(552) The Associations Among Sarcopenia, Erectile Dysfunction, and Mortality: A Mediation Analysis of a Large National Cohort

Introduction Sarcopenia and erectile dysfunction (ED) share common risk factors and are both associated with adverse clinical outcomes. Objective This study aimed to investigate the association between sarcopenia and ED, and to examine their independent and synergistic effects on mortality risk. Methods This study analyzed data from 3,768 adult males in NHANES 2001-2004. Logistic regression assessed the sarcopenia-ED association. Kaplan-Meier curves and Cox models compared survival across ED and sarcopenia groups and estimated mortality hazard ratios (HR). Mediation analysis evaluated ED's role in the sarcopenia-mortality pathway and quantified its effect proportion. Results The prevalence of sarcopenia and ED was 14.6% and 47.5%, respectively. The mean age showed a progressive increase with the severity of ED (None: 39.25; Mild: 48.38; Moderate: 57.73; Severe: 67.92; P < 0.001). Participants with sarcopenia were significantly older than those without (58.97 vs. 43.47 years; P < 0.001). The presence of ED was significantly associated with sarcopenia (Odds Ratio [OR], 4.6; 95% Confidence Interval [CI], 3.53-5.99; P < 0.001), additionally, sarcopenia was significantly associated with mild (OR, 3.03; 95%CI, 2.10-4.36; P < 0.001), moderate (OR, 5.16; 95%CI, 3.70-7.22; P < 0.001), and severe ED (OR, 8.83; 95%CI, 6.13-12.72; P < 0.001). Both ED and sarcopenia significantly contributed to all-cause and cardiovascular disease (CVD) mortality (P < 0.001). Compared to the no-ED group, severe ED group had HR of 10.89 (95% CI: 8.45-14.03) for all-cause mortality and 14.91 (95% CI: 10.32-21.53) for CVD mortality. Participants with sarcopenia had HR of 4.12 (95% CI: 3.35-5.06) for all-cause mortality and 4.45 (95% CI: 3.14-6.31) for CVD mortality compared to those without. ED partially mediated the pathways from sarcopenia to all-cause mortality, CVD mortality, and cerebrovascular disease mortality, with mediation proportions of 0.3094, 0.3582, and 0.6327, respectively (P < 0.05). Conclusions A higher risk of sarcopenia was significantly associated with increased severity of ED, and ED served as a partial mediator in the pathways linking sarcopenia to multiple mortality outcomes, which could be a marker of underlying systemic disease. Disclosure No