Comparison of metabolic syndrome subjects with and without erectile dysfunction - levels of circulating oxidised LDL and arterial elasticity

BACKGROUND: Erectile dysfunction (ED) is believed to be an early sign of systemic cardiovascular disease (CVD). Elevated levels of circulating oxidised LDL (oxLDL) and impairment of arterial elasticity have been reported to predict future cardiovascular events. We studied whether metabolic syndrome subjects with and without erectile dysfunction differ in circulating levels of oxLDL and arterial elasticity. Furthermore, we assessed whether the presence of ED acts as a clinical marker of underlying atherosclerotic process. METHODS: Seventy men with metabolic syndrome, aged 35-60 years, completed the International Index of Erectile Function questionnaire. Subject was considered to have erectile dysfunction if a sum of the questions 1-5 and 15 was ≤ 25. OxLDL was assessed by an ELISA immunoassay and arterial elasticity by a noninvasive radial artery tonometer (HDI/PulseWave™CR-2000). RESULTS: Large arterial elasticity index was significantly lower among subjects with erectile dysfunction compared with those without, 15.0 ± 3.2 ml/mmHg × 10 and 18.0 ± 3.7 ml/mmHg × 10, respectively (p = 0.001). The presence of erectile dysfunction associated with impaired large arterial elasticity, independently of traditional CVD risk factors. Reduction in arterial elasticity was also found among those with erectile dysfunction and less than 5% risk of cardiovascular death during 10 years by the SCORE. There were no significant differences in small arterial elasticity or oxLDL levels. CONCLUSION: Erectile dysfunction truly seems to be a marker of systemic vascular disease. Aggressive primary prevention should be considered for patients with metabolic syndrome and vasculogenic ED.