Murat Sambel, Abdullah Erdogan, Volkan Caglayan, Sinan Avci, Sahin Kilic, Halil Emre Yildiz, Ercument Keskin
{"title":"致动脉粥样硬化指数和甘油三酯-葡萄糖指数能否用于预测勃起功能障碍？","authors":"Murat Sambel, Abdullah Erdogan, Volkan Caglayan, Sinan Avci, Sahin Kilic, Halil Emre Yildiz, Ercument Keskin","doi":"10.1093/sexmed/qfad069","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis and insulin resistance play an important role in the development of erectile dysfunction (ED), and few studies have comprehensively evaluated more specific indicators like atherogenic indices and the triglyceride-glucose (TyG) index in the assessment of ED.</p><p><strong>Aim: </strong>This study aimed to reveal the role of atherogenic indices (atherogenic index of plasma [AIP], Castelli risk index-1/2 [CRI-1/2], and atherogenic coefficient [AC]) based on plasma lipid ratios, which have been used as more sensitive indicators of atherosclerosis in recent years, and the TyG index, a practical indicator of insulin resistance, in predicting vasculogenic ED.</p><p><strong>Methods: </strong>The study included a total of 199 patients who met the inclusion criteria and a total of 51 control subjects without ED complaints according to the International Index of Erectile Function (IIEF-5) scores (>21) between May 2021 and October 2022. For all participants, the demographic and biochemical parameters were evaluated, and atherogenic indices, namely CRI-1 (total cholesterol/high-density lipoprotein [HDL]), CRI-2 (LDL/HDL) AIP [log10(triglycerides/HDL)], and AC (non-HDL/HDL), as well as the TyG index [Ln {fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2}] were calculated.</p><p><strong>Outcomes: </strong>The TyG index, which is an indicator of insulin resistance, and atherogenic indices such as CRI-1, AIP, and AC were significantly associated with ED, and especially AIP and the TyG index seem to be more important in the evaluation of ED.</p><p><strong>Results: </strong>According to the univariate analysis, the patient group had significantly higher CRI-1 (5.3 ± 1.4 vs 4.7 ± 1.3; <i>P</i> = .005), AIP (0.31 ± 0.26 vs 0.13 ± 0.2; <i>P</i> < .001), AC (4.1 ± 1.4 vs 3.70 ± 1.2; <i>P</i> = .026), and TyG (9.16 ± 0.71 vs 8.77 ± 0.52; <i>P</i> < .001) values compared with the control group. In the correlation analysis, a significant negative correlation was found between the AIP and TyG index and the IIEF-5 scores (r<sup>2</sup> = 0.120, <i>P</i> < .001 between AIP and IIEF-5; r<sup>2</sup> = 0.091, <i>P</i> < .001 between TyG index and IIEF-5). The multivariate analysis revealed AIP and the TyG index as independent predictive factors for ED.</p><p><strong>Clinical implications: </strong>The use of atherogenic indices and TyG index in daily urology practice can help physicians in the diagnosis and follow-up of ED.</p><p><strong>Strengths and limitations: </strong>The lack of sex hormone-binding globulin and free testosterone levels represents a limitation of our study. Another limitation is that the severity of ED was determined using the IIEF-5 scores, rather than a more objective method, such as penile artery ultrasound.</p><p><strong>Conclusion: </strong>Atherogenic indices and the TyG index can be used as inexpensive and practical markers to predict the severity of arteriogenic ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799712/pdf/","citationCount":"0","resultStr":"{\"title\":\"Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction?\",\"authors\":\"Murat Sambel, Abdullah Erdogan, Volkan Caglayan, Sinan Avci, Sahin Kilic, Halil Emre Yildiz, Ercument Keskin\",\"doi\":\"10.1093/sexmed/qfad069\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Atherosclerosis and insulin resistance play an important role in the development of erectile dysfunction (ED), and few studies have comprehensively evaluated more specific indicators like atherogenic indices and the triglyceride-glucose (TyG) index in the assessment of ED.</p><p><strong>Aim: </strong>This study aimed to reveal the role of atherogenic indices (atherogenic index of plasma [AIP], Castelli risk index-1/2 [CRI-1/2], and atherogenic coefficient [AC]) based on plasma lipid ratios, which have been used as more sensitive indicators of atherosclerosis in recent years, and the TyG index, a practical indicator of insulin resistance, in predicting vasculogenic ED.</p><p><strong>Methods: </strong>The study included a total of 199 patients who met the inclusion criteria and a total of 51 control subjects without ED complaints according to the International Index of Erectile Function (IIEF-5) scores (>21) between May 2021 and October 2022. For all participants, the demographic and biochemical parameters were evaluated, and atherogenic indices, namely CRI-1 (total cholesterol/high-density lipoprotein [HDL]), CRI-2 (LDL/HDL) AIP [log10(triglycerides/HDL)], and AC (non-HDL/HDL), as well as the TyG index [Ln {fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2}] were calculated.</p><p><strong>Outcomes: </strong>The TyG index, which is an indicator of insulin resistance, and atherogenic indices such as CRI-1, AIP, and AC were significantly associated with ED, and especially AIP and the TyG index seem to be more important in the evaluation of ED.</p><p><strong>Results: </strong>According to the univariate analysis, the patient group had significantly higher CRI-1 (5.3 ± 1.4 vs 4.7 ± 1.3; <i>P</i> = .005), AIP (0.31 ± 0.26 vs 0.13 ± 0.2; <i>P</i> < .001), AC (4.1 ± 1.4 vs 3.70 ± 1.2; <i>P</i> = .026), and TyG (9.16 ± 0.71 vs 8.77 ± 0.52; <i>P</i> < .001) values compared with the control group. In the correlation analysis, a significant negative correlation was found between the AIP and TyG index and the IIEF-5 scores (r<sup>2</sup> = 0.120, <i>P</i> < .001 between AIP and IIEF-5; r<sup>2</sup> = 0.091, <i>P</i> < .001 between TyG index and IIEF-5). The multivariate analysis revealed AIP and the TyG index as independent predictive factors for ED.</p><p><strong>Clinical implications: </strong>The use of atherogenic indices and TyG index in daily urology practice can help physicians in the diagnosis and follow-up of ED.</p><p><strong>Strengths and limitations: </strong>The lack of sex hormone-binding globulin and free testosterone levels represents a limitation of our study. Another limitation is that the severity of ED was determined using the IIEF-5 scores, rather than a more objective method, such as penile artery ultrasound.</p><p><strong>Conclusion: </strong>Atherogenic indices and the TyG index can be used as inexpensive and practical markers to predict the severity of arteriogenic ED.</p>\",\"PeriodicalId\":21782,\"journal\":{\"name\":\"Sexual Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-01-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799712/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sexual Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/sexmed/qfad069\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexual Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/sexmed/qfad069","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：动脉粥样硬化和胰岛素抵抗在勃起功能障碍（ED）的发病中起着重要作用，但很少有研究全面评估动脉粥样硬化指数和甘油三酯-葡萄糖（TyG）指数等更具体的指标在 ED 评估中的作用。目的：本研究旨在揭示基于血浆脂质比率的致动脉粥样硬化指数（血浆致动脉粥样硬化指数[AIP]、卡斯泰利风险指数-1/2[CRI-1/2]和致动脉粥样硬化系数[AC]）和胰岛素抵抗的实用指标TyG指数在预测血管源性ED中的作用：该研究共纳入了199名符合纳入标准的患者，以及51名在2021年5月至2022年10月期间根据国际勃起功能指数（IIEF-5）评分（>21）无ED主诉的对照受试者。对所有参与者的人口统计学和生化参数进行评估，并计算动脉粥样硬化指数，即CRI-1（总胆固醇/高密度脂蛋白[HDL]）、CRI-2（低密度脂蛋白/高密度脂蛋白）AIP[log10（甘油三酯/高密度脂蛋白）]和AC（非高密度脂蛋白/高密度脂蛋白），以及TyG指数[Ln {空腹甘油三酯（毫克/分升）×空腹血糖（毫克/分升）/2}]：结果：作为胰岛素抵抗指标的TyG指数以及CRI-1、AIP和AC等致动脉粥样硬化指数与ED显著相关，尤其是AIP和TyG指数在ED的评估中似乎更为重要：根据单变量分析，患者组的 CRI-1 (5.3 ± 1.4 vs 4.7 ± 1.3; P = .005) 、AIP (0.31 ± 0.26 vs 0.13 ± 0.2; P < .001) 、AC (4.1 ± 1.4 vs 3.70 ± 1.2；P = .026）和 TyG（9.16 ± 0.71 vs 8.77 ± 0.52；AIP 和 IIEF-5 之间的 P 2 = 0.120，P < .001；TyG 指数和 IIEF-5 之间的 r2 = 0.091，P < .001）。多变量分析显示，AIP和TyG指数是ED的独立预测因素：临床意义：在日常泌尿科实践中使用致动脉粥样硬化指数和 TyG 指数有助于医生诊断和随访 ED：优点和局限性：缺乏性荷尔蒙结合球蛋白和游离睾酮水平是我们研究的一个局限性。另一个局限性是，ED的严重程度是通过IIEF-5评分而非阴茎动脉超声等更客观的方法来确定的：结论：动脉粥样硬化指数和 TyG 指数可作为预测动脉性 ED 严重程度的廉价而实用的指标。
Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction?
Background: Atherosclerosis and insulin resistance play an important role in the development of erectile dysfunction (ED), and few studies have comprehensively evaluated more specific indicators like atherogenic indices and the triglyceride-glucose (TyG) index in the assessment of ED.
Aim: This study aimed to reveal the role of atherogenic indices (atherogenic index of plasma [AIP], Castelli risk index-1/2 [CRI-1/2], and atherogenic coefficient [AC]) based on plasma lipid ratios, which have been used as more sensitive indicators of atherosclerosis in recent years, and the TyG index, a practical indicator of insulin resistance, in predicting vasculogenic ED.
Methods: The study included a total of 199 patients who met the inclusion criteria and a total of 51 control subjects without ED complaints according to the International Index of Erectile Function (IIEF-5) scores (>21) between May 2021 and October 2022. For all participants, the demographic and biochemical parameters were evaluated, and atherogenic indices, namely CRI-1 (total cholesterol/high-density lipoprotein [HDL]), CRI-2 (LDL/HDL) AIP [log10(triglycerides/HDL)], and AC (non-HDL/HDL), as well as the TyG index [Ln {fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2}] were calculated.
Outcomes: The TyG index, which is an indicator of insulin resistance, and atherogenic indices such as CRI-1, AIP, and AC were significantly associated with ED, and especially AIP and the TyG index seem to be more important in the evaluation of ED.
Results: According to the univariate analysis, the patient group had significantly higher CRI-1 (5.3 ± 1.4 vs 4.7 ± 1.3; P = .005), AIP (0.31 ± 0.26 vs 0.13 ± 0.2; P < .001), AC (4.1 ± 1.4 vs 3.70 ± 1.2; P = .026), and TyG (9.16 ± 0.71 vs 8.77 ± 0.52; P < .001) values compared with the control group. In the correlation analysis, a significant negative correlation was found between the AIP and TyG index and the IIEF-5 scores (r2 = 0.120, P < .001 between AIP and IIEF-5; r2 = 0.091, P < .001 between TyG index and IIEF-5). The multivariate analysis revealed AIP and the TyG index as independent predictive factors for ED.
Clinical implications: The use of atherogenic indices and TyG index in daily urology practice can help physicians in the diagnosis and follow-up of ED.
Strengths and limitations: The lack of sex hormone-binding globulin and free testosterone levels represents a limitation of our study. Another limitation is that the severity of ED was determined using the IIEF-5 scores, rather than a more objective method, such as penile artery ultrasound.
Conclusion: Atherogenic indices and the TyG index can be used as inexpensive and practical markers to predict the severity of arteriogenic ED.
期刊介绍：
Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.
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