(800) Beyond the IIEF Score: Biochemical and Hormonal Signatures Across Erectile Dysfunction Severity

Introduction Erectile dysfunction (ED) is a highly prevalent condition that affects men’s quality of life and serves as an early marker of metabolic, endocrine, and cardiovascular disorders. Its frequency increases with age and comorbidities such as diabetes, hypertension, and obesity. Hormonal and metabolic alterations, including insulin resistance, dyslipidemia, and vitamin D deficiency, contribute to its pathophysiology through endothelial dysfunction. In Mexico, where these conditions are highly prevalent, evidence regarding the biochemical and hormonal profile associated with ED severity remains limited. This information is essential to improve diagnostic approaches and comprehensive management in affected men. Objective To describe the biochemical and hormonal profile of men with ED and evaluate its association with disease severity. Methods We analyzed clinical and laboratory data from men with ED who underwent metabolic (glucose, cholesterol, triglycerides, uric acid, creatinine, BUN, urea) and hormonal testing (TSH, T3, T4, total testosterone, prolactin, vitamin D, LH, FSH, and PSA) as part of their initial diagnostic evaluation for sexual dysfunction in Monterrey, Mexico. Relative and absolute frequencies were calculated for categorical variables, and measures of central tendency and dispersion were calculated for quantitative variables. The proportion of patients with abnormal values for each analyte was determined. The association between biochemical/hormonal alterations and ED severity, according to the IIEF-EF score, was assessed using nonparametric statistical tests and logistic regression models adjusted for potential confounders. Results Over 3 years, data from 245 patients were collected, with variation in the number of completed laboratory tests. The mean age was 55 years (±11.5), and most presented with moderate (66.8%) or severe (22.9%) ED at diagnosis. Diabetes was present in 65.3% of the sample, and hypertension in 38.8%. In the overall cohort, elevated median glucose (103.2 mg/dL) and triglycerides (151.9 mg/dL), as well as low median vitamin D levels (22.5 ng/mL), were observed, while other values remained within normal reference ranges. Subgroup analysis by ED severity demonstrated a significant association between lower IIEF-EF scores and higher glucose levels (p<0.0001), uric acid (p=0.026), creatinine (p=0.007), and PSA (p=0.014). However, in multivariable models adjusted for age and BMI, hyperglycemia remained independently associated with a 4.1-fold higher risk of moderate-to-severe ED, and vitamin D levels <30 ng/mL were associated with a 4.48-fold increased risk, compared with patients without abnormalities in these parameters. Conclusions In this study, hyperglycemia and vitamin D deficiency were independently associated with greater ED severity. These findings underscore the importance of evaluating and treating metabolic and hormonal abnormalities as part of comprehensive management of ED and suggest that optimizing glucose regulation and correcting vitamin D deficiency may improve patient outcomes. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Medical Group