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Giovanni Corona, Edoardo Mannucci, Luisa Petrone, Claude Schulman, Giancarlo Balercia, Alessandra D. Fisher, Valerio Chiarini, Gianni Forti, Mario Maggi, A Comparison of NCEP-ATPIII and IDF Metabolic Syndrome Definitions with Relation to Metabolic Syndrome-Associated Sexual Dysfunction, The Journal of Sexual Medicine, Volume 4, Issue 3, May 2007, Pages 789–796, https://doi.org/10.1111/j.1743-6109.2007.00498.x
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ABSTRACT
Metabolic syndrome (MetS) is a clustering of cardiovascular and metabolic risk factors, often associated with erectile dysfunction (ED) and hypogonadism. Recently, the International Diabetes Federation (IDF) proposed a substantial revision of the National Cholesterol Education Program–Third Adult Treatment Panel (NCEP-ATPIII) MetS criteria, essentially lowering the diagnostic cutoff values.
To investigate the associations between these two recently proposed definitions of MetS with the relative risk of arteriogenic ED and hypogonadism in a large cohort of patients with male sexual dysfunction.
A consecutive series of 1086 patients with sexual dysfunction (mean age 51.9 ± 12.8 years) was studied.
Several hormonal, biochemical, and instrumental (penile Doppler ultrasound) parameters were studied, along with ANDROTEST, a 12-item validated structured interview, specifically designed for the screening hypogonadism in a sexual dysfunction population. In particular, a score >8 is predictive of low testosterone (<10.4 nmol/L) with a sensitivity and specificity of about 70%.
The prevalence of MetS was 32.0% and 44.7% according to NCEP-ATPIII and IDF criteria, respectively. After adjustment for confounding factors, only NCEP-ATPIII was significantly associated with dynamic prostaglandin E1-stimulated penile flow (Vpmax, B=−7.7 ± 3.8; P <0.05). Patients with MetS defined according to both criteria reported lower total and free testosterone levels, higher prevalence of hypogonadism, and higher ANDROTEST score. However, when IDF, but not NCEP-ATPIII, criteria were fulfilled, the prevalence of hypogonadism was significantly lower than that observed in patients fulfilling both criteria (15.6% vs. 34.8%, respectively; P <0.00001). Conversely, patients fulfilling NCEP-ATPIII, but not IDF, criteria did not show a significant different prevalence of hypogonadism than those positive for both sets of criteria (30.8% vs. 34.8%; P =NS).
In patients with ED, NCEP-ATPIII criteria seem to be a better predictor of hypogonadism and impaired penile blood flow than IDF ones.
