(553) The Association Between Erectile Dysfunction and Biological Aging: Data from a Large National Population Cohort

Introduction Biological age indicators provide a more precise reflection of an individual's aging status and capture key pathological pathways of erectile dysfunction (ED), including endothelial dysfunction, chronic inflammation, and metabolic disturbances. Objective This study aimed to investigate the association between biological age indicators and ED, and to examine the mediating role of ED in the relationship between biological age and all-cause mortality. Methods We analyzed data from 1,978 adult male participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Logistic regression was used to assess associations between biological age indicators and ED, while Cox proportional hazards models compared survival differences. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic performance of biological age indicators for ED, and mediation analysis quantified ED's role in the pathway between biological age indicators and all-cause mortality. Results The prevalence of ED in the study population was 48.63%. Both GOLDBioAge acceleration (OR=2.45, 95% CI:1.98-2.99, P<0.001; HR=5.34, 95% CI:4.28-6.67, P<0.001) and LightBioAge acceleration (OR=2.46, 95% CI:2.01-2.99, P<0.001; HR=2.82, 95% CI:2.27-3.50, P<0.001) showed significant associations with ED. ROC analysis revealed that GOLDBioAge acceleration and GOLDBioAge had the highest diagnostic performance for ED (AUC=0.81, 95% CI:0.78-0.84 and AUC=0.80, 95% CI:0.77-0.83, respectively). Mediation analysis demonstrated that ED mediated 18.19% of the effect of GOLDBioAge acceleration on all-cause mortality (ACME=0.0489, 95% CI:0.0335-0.0700, P<2e-16) and 31.39% of the effect of LightBioAge acceleration (ACME=0.0431, 95% CI:0.0302-0.0600, P<2e-16). Conclusions GOLDBioAge and its acceleration metric demonstrate strong diagnostic and predictive capability for ED. The significant mediating role of ED in the biological age-mortality relationship suggests that biological age indicators may serve as potential tools for ED screening, assessment, and prevention in clinical practice. Disclosure No