Síndrome metabólica e disfunção eréctil - avaliação de parâmetros clínicos e hemodinâmicos

Abstract

Objectives: To estimate the prevalence of cardiovascular risk factors, including metabolic syndrome (MS), in a series of Portuguese patients with erectile dysfunction (ED) and to quantify their individual and aggregate role regarding penile hemodynamics and degree of ED severity. Material and methods: A cross-sectional study of 408 patients seen in the Urology Department of Hospital Sao Joao (Portugal) within the period 2008-2010 was performed. MS was defined in accordance with the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. For this purpose, we used the dichotomized variables: hypertension (HTA), glucose intolerance (GI), hypertriglyceridemia (HTG), decreased HDL cholesterol and central obesity. Penile hemodynamics were measured using the dynamic penile color Doppler ultrasound (D-PCDU) and ED severity was assessed with the International Index of Erectile Function-5 questions (IIEF-5). Results: There was high prevalence of HTA (46.3%), GI (36.0%), HTG (24.8%), decreased HDL (22.3%) and central obesity (41.2%). Prevalence of MS was 26.5%. The median of IIEF-5 and peak systolic velocity (PSV) was 12.0 and 34.0 cms, respectively. Multivariate analysis revealed HTA and GI as independent factors decreasing the value of PSV (p=.002) and the score IEEF-5 (p=.010), respectively. Conclusion: We emphasize the high prevalence of cardiovascular risk factors in a population of patients with ED as well as the strong independent association between AHT and hemodynamic worsening of erectile function.