Erectile dysfunction in patients with nonalcoholic fatty liver disease

There is a lack of studies on erectile dysfunction (ED) in patients diagnosed with nonalcoholic fatty liver disease (NAFLD). The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients.

We conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide.

The mean age of the study population was 42.4±7.7years (79.1%≥40years). Of the 192 patients with NAFLD, 88 (45.8%) had ED, 28 (14.6%) had metabolic syndrome, 25 (13%) had type-2 diabetes mellitus (DM), and 131 (68.2%) had insulin resistance (IR). The mean level of serum testosterone was 3.17±2.94ng/mL, while the mean insulin resistance index was 2.9±1.7. Mild ED (38.6%) was the most frequent grade of ED. Age≥40years (odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7-24.1; p- 0.006), IR (OR 5.9; 95% CI 1.7-20.6; p- 0.005), and low serum testosterone (OR 5.1; 95% CI 1.5-17.1; p- 0.009) were the predictors of ED.

ED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis.

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology. 2017 Mar 16 [Epub ahead of print]

Ahmad Farooq Alsayed Hasanain, Reem Ezzat Mahdy, Ali Mohamed Abdel-Rahman Mahran, Ahmed Serag Mahmoud Safwat, Asmaa Omar Mohamed, Sherif Mohamed Abdel-Aal

Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt. Electronic address: ., Department of Internal Medicine (Gastroenterology Unit), Faculty of Medicine, Assiut University, Egypt., Department of Dermatology and Andrology (Andrology Unit), Faculty of Medicine, Assiut University, Egypt., Department of Urology, Faculty of Medicine, Assiut University, Egypt., Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt., Department of Diagnostic Radiology, Faculty of Medicine, Assiut University, Egypt.