Diabetes and cardiovascular disease are risk factors for erectile dysfunction (ED). Selective inhibitors of the type 5 phosphodiesterase are the first option for treating ED. However, it is unknown why there are patients with low response to this treatment. Polymorphisms in the PDE5A gene may influence the response to PDE5 inhibitors treatment.
The aim of this study is to analyze the relationship between PDE5A polymorphisms, diabetes, and the efficacy of sildenafil treatment.
A Spanish prospective cohort of 170 Caucasian male patients diagnosed with ED and ischemic heart disease treated with angioplasty was studied.
ED was evaluated according to the 5-item version of the International Index for Erectile Function before and after treatment with sildenafil 50 mg. The gene sequence of the PDE5A gene was analyzed for the presence of rs12646525 and rs3806808 polymorphisms. Glucose and glycosylated hemoglobin levels were measured in blood serum samples. The relationship between treatment response, genotype, and glycemic status was analyzed.
Patients with G-allele of rs3806808 polymorphism showed a worse response to the treatment compared to TT-homozygote patients. Nondiabetic G-allele carriers showed a worse treatment response than TT-homozygotes patients. These differences were not seen in diabetic patients. There were no significant differences in treatment response according to the rs12646525 polymorphism in total population or according to the glycemic status. Logistic regression analysis showed that nondiabetic carriers of the major allele of both the rs12646525 and rs3806808 polymorphism had a significantly higher likelihood to respond to the treatment than diabetic patients carriers of the minor allele (P < .05).
The response to sildenafil treatment depends on polymorphisms in the PDE5A gene and the glycemic status of the patients.
The journal of sexual medicine. 2016 May 24 [Epub ahead of print]
Cristobal Marchal-Escalona, Bernardo Herrera-Imbroda, Mercedes Clemente-Postigo, Juan Alcaide-Torres, Antonio Quiñonero, Marta Marchal, María Isabel Queipo-Ortuño, Isabel María Aragón, Antonio Martín-Morales, María Fernanda Lara, Fernando Cardona
Department of Urology, University Hospital Virgen de la Victoria, Campus Universitario de Teatinos s/n, Malaga, Spain., Department of Urology, University Hospital Virgen de la Victoria, Campus Universitario de Teatinos s/n, Malaga, Spain., CIBER Fisiopatología de la Obesidad y Nutrición. CB06/03, Instituto de Salud Carlos III, Madrid, Spain; Unidad Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga, Spain., CIBER Fisiopatología de la Obesidad y Nutrición. CB06/03, Instituto de Salud Carlos III, Madrid, Spain; Unidad Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga, Spain., Department of Urology, University Hospital Virgen de la Victoria, Campus Universitario de Teatinos s/n, Malaga, Spain., Nursing Department, Hospital Parque S. Antonio, Malaga, Spain., CIBER Fisiopatología de la Obesidad y Nutrición. CB06/03, Instituto de Salud Carlos III, Madrid, Spain; Unidad Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga, Spain., Department of Urology, University Hospital Virgen de la Victoria, Campus Universitario de Teatinos s/n, Malaga, Spain., Department of Urology, Hospital Regional de Málaga, Málaga, Spain., Department of Urology, University Hospital Virgen de la Victoria, Campus Universitario de Teatinos s/n, Malaga, Spain. Electronic address: ., CIBER Fisiopatología de la Obesidad y Nutrición. CB06/03, Instituto de Salud Carlos III, Madrid, Spain; Unidad Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga, Spain.