The influence of metabolic profile of obese men on the severity of erectile dysfunction: are metabolically healthy obese individuals protected?

Objective: To determine the prevalence of erectile dysfunction (ED) in metabolically healthy obese (MHO) individuals, and to compare ED severity and hypogonadism prevalence in MHO, metabolically unhealthy obese (MUO) and metabolically healthy non-obese individuals.Material and methods: ED patients (n=460) were evaluated by standardized protocol, that included clinical evaluation, abridged 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire survey, and Penile Duplex Doppler Ultrasound (PDDU) exam. Patients were classified as obese [body mass index (BMI) ≥30.0 kg/m2] and non-obese (BMI <30.0 kg/m2), and metabolic health status was defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. Statistical analysis was performed and statistical significance was considered at p-level <0.05.Results: The mean age of the subjects was 56.2±10.5 years. MHO was present in 40% of obese individuals (n=37). MUO had lower mean peak systolic velocity (mPSV) compared to MHO (28.1 cm/s vs. 36.9 cm/s; p=0.005), and IIEF-5 scores were also lower in MUO compared to MHO patients (10.2 vs. 13.1; p=0.018). No statistical differences in IIEF-5 score, mPSV and hypogonadism prevalence between MHO and metabolically healthy non-obese (MHNO) patients were observed.Conclusion: Our results lead us to conclude that healthy metabolic profile protects obese individuals from severity of ED. The strong association between obesity and ED may be otherwise attributed to metabolic abnormalities present in the obese.