Abstract
Purpose: :
Erectile dysfunction (ED) and retinopathy are prevalent manifestations of systemic vascular disease in diabetic men. However, to the best of our knowledge, the association between ED and diabetic retinopathy has never been studied.
Methods: :
A prospective study conducted between October 2008 and April 2010 in the Retina clinic of a tertiary medical center. The study group included men with proliferative diabetic retinopathy (PDR) or with severe non-proliferative diabetic retinopathy (NPDR). The control group included diabetic men without retinopathy or with mild NPDR. All men filled in the Sexual Health Inventory for Males questionnaire (SHIM) in order to detect ED and assess its severity. Significant ED was defined as SHIM questionnaire score lower than 18.
Results: :
The cohort included 103 diabetic men: 65 (63.2%) men in the study group and 38 (36.8%) men in the control group. Mean age for the entire cohort was 63.7±8.7 years, and mean diabetes duration was 14.6±8.9 years. Mean SHIM score for the entire cohort was 11.5±6.5, and 76 (73.8%) men had significant ED. Men in the study group had higher prevalence of significant ED compared with men in the control group [87.7% vs. 50.0%; OR 7.1 (95%CI 2.7-18.9); p<0.0001], as well as lower mean SHIM score (9.5±5.3 vs. 14.7±6.9; p<0.0001). Binary logistic regression analysis and linear regression analysis showed that significant ED and SHIM scores, respectively, were associated with diabetic retinopathy (p<0.0001 for both) independent of age, diabetes duration, ischemic heart disease, cerebrovascular disease, hypertension, hyperlipidemia and smoking.
Conclusions: :
ED is associated with diabetic retinopathy independent of age, diabetes duration, macro-vascular co-morbidities and cardiovascular risk factors. We believe diabetic men with retinopathy should be screened for ED, and vice versa.
Keywords: diabetic retinopathy • diabetes