Erectiledysfunction (ED), a very frequent finding among type 2 diabetes patients
(T2DM), is associated with cardiovascular disease. To investigate the
prevalence of ED among our T2DM population and its association with
microangiopathic complications (diabetic retinopathy (DR) and microalbuminuria
[mAlb]), we performed a retrospective cross-sectional study involving 121
patients attending the Diabetology Unit of Padua Hospital. All subjects were
studied with accurate anamnesis, IIEF-5 questionnaire, microalbuminuria
determined in spot urine sample, fundus examination and carotid artery
echo-color-doppler. ED prevalence was 64.8% while DR and mAlb prevalence was
25.6% and 23.1% respectively. In ED group vs. non-ED, DR prevalence was 32.9%
vs. 11.9% (p=0.012) and mAlb prevalence was 26.6% vs. 16.7% (p=0.218). ED group
had a worse glycemic control (HbA1c 7.6 ± 1.6 vs. 7.0 ± 1.0 %, p=0.010) and a
longer T2DM duration (10.3 ± 9.2 vs. 6.0 ± 5.7 years, p=0.002). Furthermore, ED
was associated with a higher carotid intima-media thickness (IMT 0.9 ± 0.2 vs.
0.8 ± 0.2 mm, p=0.049). ED was the first vascular complication in 57% of
patients, occurring some years before DR and mAlb. Association with DR and mAlb
is independent of common cardiovascular risk factors. In conclusion, ED onset
in diabetic subjects is a very important finding that can be considered an
early microangiopathic marker in T2DM subjects, suggesting the evaluation for
the presence of other microangiopathic complications and a more intense control
of cardiovascular risk factors.
ED:
Erectile Dysfunction; T2DM: Type 2 Diabetes Mellitus; DR: Diabetic Retinopathy;
Malb: Microalbuminuria; DN: Diabetic Neuropathy; IIEF-5: International Index Of
Erectile Function – 5; MI: Myocardial Infarction; CVD: Cardiovascular Disease;
CHD: Coronary Heart Disease; Hba1c: Glycated Hemoglobin; LH: Luteinizing
Hormone; FSH: Follicle-Stimulating Hormone; E2: Estradiol; PSA:
Prostatic-Specific Antigen; Egfr: Estimated Glomerular Filtration Rate; LDL:
Low-Density Lipoprotein; HDL: High-Density Lipoprotein; IMT: Intima-Media
Thickness; BMI: Body Mass Index; NO: Nitric Oxide.
Type 2
diabetes mellitus (T2DM) is not merely a disorder of carbohydrate metabolism,
but a cause of vascular diseases affecting nearly all arterial vessels which
are classically divided in microangiopathic and microangiopathic. The link
between diabetes and macroangiopathic disease was suggested many years ago,
observing a higher risk of myocardial infarction (MI) and cardiovascular death
in several diabetic populations. In Italy, diabetic patients have a
cardiovascular mortality excess of about 30-40% vs. non diabetic individuals.
Microangiopathic disease is characterized by three major manifestations:
diabetic retinopathy (DR), diabetic neuropathy (DN) and diabetic nephropathy.
Around 30% of diabetic patients suffer from DR, ranging from mild to severe.
Male sex, higher glycated haemoglobin levels, longer duration of diabetes
mellitus, higher blood pressure values and use of insulin are all associated
with the development of retinopathy. Diabetic nephropathy in T2DM occurs in
20-40% of patients and microalbuminuria (mAlb) is a marker of early nephropathy.
No comments:
Post a Comment