.Department of Biochemistry, Faculty of MedicineBaskent UniversityAnkaraTurkey

Personalised recommendations