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Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study

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Abstract

Purpose

The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS—along with its components—and ED.

Methods

All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively.

Results

Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED—as derived from preclinical and clinical models—although independent, is marginal.

Conclusions

The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy

    D. G. Corona & A. Sforza

  2. Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy

    W. Vena & A. Pizzocaro

  3. Andrology, Women’s Endocrinology and Gender Incongruence Unit, “Mario Serio” Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy

    G. Rastrelli & L. Vignozzi

  4. Endocrinology Unit, “Mario Serio” Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy

    C. Sparano & M. Maggi

Authors
  1. D. G. Corona
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  2. W. Vena
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  3. A. Pizzocaro
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  4. G. Rastrelli
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  6. A. Sforza
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  7. L. Vignozzi
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  8. M. Maggi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by GC and MM. The first draft of the manuscript was written by GC and MM, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to D. G. Corona.

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None of the authors declared any conflict of interest.

Research involving human participants and/or animals

All the data provided were collected as part of the routine clinical procedure, according to our hospital’s approval protocol (L99-A08 292/2014) for the diagnostic workup for each patient referred to our unit for Sexual dysfunction.

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For this type of the study no informed consent was required.

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Corona, D.G., Vena, W., Pizzocaro, A. et al. Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study. J Endocrinol Invest 46, 2195–2211 (2023). https://doi.org/10.1007/s40618-023-02136-x

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