Title POVEZANOST EREKTILNE DISFUNKCIJE I SERUMSKE VRIJEDNOSTI VITAMINA
Title (english) The association of erectile dysfunction and vitamin D serum concentration
Author Bojan Sudarevuć
Mentor Lada Zibar (mentor)
Committee member Tatjana Bačun (predsjednik povjerenstva)
Granter Josip Juraj Strossmayer University of Osijek Faculty of Medicine Osijek Osijek
Defense date and country 2017-02-10, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Urology
Universal decimal classification (UDC ) 61 - Medical sciences
Abstract Cilj istraživanja bio je ispitati serumsku koncentraciju vitamina D (VD) u oboljelih od erektilne disfunkcije (ED), s pretpostavkom da imaju manju koncentraciju 25(OH)D u usporedbi s kontrolnim ispitanicima te da intenzitet ED-a negativno korelira s koncentracijom VD-a. Pretpostavka uloge VD-a u patofiziologiji ED-a utemeljena je na prethodnim istraživanjima o zajedničkim rizičnim čimbenicima (RČ) te mehanizmu nastanka ED-a i drugih bolesti koje su dovedene u vezu s nedostatkom vitamina D (NVD). Nacrt istraživanja. U presječno istraživanje uključeno je 60 muškaraca: 32 oboljela od ED-a i 28 zdravih kontrolnih ispitanika. Ispitanici i postupci. Isključni kriteriji bili su poslijeoperacijski, anatomski i neurološki uzrokovan ED, karcinom prostate te simptomi infekcije mokraćnog sustava. Nakon informiranog pristanka, uslijedila je anamneza, fizikalni pregled te ispunjavanje upitnika International Index of Erectile Function-5 (IIEF-5) radi procjene erektilne funkcije i kategorizacije ispitanika. Krv za analizu 25(OH)D i ostalih laboratorijskih obilježja (crvena i diferencijalna krvna slika, trombociti, biokemijske i hormonske analize, hemoglobin A1c, ionogram i lipidogram) vađena je iz kubitalne vene, uz uzorkovanje provedeno tijekom dva zimska mjeseca iste godine radi izbjegavanja utjecaja sunčeva zračenja na sintezu VD-a u koži. Rezultati. Medijan koncentracije 25(OH)D iznosio je 8,36 ng/ml, dvojica ispitanika bila su insuficijentnih (21 - 29 ng/ml), a svi ostali nedostatnih koncentracija VD (< 20 ng/ml). Razlike u koncentraciji VD-a između oboljelih od ED-a i kontrolnih ispitanika nije bilo, kao ni pri usporedbi skupina ED-a različitog intenziteta. Međutim, u oboljelih od šećerne bolesti koji su ujedno imali ED, pronađena je manja koncentracija VD-a u odnosu na ostale ispitanike (P = 0,034). U kontrolnih ispitanika izmjerene su veće koncentracije paratireoidnog hormona (PTH) u odnosu na oboljele od ED-a (P = 0,031) no, ukupno gledajući, ispitanici su imali uredne vrijednosti PTH. Koncentracija PTH pozitivno je korelirala s boljom erektilnom funkcijom, a prilikom multivarijante raščlambe PTH se pokazao kao neovisan RČ ED-a, smanjujući svakim svojim jediničnim povećanjem rizik ED-a za 4 %. Zaključak. Nije pronađena povezanost između koncentracije VD-a i ED-a, osim u dijabetičara s ED-om koji su imali manje koncentracije VD-a u odnosu na ostale ispitanike. Veća koncentracija PTH u osoba s normalnom funkcijom paratireoideja ima moguću protektivnu ulogu u očuvanju erektilne funkcije.
Abstract (english) Objectives. Determination of vitamin D (VD) status in patients with erectile dysfunction (ED) and testing of the hypothesis that ED patients have lower serum 25(OH)D level in comparison with healthy subjects, as well as that the intensity of ED correlates with 25(OH)D levels. The assumption of possible VD role in ED pathophysiology is based upon previous research on the interplay between common risk factors of ED and other ailments that have been linked to vitamin D deficiency (NVD). Study design. 60 male participants were included in this cross-sectional study: 32 ED patients and 28 control subjects without ED. Patients and Methods. Exclusion criteria were postoperative, anatomical and neurogenic ED, prostate cancer, notable lower urinary tract symptoms and non-approval to participate in the study. After a written informed consent was obtained, anamnesis and physical examination followed, as well as completing the International Index of Erectile Function-5 (IIEF-5) questionnaire, for assessing erectile function and to categorize the study subjects according to ED severity. The blood for 25(OH)D and other laboratory parameters of interest (high- sensitivity C-reactive protein, complete and differential blood count, biochemical, hormonal and electrolyte analysis, glycated hemoglobin and lipid profile) was drawn from the cubital vein, with sampling performed during two winter months of the same year to avoid seasonal variations in cutaneous VD production. Results. Median level of 25(OH)D for all participants was 8.36 ng/mL (interquartile range 4.84 - 11.67 ng/mL), two had insufficient (21 - 29 ng/mL), while all other subjects had deficient VD (< 20 ng/mL). There was no difference in VD levels between ED patients and control subjects (P = 0.894), nor was there any difference when comparing ED groups of disparate severity. 25(OH)D levels did not significantly correlate with the results of IIEF-5 questionnaire. However, patients with both diabetes and ED had lower VD levels in comparison with all other study subjects (P = 0.034). Control subjects without ED had higher parathyroid hormone (PTH) levels compared to ED patients (median 46.8 versus 38 pg/mL, P = 0.031), although PTH levels were normal in general. PTH level positively correlated with 63 better erectile function and in multivariate analysis PTH level showed to be an independent risk factor for ED, lowering ED risk by 4 % with every unit increase. Conclusion. In current research no association between VD status and erectile function was found, except for patients with diabetes and ED, who had lower VD levels compared to all other study subjects. Higher PTH levels in men with normal function of the parathyroid gland appear to have a protective role in preserving the erectile function.
Keywords
vitamin D
paratireoidni hormon
upitnik IIEF-5
erektilna disfunkcija
nedostatak vitamina D.
Keywords (english)
vitamin D
parathyroid hormone
IIEF-5 questionnaire
erectile dysfunction
vitamin D deficiency.
Language croatian
URN:NBN urn:nbn:hr:152:534616
Study programme Title: University Postgraduate Study Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2017-05-12 13:23:24