Central Obesity is an Independent Predictor of Erectile Dysfunction in Older Men

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Abstract
Purpose: There is a growing body of evidence in the literature correlating erectile dysfunction to obesity. We investigated the correlation of different anthropometric indexes of central obesity to erectile dysfunction. Materials and Methods: A cross-sectional study was performed including 256 consecutive men 40 years old or older. All men completed the International Index of Erectile Function, and were evaluated routinely with a clinical history, physical examination and blood analysis for fasting serum glucose, lipid profile and serum testosterone. Anthropometric measures included body mass index, waist circumference, sagittal abdominal diameter, maximal abdominal circumference, and waist-hip, waist-thigh, waist-height, sagittal abdominal diameter-thigh and sagittal abdominal diameter-height indexes. Results: In men 40 to 60 years old the different anthropometric indexes of central obesity were not correlated with the presence of erectile dysfunction (p >0.05). Men older than 60 years (41%, range 61 to 81) demonstrated an association among erectile dysfunction and waist-hip index (p = 0.04), waist-thigh index (p = 0.02), sagittal abdominal diameter (p = 0.03), sagittal abdominal diameter-height index (p = 0.02) and maximal abdominal circumference (p = 0.04). After logistic regression analysis an independent effect on the presence of erectile dysfunction was observed for waist-hip index (OR 8.56, 95% CI 1.44–50.73), sagittal abdominal diameter (OR 7.87, 95% CI 1.24–49.75), sagittal abdominal diameter-height index (OR 14.21, 95% CI 1.11–182.32), maximum abdominal circumference (OR 11.72, 95% CI 1.73–79.18) and waist circumference (OR 19.37, 95% CI 1.15–326.55). Conclusions: This study suggests that central obesity, assessed by several anthropometric indicators, is associated to the presence of erectile dysfunction in men older than 60 years. Sagittal abdominal diameter, sagittal abdominal diameter-height index, maximum abdominal circumference, waist circumference and waist-hip index were useful indicators to predict the presence of erectile dysfunction.