Causal Relationship Between Dietary-Derived Antioxidants and Erectile Dysfunction: A Mendelian Randomization Study

Current research suggests a correlation between erectile dysfunction (ED) and dietary-derived antioxidants. However, the causal relationship between these factors remains unclear. This study aims to investigate the causal relationship between dietary-derived antioxidants and ED using Mendelian randomization (MR) analysis, based on genetic prediction. This study employed bidirectional two-sample MR analysis to investigate the causal relationship between dietary-derived antioxidants and ED. The primary results were based on inverse variance-weighted analysis with random effects. To assess the robustness and reliability of the findings, sensitivity analyses were conducted, including tests for heterogeneity, horizontal pleiotropy, and leave-one-out analysis. Additionally, multivariate MR analysis was performed to further validate the robustness of the results. The inverse variance-weighted results revealed a significant causal relationship between plasma vitamin A levels and ED (odds ratio [OR]: 3.44; 95% confidence interval [95% CI]: 1.22-9.68; p=0.019), suggesting that elevated plasma vitamin A levels are a risk factor for ED. A reverse causal relationship was observed between ED and carotene levels (OR: 0.97, 95% CI: 0.95-1.00; p=0.04). After adjusting for smoking status, the causal association between vitamin A and ED remained significant. The heterogeneity test indicated variability in the relationship between carotene and ED, while the pleiotropy test revealed that the MR-PRESSO p-value for zinc and ED was less than 0.05. This study identifies specific causal relationships between dietary antioxidants and ED, providing a foundation for understanding the pathogenesis of ED, guiding the development of dietary intervention strategies, and informing clinical treatment approaches.