Biological aging matters: a cross-sectional study uncovering the association between phenotypic age acceleration and erectile dysfunction based on 2360 male individuals

The current study aimed to explore the potential associations between Phenotypic Age (PhenoAge)/PhenoAge acceleration (PhenoAgeAccel) and erectile dysfunction (ED). We carried out a cross-sectional study based on data from 2360 male participants from the National Health and Nutrition Examination Survey program in the year 2001−2004. ED was evaluated according to a self-administered questionnaire. PhenoAge and PhenoAgeAccel were employed to evaluate the biological aging speed as previously reported. Weighted logistic regression analyses were performed to reveal the association between either PhenoAge or PhenoAgeAccel and ED. We also applied restricted cubic spline (RCS) models to explore the non-linearity in such associations. Sensitivity analyses were performed to detect the robustness of the main finding. Significantly higher PhenoAge and PhenoAgeAccel were observed in participants with ED compared with no ED group (both <i>p</i> &lt; 0.0001). Multivariate logistic analyses exhibited significant associations of both PhenoAge and PhenoAgeAccel, either in continuous or categorical forms, with ED, with comprehensive adjustment. RCS models revealed the non-linear relationship between either PhenoAge or PhenoAgeAccel and ED. Sensitivity analyses showed the associations between PhenoAge/PhenoAgeAccel and ED remained significant. Our results suggested a significantly positive association between either PhenoAge or PhenoAgeAccel and ED. Future researches are needed to verify our findings.