OBJECTIVE: Vascular dysfunction is a major contributor to diabetes complications.
It is also the primary physiologic cause of erectile dysfunction and considered an independent predictor of cardiovascular disease (CVD) in males over age 40. A cohort of individuals with 50 or more years of type 1 diabetes, Joslin Medalists, have low rates of small but not large vessel complications. This study aims to identify the prevalence and longitudinal association of sexual dysfunction (SD) with CVD in Joslin Medalists.
RESEARCH DESIGN AND METHODS: Description and association of self-assessment of SD in males of the Medalist cohort by self-reported sexual problems with CVD. SD is validated through the use of the abbreviated International Index of Erectile Dysfunction (IIEF).
RESULTS: Of 301 males in the Medalist Study, 69.8% reported a history of SD. Unadjusted risk factors included elevated glycated hemoglobin (HbA1c) (P = 0.02), elevated BMI (P = 0.03), higher total cholesterol (P = 0.02), lower HDL (P < 0.01), and increased levels of interleukin-6 (P = 0.03). SD was independently associated with CVD (age-, HbA1c-, and BMI-adjusted OR 1.9 [95% CI 1.0-3.5]). In adjusted analyses, retinal, neural, and renal complications were not associated (P > 0.05) with SD. Current report of SD (IIEF score ≤ 17) in a subset of Medalists was significantly correlated with self-reported longitudinal SD.
CONCLUSIONS: SD in those with extreme-duration type 1 diabetes is independently associated with CVD, representing a large vessel pattern. The findings suggest that SD may predict CVD in those with type 1 diabetes of long duration. These individuals have also been found to be relatively free of microvascular complications.
Written by:
Turek SJ, Hastings SM, Sun JK, King GL, Keenan HA. Are you the author?
Research Division, Joslin Diabetes Center, Boston, Massachusetts.
Reference: Diabetes Care. 2013 Jun 18. Epub ahead of print.
PubMed Abstract
PMID: 23780949
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