Association between serum lipid profile and erectile dysfunction in adult patients with type 2 diabetes mellitus

M. Tanvir A. Siddique

doi:10.18203/issn.2455-4529.IntJResDermatol20260371

Authors

M. Tanvir A. Siddique Department of Dermatology and Venereology, Dhaka Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20260371

Keywords:

Serum lipids, Erectile dysfunction, T2DM

Abstract

Background: Diabetes mellitus (DM) is a major global health concern, with men affected having a threefold higher risk of erectile dysfunction (ED) than non-diabetic men. The study aims to determine the association between serum lipid profile abnormalities and ED in adult patients with type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study at the Departments of Dermatology and Venereology and Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh (March 2019–July 2020) included 382 married men with T2DM. Age, body mass index (BMI), diabetes duration, glycated haemoglobin (HbA1c), and lipid profile were recorded. ED was assessed using the Bengali IIEF-5 and classified as severe, moderate, mild, or no ED. Data were analyzed with statistical package for the social sciences (SPSS) v23.0 (t-test, Chi-square; p≤0.05).

Results: Among 382 men with type 2 diabetes, 158 (41.4%) had ED. Those with ED were older (48.7 versus 44.3 years), had higher BMI (26.5 versus 25.9 kg/m²), higher HbA1c (8.21 versus 7.95), and longer diabetes duration (7.14 versus 5.95 years; all p ≤ 0.05). ED severity was severe 10.2%, moderate 13.4%, and mild 17.8%. Triglycerides were higher (225.1 versus 200.8 mg/dl, p<0.001) and LDL-C slightly lower (131.97 versus 136.02 mg/dl, p=0.025), with no differences in total cholesterol or HDL-C.

Conclusion: Elevated triglycerides and slightly lower LDL-C are associated with erectile dysfunction in men with T2DM, highlighting the role of lipid abnormalities in its development.

Metrics

Metrics Loading ...

References

International Diabetes Federation. IDF diabetes atlas. 8th ed. Brussels: International Diabetes Federation. 2017;905-11.

Reddy YN, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138(9):861-70. DOI: https://doi.org/10.1161/CIRCULATIONAHA.118.034646

Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137-49. DOI: https://doi.org/10.1016/j.diabres.2013.11.002

Huang K, Yin S, Xiao Y, Wang J, Cui J, Wang J, Bai Y. Sexual dysfunction in patients with diabetes: association between remnant cholesterol and erectile dysfunction. Lipids Health Dis. 2024;23(1):55. DOI: https://doi.org/10.1186/s12944-024-02046-8

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442. DOI: https://doi.org/10.1371/journal.pmed.0030442

Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281(6):537-44. DOI: https://doi.org/10.1001/jama.281.6.537

Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151(1):54-61. DOI: https://doi.org/10.1016/S0022-5347(17)34871-1

Ugwumba FO, Okafor CI, Nnabugwu II, Udeh EI, Echetabu KN, Okoh AD, et al. Prevalence of, and risk factors for erectile dysfunction in male type 2 diabetic outpatient attendees in Enugu, South East Nigeria. Ann Afr Med. 2018;17(4):215-20. DOI: https://doi.org/10.4103/aam.aam_3_18

Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes. 2014;7:95-105. DOI: https://doi.org/10.2147/DMSO.S36455

Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr, et al. Definitions, epidemiology, and risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598-607. DOI: https://doi.org/10.1111/j.1743-6109.2010.01778.x

Penson DF, Latini DM, Lubeck DP, Wallace KL, Henning JM, Lue TF. Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients? Results from the ExCEED database. Diabetes Care. 2003;26(4):1093-9. DOI: https://doi.org/10.2337/diacare.26.4.1093

Al-Hunayan A, Al-Mutar M, Kehinde EO, Thalib L, Al-Ghorory M. The prevalence and predictors of erectile dysfunction in men newly diagnosed with type 2 diabetes mellitus. BJU Int. 2007;99(1):130-4. DOI: https://doi.org/10.1111/j.1464-410X.2006.06550.x

Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553-79. DOI: https://doi.org/10.2337/diacare.26.5.1553

Lewis RW. Epidemiology of erectile dysfunction. Urol Clin North Am. 2001;28(2):209-16. DOI: https://doi.org/10.1016/S0094-0143(05)70132-4

Heidler S, Temml C, Broessner C, Mock K, Rauchenwald M, Madersbacher S, Ponholzer A. Is the metabolic syndrome an independent risk factor for erectile dysfunction? J Urol. 2007;177(2):651-4. DOI: https://doi.org/10.1016/j.juro.2006.09.043

Jackson G. The metabolic syndrome and erectile dysfunction: multiple vascular risk factors and hypogonadism. Eur Urol. 2006;50(3):426-7. DOI: https://doi.org/10.1016/j.eururo.2006.03.035

Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151-7. DOI: https://doi.org/10.1016/j.amjmed.2006.06.010

Fung MM, Bettencourt R, Barrett-Connor E. Heart disease risk factors predict erectile dysfunction 25 years later: the Rancho Bernardo Study. J Am Coll Cardiol. 2004;43(8):1405-11. DOI: https://doi.org/10.1016/j.jacc.2003.11.041

Kostis JB, Dobrzynski JM. The effect of statins on erectile dysfunction: a meta-analysis of randomized trials. J Sex Med. 2014;11(7):1626-35. DOI: https://doi.org/10.1111/jsm.12521

Mulhall J, Teloken P, Brock G, Kim E. Obesity, dyslipidemias and erectile dysfunction. J Sex Med. 2006;3(5):778-86. DOI: https://doi.org/10.1111/j.1743-6109.2006.00286.x

Vrentzos GE, Paraskevas KI, Mikhailidis DP. Dyslipidemia as a risk factor for erectile dysfunction. Curr Med Chem. 2007;14(16):1765-70. DOI: https://doi.org/10.2174/092986707781058931

Kim JH, Klyachkin ML, Svendsen E, Davies MG, Hagen PO, Carson CC. Experimental hypercholesterolemia in rabbits induces cavernosal atherosclerosis with endothelial and smooth muscle cell dysfunction. J Urol. 1994;151(1):198-205. DOI: https://doi.org/10.1016/S0022-5347(17)34916-9

Thorve VS, Kshirsagar AD, Vyawahare NS, Joshi VS, Ingale KG, Mohite RJ. Diabetes-induced erectile dysfunction: epidemiology, pathophysiology and management. J Diabetes Complications. 2011;25(2):129-36. DOI: https://doi.org/10.1016/j.jdiacomp.2010.03.003

Toda N, Ayajiki K, Okamura T. Nitric oxide and penile erectile function. Pharmacol Ther. 2005;106(2):233-66. DOI: https://doi.org/10.1016/j.pharmthera.2004.11.011

Miner M, Billups KL. Erectile dysfunction and dyslipidemia: relevance and role of phosphodiesterase type-5 inhibitors and statins. J Sex Med. 2008;5(5):1066-78. DOI: https://doi.org/10.1111/j.1743-6109.2008.00783.x

Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. The multinational Men’s Attitudes to Life Events and Sexuality (MALES) study: prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin. 2004;20(5):607-17. DOI: https://doi.org/10.1185/030079904125003467

O’Brien T, Nguyen TT, Zimmerman BR. Hyperlipidemia and diabetes mellitus. Mayo Clin Proc. 1998;73(10):969-76. DOI: https://doi.org/10.4065/73.10.969

Abdlshikure SA, Mamo AG, Fikadu B, Seid A. Prevalence and determinants of erectile dysfunction among type 2 diabetes mellitus patients at selected government hospitals in Gurage Zone: a cross-sectional study. PLoS One. 2025;20(4):e0318908. DOI: https://doi.org/10.1371/journal.pone.0318908

Parmar RS, Verma S, Neelkamal, Pathak VK, Bhadoria AS. Prevalence of erectile dysfunction in type 2 diabetes mellitus and its predictors among diabetic men. J Fam Med Prim Care. 2022;11(7):3875-9. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1130_21

Giugliano F, Maiorino M, Bellastella G, Gicchino M, Giugliano D, Esposito K. Determinants of erectile dysfunction in type 2 diabetes. Int J Impot Res. 2010;22(3):204-9. DOI: https://doi.org/10.1038/ijir.2010.1

Xu Y, Zhang Y, Yang Y, Liu L, Chen Y, Liu X. Prevalence and correlates of erectile dysfunction in type 2 diabetic men: a population-based cross-sectional study. Int J Impot Res. 2019;31(1):9-14. DOI: https://doi.org/10.1038/s41443-018-0060-4

Tamrakar D, Bhatt DS, Sharma VK, Poudyal AK, Yadav BK. Association between erectile dysfunction and type 2 diabetes mellitus. J Nepal Health Res Counc. 2021;19(2):378-83. DOI: https://doi.org/10.33314/jnhrc.v19i2.3394

Goyal A, Singh P, Ahuja A. Prevalence and severity of erectile dysfunction as assessed by IIEF-5 in North Indian type 2 diabetic males and its correlation with variables. J Clin Diagn Res. 2013;7(12):2936-8. DOI: https://doi.org/10.7860/JCDR/2013/7718.3777

Mahbub MI, Kamrul-Hasan AB, Selim S, Mir AS, Saifuddin M, Pathan MF. Frequency and predictors of erectile dysfunction in Bangladeshi men with type 2 diabetes mellitus. Mymensingh Med J. 2019;28(1):137-43.