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Predictive value of Prognostic Nutritional Index (PNI) for the severity of vasculogenic erectile dysfunction

  • Urology - Original Paper
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Abstract

Purpose

Our aim was to investigate the association of prognostic nutritional index (PNI) score with erectile dysfunction (ED), therefore, we prospectively evaluated the relationship between penile doppler ultrasonography (PDU) findings, PNI and Sexual Health Inventory for Men (SHIM) scores in patients with ED.

Methods

A total of 414 patients’ characteristics, laboratory findings, SHIM and PNI scores were recorded. The PNI is calculated using the formula: 10 × serum albumin + 0.005 × total lymphocyte count. PDU was performed in patients with a SHIM score of 17 and below, while patients with a SHIM score ≥ 18 were recruited for the control group. Correlation analysis was performed to evaluate the relationship between PNI, SHIM scores and PDU parameters. The predictive value of variables for severe ED was assessed with regression analysis.

Results

A significant difference was demonstrated between the ED subgroups and control group for total cholesterol (p = 0.04), serum albumin (p = 0.03), total lymphocyte count (p = 0.02), BDI score (p < 0.001), and PNI score (p = 0.03). A strong positive correlation between PNI score and PSV (rho = 0.73; p = 0.001), a moderate negative correlation between PNI score and EDV (rho = − 0.54; p = 0.02), and a moderate positive correlation between PNI and SHIM scores (rho = 0.61; p = 0.02) were demonstrated. PNI score ≤ 40 (OR: 3.49; p = 0.01), age (OR: 2.15; p = 0.03) and total cholesterol (OR: 2.03; p = 0.04) were determined as significant predictors of severe ED in multivariate analysis.

Conclusion

Our results demonstrated that PNI score is significantly lower in patients with severe and moderate ED. It has been also revealed that the PNI score is an independent predictive factor for severe ED.

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References

  1. Salonia A, Bettocchi C, Carvalho J, Corona G, Jones TH, Kadioglu A et al (2022) EAU guidelines on sexual and reproductive health 2022. EAU Guidelines Office, Arnhem

    Google Scholar 

  2. Nguyen HMT, Gabrielson AT, Hellstrom WJG (2017) Erectile dysfunction in young men-A review of the prevalence and risk factors. Sex Med Rev 5(4):508–520

    Article  PubMed  Google Scholar 

  3. Chew KK, Bremner A, Stuckey B, Earle C, Jamrozik K (2009) Is the relationship between cigarette smoking and male erectile dysfunction independent of cardiovascular disease? Findings from a population-based cross-sectional study. J Sex Med 6(1):222–231

    Article  PubMed  Google Scholar 

  4. Elzanaty S, Rezanezhad B, Willenheimer R, Borgquist R (2016) Association between erectile function and biomarkers of subclinical atherosclerosis: a study based on middle-aged healthy men from the general population. Curr Urol 9(3):119–123

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mehu M, Narasimhulu CA, Singla DK (2022) Inflammatory cells in atherosclerosis. Antioxidants (Basel) 11(2):233

    Article  CAS  PubMed  Google Scholar 

  6. Lee-Rueckert M, Lappalainen J, Kovanen PT, Escola-Gil JC (2022) Lipid-Laden macrophages and inflammation in atherosclerosis and cancer: an integrative view. Front Cardiovasc Med 9:777822

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Barbu E, Popescu MR, Popescu AC, Balanescu SM (2022) Inflammation as a precursor of atherothrombosis, diabetes and early vascular aging. Int J Mol Sci 23(2):963

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Zhang Y, Feng X, Wu X, Zhang W, Dai Y, Jiang H et al (2022) A systematic review and meta-analysis of the relationship between erectile dysfunction and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. Andrologia 54(3):e14337

    Article  CAS  PubMed  Google Scholar 

  9. Jamaluddin BM, Srivastava GK, Gupta NP (2019) Role of serum high-sensitivity C-reactive protein as a predictor of therapeutic response to tadalafil in patients with erectile dysfunction: a prospective observational study. J Sex Med 16(12):1912–1921

    Article  CAS  PubMed  Google Scholar 

  10. Kim SI, Kim SJ, Kim SJ, Cho DS (2021) Prognostic nutritional index and prognosis in renal cell carcinoma: a systematic review and meta-analysis. Urol Oncol 39(10):623–630

    Article  PubMed  Google Scholar 

  11. Arques S (2018) Human serum albumin in cardiovascular diseases. Eur J Intern Med 52:8–12

    Article  CAS  PubMed  Google Scholar 

  12. Major AS, Fazio S, Linton MF (2002) B-lymphocyte deficiency increases atherosclerosis in LDL receptor-null mice. Arterioscler Thromb Vasc Biol 22(11):1892–1898

    Article  CAS  PubMed  Google Scholar 

  13. Ramanathan R, Mulhall J, Rao S, Leung R, Martinez Salamanca JI, Mandhani A et al (2007) Predictive correlation between the International Index of Erectile Function (IIEF) and Sexual Health Inventory for Men (SHIM): implications for calculating a derived SHIM for clinical use. J Sex Med 4(5):1336–1344

    Article  PubMed  Google Scholar 

  14. Reynolds WM, Gould JW (1981) A psychometric investigation of the standard and short form beck depression Inventory. J Consult Clin Psychol 49(2):306–307

    Article  CAS  PubMed  Google Scholar 

  15. MacDonald SM, Burnett AL (2021) Physiology of erection and pathophysiology of erectile dysfunction. Urol Clin N Am 48(4):513–525

    Article  Google Scholar 

  16. Behrendt D, Ganz P (2002) Endothelial function. From vascular biology to clinical applications. Am J Cardial 90(10C):40L-48L

    Article  CAS  Google Scholar 

  17. De Souza ILL, Ferreira EDS, Vasconcelos LHC, Cavalcante FA, da Silva BA (2022) Erectile dysfunction: key role of cavernous smooth muscle cells. Front Pharmacol 13:895044

    Article  PubMed  PubMed Central  Google Scholar 

  18. Aversa A, Bruzziches R, Francomano D, Natali M, Gareri P, Spera G (2010) Endothelial dysfunction and erectile dysfunction in the aging man. Int J Urol 17(1):38–47

    Article  PubMed  Google Scholar 

  19. Peluso I, Morabito G, Urban L, Ioannone F, Serafini M (2012) Oxidative stress in atherosclerosis development: the central role of LDL and oxidative burst. Endocr Metab Immune Disord Drug Targets 12(4):351–360

    Article  CAS  PubMed  Google Scholar 

  20. Han X, Cai J, Li Y, Rong X, Li Y, He L et al (2022) Baseline objective malnutritional indices as immune-nutritional predictors of long term recurrence in patients with acute ischemic stroke. Nutrients 14(7):1337

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Wang YH, Chen SY, Wang TD, Hwang BS, Huang TS, Su TC (2009) The relationships among serum glucose, albümin concentrations and carotid atherosclerosis in men with spinal cord injury. Atherosclerosis 206(2):528–534

    Article  CAS  PubMed  Google Scholar 

  22. Joki N, Hase H, Tanaka Y, Takahashi Y, Saijyo T, Ishikawa H et al (2006) Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients. Nephrol Dial Transplant 21(6):1633–1639

    Article  CAS  PubMed  Google Scholar 

  23. Balun A, Akgümüş A, Özbek K, Güven Çetin Z (2023) Prognostic nutritional index as a novel predictor of in-stent restenosis: a retrospective study. Medicina (Kaunas) 59(4):663

    Article  PubMed  Google Scholar 

  24. Demir S, Barlas IS (2021) An independent indicator of erectile dysfunction is C-reactive protein/albumin ratio. Andrologia 53(7):e14073

    Article  CAS  PubMed  Google Scholar 

  25. Sambel M, Kilic M, Demirbas M, Onen E, Oner S, Erdogan A et al (2018) Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios. Int J Impot Res 30(1):27–35

    Article  PubMed  Google Scholar 

  26. Aslan A, Kaya Y, Cirakoglu A, Benli E, Demir EY, Calgin MK (2019) Neutrophil-lymphocyte ratio could be a marker for erectile dysfunction. Urol J 16(2):216–220

    PubMed  Google Scholar 

Download references

Funding

The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Urology, University of Health Sciences Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey

    Burak Arslan, Bugra Cetin, Sina Kardas, Suat Ekinci, Mehmet Ozalevli & Enver Özdemir

  2. Department of Radiology, University of Health Sciences Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey

    Arif Burak Kecebas, Alaaddin Ates & Okan Gurkan

  3. Department of Urology, OTA-Jinemed Hospital, Istanbul, Turkey

    Muammer Aydin

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  1. Burak Arslan
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  2. Arif Burak Kecebas
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Correspondence to Burak Arslan.

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All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the ethical committee of the University of Health Sciences Gaziosmanpaşa Training and Research Hospital (approval no: 2022/30).

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Arslan, B., Kecebas, A.B., Ates, A. et al. Predictive value of Prognostic Nutritional Index (PNI) for the severity of vasculogenic erectile dysfunction. Int Urol Nephrol 55, 2773–2779 (2023). https://doi.org/10.1007/s11255-023-03716-9

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  • DOI: https://doi.org/10.1007/s11255-023-03716-9

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