Low Serum 25-Hydroxyvitamin D Level as a Potential Risk Factor of Erectile Dysfunction in Elderly Men with Moderate to Severe Lower Urinary Tract Symptoms

Purpose: To evaluate the correlation between vitamin D level and erectile dysfunction (ED) in male lower urinary tract symptoms (LUTS) patients. Materials and Methods: We analyzed data from 534 male patients who were tested for LUTS from 2014 to 2017. LUTS severity was classified into mild (≤7) or moderate to severe (≥8) based on total IPSS scores. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D [25(OH)D] level of less than 20 ng/mL. The severity of ED was dichotomized into mild (≥17points) or moderate to severe (≤16 points) depending on total IIEF-5 scores. The association of the serum 25(OH)D level with moderate to severe ED was assessed using logistic regression analysis. Results: In the entire cohort, moderate to severe ED was significantly associated with age ≥60 years (odds ratio [OR], 1.762; 95% confidence interval [CI], 1.011–3.073) and moderate to severe LUTS (OR, 2.075; 95% CI, 1.134–3.789), but not with serum 25(OH)D level (OR, 1.001; 95% CI, 0.979–1.023). Whereas, in the subgroup consisting of moderate to severe LUTS patients over 60 years (n=223), either low serum 25(OH)D level (OR, 0.944; 95% CI, 0.903–0.986) or vitamin D deficiency (OR, 2.949; 95% CI, 1.118–7.782) was the independent risk factor of moderate to severe ED as a result of each multivariate analysis. Conclusions: Low vitamin D status closely correlated with moderate to severe ED in elderly men with moderate to severe LUTS.

研究目的：本研究旨在评估男性下尿路症状（lower urinary tract symptoms, LUTS）患者体内维生素D水平与勃起功能障碍（erectile dysfunction, ED）之间的相关性。
材料与方法：本研究分析了2014年至2017年间534例接受下尿路症状筛查的男性患者数据。根据国际前列腺症状评分（International Prostate Symptom Score, IPSS）总分，将下尿路症状严重程度划分为轻度（≤7分）与中重度（≥8分）。维生素D缺乏定义为血清25-羟维生素D[25(OH)D]水平低于20 ng/mL。根据勃起功能指数5（International Index of Erectile Function 5, IIEF-5）总分，将勃起功能障碍严重程度二分为轻度（≥17分）与中重度（≤16分）。采用logistic回归分析评估血清25(OH)D水平与中重度勃起功能障碍之间的关联。
结果：在全部研究队列中，中重度勃起功能障碍与年龄≥60岁（比值比（odds ratio, OR）=1.762；95%置信区间（confidence interval, CI）=1.011~3.073）及中重度下尿路症状（OR=2.075；95%CI=1.134~3.789）存在显著相关性，但与血清25(OH)D水平无显著关联（OR=1.001；95%CI=0.979~1.023）。而在年龄≥60岁的中重度下尿路症状患者亚组（n=223）中，经分别开展的多变量分析结果显示，低血清25(OH)D水平（OR=0.944；95%CI=0.903~0.986）或维生素D缺乏（OR=2.949；95%CI=1.118~7.782）均为中重度勃起功能障碍的独立危险因素。
结论：对于合并中重度下尿路症状的老年男性群体，维生素D水平低下与中重度勃起功能障碍密切相关。