摘要
背景：勃起功能障碍（ED）的特征是阴茎无法勃起或勃起不坚，无法进行性交。虽然以往的研究表明 ED 与前列腺病变之间存在潜在联系，但良性前列腺增生症（BPH）、前列腺炎、前列腺癌（PCa）和 ED 之间的关联仍有待阐明：这项观察性研究从 2001-2004 年国家健康调查（NHANES）中提取了参与者（40-80 岁，n=2225）的数据。调查包括以下几个方面：评估亚组中的 ED 患病率，比较有 ED 和无 ED 患者的基线特征，在 40-60 岁和 60-80 岁年龄组中使用多变量加权逻辑回归分析良性前列腺增生症、前列腺炎、PCa 和 ED 之间的关联，以及基于体重指数、高血压、糖尿病和吸烟状况的亚组分析：在 2225 名参与者中，加权 ED 患病率为 27.47%，其中 40-60 岁年龄组为 16.17%，60-80 岁年龄组为 56.98%。良性前列腺增生症的 ED 患病率为 47.57%，前列腺炎为 34.62%，PCa 为 85.62%。ED 组和非 ED 组之间的比较分析表明，教育水平、PIR、吸烟和酗酒状况、肌酐、总胆固醇、低密度脂蛋白胆固醇、糖尿病、高血压、良性前列腺增生症和 PCa 存在显著差异。多变量逻辑回归分析发现，在 60-80 岁年龄组中，BPH 是导致 ED 的独立风险因素（OR=1.93；95% CI，1.18-3.18，P=0.02），而在 40-60 岁年龄组（OR=11.90；95% CI，1.41-100.50，P=0.03）和 40-80 岁年龄组（OR=7.30；95% CI，2.12-25.08，P=0.01）中，PCa 与 ED 呈正相关。前列腺炎与 ED 之间没有明显的相关性。亚组分析表明，在非糖尿病、超重/肥胖和吸烟组中，良性前列腺增生症与 ED 之间的关系显著，而在非糖尿病、高血压患者的所有体重指数（BMI）类别中，以及在吸烟和非吸烟组中，PCa 与 ED 之间的关系更为明显。结论：该研究确定了良性前列腺增生症（BPH）和前列腺癌（PCa）之间的关系：结论：该研究将良性前列腺增生症（BPH）和前列腺癌（PCa）确定为导致性功能障碍的重要风险因素，但未发现前列腺炎与性功能障碍之间存在实质性联系。这一发现凸显了为前列腺增生症和前列腺癌患者量身定制筛查和管理方案以减轻 ED 负担的必要性。Background: Erectile dysfunction (ED) is characterized by the inability to achieve or maintain penile erection sufficient for intercourse. While previous research suggests a potential link between ED and prostate pathologies, the association between benign prostatic hyperplasia (BPH), prostatitis, prostatic cancer (PCa), and ED remains to be elucidated.
Methods: Data from participants (40-80 years, n=2225) were extracted from the NHANES 2001-2004 for this observational study. The investigation encompassed the following aspects: assessment of ED prevalence within subgroups, comparison of baseline characteristics between individuals with and without ED, analysis of associations between BPH, prostatitis, PCa, and ED using multivariable weighted logistic regression in the 40-60 and 60-80 age groups and subgroup analysis based on body mass index, hypertension, diabetes, and smoking status.
Results: Among the 2225 participants, the weighted prevalence of ED was 27.47%, with 16.17% in the 40-60 years age group and 56.98% in the 60-80 years age group. BPH had an ED prevalence of 47.57%, prostatitis 34.62%, and PCa 85.62%. Comparative analysis between ED and non-ED groups revealed significant differences in education levels, PIR, smoking and alcohol status, creatinine, total cholesterol, LDL cholesterol, diabetes, hypertension, BPH, and PCa. Multivariate logistic regression analysis identified BPH as an independent risk factor for ED in the 60-80 years age group (OR=1.93; 95% CI, 1.18-3.18, P=0.02), and PCa was positively associated with ED in both the 40-60 years group (OR=11.90; 95% CI, 1.41-100.50, P=0.03) and the 40-80 years group (OR=7.30; 95% CI, 2.12-25.08, P=0.01). No clear correlation was found between prostatitis and ED. Subgroup analyses indicated that the association between BPH and ED was significant in non-diabetic, overweight/obese, and smoking groups, while the association between PCa and ED was more pronounced in non-diabetic, hypertensive individuals across all body mass index (BMI) categories, and in both smoking and non-smoking groups. Prostatitis showed no significant relationship with ED in any subgroup.
Conclusion: The study established BPH and PCa as significant risk factors for ED, with no substantial link detected between prostatitis and ED. This finding highlights the necessity for tailored screening and management protocols for individuals with BPH and PCa to mitigate the burden of ED.
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