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Prevalence of erectile dysfunction according to (a) body fat percentage and (b) body mass index. Body fat percentage Q1: 20.5%, Q2: 20.6–23.2%, Q3: 23.3–25.8%, Q4: 25.9–28.8%, Q5: 28.9%. Body mass index Q1: 23.1 kg m−2, Q2: 23.2–24.4 kg m−2, Q3: 24.5–25.5 kg m−2, Q4: 25.6–27.0 kg m−2, Q5: 27.1 kg m−2. IIEF-5: 5-item version of the international index of erectile dysfunction.
Source publication
The aim of this study was to assess the relationship between body fat mass (BFM) and erectile dysfunction (ED) in Korean men. This study was a cross-sectional study using data on 208 men (the mean age=67.4+/-8.2). ED was diagnosed by the International Index of Erectile Function (IIEF)-5 and body fat percentage (BF%) was quantified with bioelectrica...
Context in source publication
Context 1
... differences of the other variables were not found across ED categories (Table 1). Subjects with the lowest quintile or the highest quintile of BF% or BMI had a lower proportion of men with IIEF-5X18 and a higher proportion of men with IIEF-5p17 and men without sexual activity within the most recent 6 months compared to the other subjects (Figure 3a and b). ...
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Citations
... We found only one study that looked at ED in elderly men based on their BMI. Cho et al. [22] conducted a study with 208 elderly Koreans in a suburban area, all aged 65 or older (average age 67.4 ± 8.2 years). ED was diagnosed using the IIEF-5 questionnaire; however, the cutoff value for ED was a score of 18, in contrast to Rosen et al.'s [19] cutoff value of ≤21 for diagnosing ED. ...
... and the fifth BMI quintile (27.1 and above), with an OR of 4.92 (95% CI: 0.96-25.34) [22]. We added a similar threshold of a score of 18 in the IIEF-5 questionnaire in our analysis. ...
Background: This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods: Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results: The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg², and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0–13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions: The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.
... The Institutional Review Board of each institution approved this study protocol. The details of the data collection can be found elsewhere [36,37]. ...
Recent deep learning algorithms have further improved risk classification capabilities. However, an appropriate feature selection method is required to overcome dimensionality issues in population-based genetic studies. In this Korean case–control study of nonsyndromic cleft lip with or without cleft palate (NSCL/P), we compared the predictive performance of models that were developed by using the genetic-algorithm-optimized neural networks ensemble (GANNE) technique with those models that were generated by eight conventional risk classification methods, including polygenic risk score (PRS), random forest (RF), support vector machine (SVM), extreme gradient boosting (XGBoost), and deep-learning-based artificial neural network (ANN). GANNE, which is capable of automatic input SNP selection, exhibited the highest predictive power, especially in the 10-SNP model (AUC of 88.2%), thus improving the AUC by 23% and 17% compared to PRS and ANN, respectively. Genes mapped with input SNPs that were selected by using a genetic algorithm (GA) were functionally validated for risks of developing NSCL/P in gene ontology and protein–protein interaction (PPI) network analyses. The IRF6 gene, which is most frequently selected via GA, was also a major hub gene in the PPI network. Genes such as RUNX2, MTHFR, PVRL1, TGFB3, and TBX22 significantly contributed to predicting NSCL/P risk. GANNE is an efficient disease risk classification method using a minimum optimal set of SNPs; however, further validation studies are needed to ensure the clinical utility of the model for predicting NSCL/P risk.
... Most previous studies measured body composition with dual x-ray absorptiometry (DXA) [3,12,22] or CT, [4,13] therefore, the validity of our results compared with these studies cannot be established. According to another study from our center, however, the correlation coefficient between InBody and DXA measurements was 0.93, and the mean error was 1.2% (95% confidence interval [CI], 4.6 to 7.1), indicating a good correlation between the two methods [23]. Only 51 male patients were included for our study, which may have limited the statistical power and thus the extrapolation of our result to male patients. ...
Background/aims:
To explore the associations between body composition and pain, disease activity, and disability in rheumatoid arthritis (RA).
Methods:
The study enrolled 335 patients with RA and underwent body composition measurement with an InBody analyzer. The associations of body mass index (BMI), body fat mass, and skeletal muscle mass with disease activity score in 28 joints (DAS28), an index derived to measure the subjective component of DAS28 (DAS28-P), a pain visual analogue scale (VAS), and disability measured with the health assessment questionnaire (HAQ) were explored. Obesity was defined as BMI ≥ 25 kg/m2.
Results:
The median (interquartile range) disease duration was 6 years (3.5 to 9) and the mean DAS28 score was 3.6 ± 1.1. The mean BMI was 23.6 ± 3.6 kg/m2 and 109 patients (32.5%) were obese. Compared with non-obese patients, obese patients had a higher C-reactive protein (1.68 mg/dL vs. < 0.1 mg/dL, p = 0.013), higher pain VAS score (40 vs. 35, p = 0.031), and higher DAS28-erythrocyte sedimentation rate score (3.75 ± 1.18 vs. 3.46 ± 1.11, p = 0.031). In multivariate regression analysis, the DAS28 score in females was positively associated with the current steroid dose, body fat mass, and HAQ score, while the HAQ score in females was associated with older age, DAS28, lower skeletal muscle mass, and higher body fat/skeletal muscle ratio. In the multivariate regression analysis, the DAS28-P score in females was positively associated with body fat/skeletal muscle ratio and HAQ.
Conclusions:
Body composition, such as the body fat mass and body fat/skeletal muscle ratio, is significantly associated with disease activity and disability in female RA patients.
... AMS scores range from 17 (minimum, asymptomatic) to 85 (maximum, extremely severe symptoms). AMS severity was graded as no/little complaints (≤26), mild (27)(28)(29)(30)(31)(32)(33)(34)(35)(36), moderate (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), and severe (≥50). 18 Finally, MetS was defined if the patient met three or more of the updated parameters for the diagnosis of MetS according to the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute definition. ...
... In addition, negative correlations between IIEF-5 score and adiposity markers including BMI, WC, FM%, and VFR and a positive correlation with FFM% were noted. Accordingly, Cho et al. 32 found a U-shaped relationship between body fat percentage (measured using bioelectrical impedance) and ED (defined as an IIEF-5 score less than 18) in men older than 45 years. Men aged ≥65 years with the highest quartiles of total body fat percentage and trunk fat percentage (measured with dual-energy X-ray absorptiometry) had a greater prevalence of moderate to severe ED, according to the Massachusetts Male Aging Study (MMAS) questionnaire. ...
Erectile dysfunction (ED), a condition closely related to cardiovascular morbidity and mortality, is frequently associated with obesity. In this study, we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young (18-49 years) nondiabetic obese (body mass index [BMI] ≥ 30 kg m-2) men from primary care. Erectile function (International Index of Erectile Function [IIEF-5] questionnaire), quality of life (Aging Males' Symptoms [AMS scale]), and body composition analysis (Tanita MC-180MA) were determined. Total testosterone was determined using high-performance liquid chromatography-mass spectrometry. Multivariate logistic regression analysis was used to study the factors associated with ED. ED prevalence was 42.1%. Subjects with ED presented higher BMI, waist circumference, number of components of the metabolic syndrome, AMS score, insulin resistance, and a more unfavorable body composition than those without ED. Multivariate logistic regression analysis showed that a pathological AMS score (odds ratio [OR]: 4.238, P < 0.001), degree of obesity (BMI ≥ 40 kg m-2, OR: 2.602, P = 0.005, compared with BMI 30-34.9 kg m-2), high-density lipoprotein (HDL)-cholesterol levels (OR: 0.956, P = 0.004), and age (OR: 1.047, P = 0.016) were factors independently associated with ED. In conclusion, we demonstrate that, in a primary care-based cohort of nondiabetic young obese men, ED affected >40% of subjects. A pathological AMS score, the degree of obesity, and age were positively associated with ED, while elevated HDL-cholesterol levels were inversely associated with the odds of presenting ED. Further prospective studies are needed to evaluate the long-term consequences of ED in this population.
... For example, the Hallym Aging Study measured body fat percentage and its relationship to ED in Korean men. 91 Men with the lowest and highest body fat were more likely to have ED. Central obesity is associated with metabolic syndrome, vascular dysfunction, and low testosterone, all of which contribute to the development of ED. 92,93 Fat tissue secretes more than 35 hormones and cytokines, nearly all of which promote inflammation, insulin resistance, and eventually, vascular disease. ...
Erectile dysfunction (ED) is common with aging. Formerly ED treatment was offered mainly by urologists, but the approval and widespread use of phosphodiesterase inhibitors has enabled primary care clinicians to provide targeted ED treatment. Although large, multicenter clinical trials have shown efficacy and safety with these drugs, they are ineffective in 30–35% of men, may cause sideeffects, and do not improve the underlying pathology. A thorough understanding of erectile physiology and causes of ED and a comprehensive treatment plan addressing all contributing factors may be more effective than pharmaceutical management and may improve aspects of psychological and physical health beyond erectile problems.
... In turn, significant correlations were found between the above mentioned sexual parameters and BMI or WHR. The results of our study are in agreement with other studies on cohorts of older men showing that several measures of obesity and central adiposity are significantly associated with ED prevalence [8,[41][42][43]. Orgasmic function was not correlated with any studied parameters. ...
Introduction:
In older men, sexual disorders may be the result of a decrease in testosterone and an increase in sex hormone binding globulin (SHBG) serum levels. Although obesity may enhance the decline of testosterone, it is also the cause of metabolic disorders, which are additional risk factors of erectile dysfunction. The purpose of this study was to investigate whether elevated body weight is associated with decreased serum testosterone concentrations and reduced sexual function in young men.
Material and methods:
Data on general health, medication, depressive symptomatology and sexual life was obtained from 136 men aged 20-49 years. Blood levels of LH, total testosterone (TT), dehydroepiandrosterone sulfate (DHEA-S), oestradiol, SHBG, total cholesterol, LDL- and HDL-cholesterol, and triglycerides were determined. Body mass index (BMI), waist to hip ratio (WHR) and free testosterone index (FTI) were calculated.
Results:
A significantly reduced occurrence of sexual fantasies, morning erections and erectile function scores was observed in the oldest group compared to the youngest men with normal BMI, although orgasmic function was unchanged. A significant decrease in TT serum levels was observed in obese 30-year-olds compared to men with normal BMI, while in obese 40-year-olds decreased LH and SHBG levels were also found. No differences in the levels of lipids and sexual achievements were found among men with different BMI. However, erectile function and morning erections significantly negatively correlated with age, BMI and WHR, and positively with FTI, but not with other studied hormones and lipids.
Conclusions:
In young men, obesity can lead to a deterioration of erectile function as a result of lower testosterone levels as the only reason.
... The Hallym Aging Study (HAS) is a prospective cohort of 1,520 individuals (30% aged 45-64 years and 70% aged 65 years or older) in Chuncheon, a small city in South Korea. Details of the HAS have been published elsewhere [21][22][23][24]. The first wave began in 2003 and an in-depth clinical study was started in 2004. ...
Body composition changes with ageing can influence the adiponectin concentration. However, the component of body composition that is associated with adiponectin concentrations in older adults remains unclear.
There were 152 males and 168 females aged 65 years or older that participated in the 2010 Hallym Aging Study (HAS). Body composition (assessed by dual energy X-ray absorptiometry; DXA), anthropometric parameters and adiponectin were obtained from all participants. Multivariate linear regression models assessed the association of body fat percentage, regional muscle and bone mineral contents of body composition and waist/height ratio with adiponectin concentration. Age, albumin, testosterone concentration and metabolic parameters were considered as confounding factors.
In correlation analysis, age was positively associated with adiponectin in males (P < 0.01), but not in females. Fasting glucose, albumin, arm skeletal muscle mass and bone mineral content were negatively associated with adiponectin in males (P < 0.05). Testosterone and leg bone mineral content were negatively associated with adiponectin in females (P < 0.05). In multivariate linear regression models, body fat percentage and albumin (P < 0.05) were negatively associated with adiponectin, and high-density lipoprotein cholesterol (HDL-C) (P < 0.001) and age (P < 0.01) were positively associated with adiponectin in older males. In older females, the only factors that correlated significantly with adiponectin concentration were the homeostasis model assessment of insulin resistance (P < 0.001) and HDL-C (P < 0.05). The waist/height ratio and bone mineral content were not associated with adiponectin in either gender.
Plasma adiponectin levels correlated negatively with body fat percentage in older males but not in older females. The differential results between older males and females suggest that certain gender-specific mechanisms may affect the association between adiponectin and age-related body composition changes.
... The odds ratio for ED was reported to be more than 60% higher in overweight males than in normal weight males. 10 For Korean men, central obesity was shown to be significantly correlated with ED, 11 and body mass index (BMI) and body fat percentage were also shown to be associated with ED. 12 The MMAS showed that physical activity status was associated with ED and that the odds ratio for ED decreased by approximately 70% in men who initiated physical activity at their middle age, relative to that for men who remained sedentary when the subjects were followed-up for more than 8 years. 13 ...
In February 2011, the Korean Society for Sexual Medicine and Andrology (KSSMA) realized the necessity of developing a guideline on erectile dysfunction (ED) appropriate for the local context, and established a committee for the development of a guideline on ED. As many international guidelines based on objective evidence are available, the committee decided to adapt these guidelines for local needs instead of developing a new guideline. Considering the extensive research activities on ED in Korea, data with a high level of evidence among those reported by Korean researchers have been collected and included in the guideline development process. The latest KSSMA guideline on ED has been developed for urologists. The KSSMA hopes that this guideline will help urologists in clinical practice.
... Endothelial dysfunction causes impaired arteriolar smooth muscle relaxation, thereby preventing vasodilatation and leading to the development of ED. 12 One small study in Asian men showed that body fat percent measured by bioelectrical impedance (BIA) had a U-shaped association with ED, with the highest prevalence of ED in men in the lowest and highest quintiles of body fat percent. 13 To our knowledge, the association between body composition and ED prevalence has not been evaluated among older U.S. men. We performed a cross-sectional analysis to investigate the association of body composition as measured with dual x-ray absorptiometry (DXA) with prevalent ED among older U.S. men participating in the Osteoporotic Fractures in Men (MrOS) study cohort. ...
... 30 Another small cross-sectional study, conducted in Korean men aged 45 years or older without heart disease, stroke, cancer, depression or treated thyroid disease, reported a 'U' shaped association between quintiles of body fat percentage as measured by BIA and odds of any ED, defined as IIEF-5 score <18. 13 There were several important differences between the MrOS study cohort and prior studies that may contribute to the differences reported in their associations between obesity and ED. Compared to the MrOS analysis cohort, prior studies enrolled much younger populations, 13,30,8 and excluded participants with vascular disease and other ED risk factors. ...
... 13 There were several important differences between the MrOS study cohort and prior studies that may contribute to the differences reported in their associations between obesity and ED. Compared to the MrOS analysis cohort, prior studies enrolled much younger populations, 13,30,8 and excluded participants with vascular disease and other ED risk factors. 30 Consequently, their results may be less applicable to older men with comorbid conditions. ...
To examine the association between body size and composition and erectile dysfunction (ED) in older men.
Cross-sectional analysis of the Osteoporotic Fractures in Men study.
Six U.S. clinical sites.
Community-dwelling men aged 65 and older.
Body composition measures using anthropometry (body weight, body mass index (BMI)) and dual X-ray absorptiometry (total body fat percentage, trunk fat percentage, ratio of trunk and total body fat). ED was assessed using the single-item Massachusetts Male Aging Study (MMAS) scale and the five-item International Index of Erectile Function questionnaire (IIEF-5).
In men completing the MMAS scale (n = 4,108), prevalence of complete ED was 42%. In sexually active men completing the IIEF-5 questionnaire (n = 1,659), prevalence of moderate to severe ED was 56%. In multivariate-adjusted analyses reporting prevalence ratios (PRs) and 95% confidence intervals (CIs), the prevalence of MMAS-defined complete ED was significantly greater in men in the highest quartile of body weight (PR = 1.24, 95% CI = 1.16-1.34), total body fat percentage (PR = 1.25, 95% CI = 1.13-1.40), and trunk fat percentage (PR = 1.24, 95% CI = 1.15-1.38), and was greater in men with a BMI greater than 30.0 kg/m(2) than in those with BMI of 22.0 to 24.9 kg/m(2) (PR = 1.17, 95% CI = 1.05-1.31). Associations appeared similar for IIEF-5-defined moderate to severe ED in analyses adjusted for age and study site.
In a cohort of older men, high body weight, BMI, and total body fat percentage were independently associated with greater prevalence of moderate to severe and complete ED. Future studies should investigate whether interventions to promote weight loss and fat loss will improve erectile function in older men.
... It has also been shown that weight loss improves endothelial function in obese subjects and subsequent ED. Cho et al.[32] studied the relationship between body fat mass (BFM), measured via bioelectrical impedance, and ED in 208 Korean men (aged 67.4 ± 8.2). The authors used BFM, and not BMI, as a measure of obesity in the geriatric population " because decrease of height and loss of muscle mass accompany geriatric obesity. ...
Obesity is associated with increased risk of erectile dysfunction (ED); however, the underlying causes of ED in obese individuals remain poorly defined. The aim of this review is to discuss the evidence available on the relationship between obesity and ED. A search of published studies in PubMed from 1970 through 2009 was conducted, and relevant articles were evaluated and discussed.
Visceral obesity is a public health threat, and is associated with increased risk of diabetes, vascular disease, endothelial dysfunction, and ED. Plasma testosterone levels are reduced in obesity, further contributing to an increased risk of vascular pathology in obesity. The recognition of the relationship between obesity, reduced testosterone levels, and ED has paved the way for new approaches to manage and treat obese, hypogonadal patients with ED. Obesity profoundly and adversely impacts overall health and, in particular, vascular health, by increasing proinflammatory factors, altering endothelial function and the androgen endocrine milieu, thus increasing the risk of ED.
