Abstract：
OBJECTIVE: Lipid parameters have been shown to have significant predictive value for cardiovascular disease, but few studies have evaluated their correlation with erectile dysfunction (ED) in young men.
METHODS: The case-control study encompassed 186 young ED patients (ages 20-40) and 186 healthy controls. Lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL ratio, TG/HDL ratio, and LDL-C/HDL-C ratio, were assessed in all participants. The International Index of Erectile Function (IIEF-5) scores were collected for all participants to evaluate erectile status. Multivariate logistic regression analysis was utilized to appraise the association of lipid-related parameters with ED. Single-nucleotide polymorphisms (SNPs) significantly correlated with lipid parameters (TC, TG, LDL-C, HDL-C) were selected from genome-wide association studies (GWAS) as instrumental variables (IV) (P < 5.0 × 10-8). Summary data for ED was gathered from a GWAS with a sample size of (n = 17,353 cases/28,210 controls). The inverse variance weighted (IVW) method was employed as the primary mendelian randomization (MR) analysis method to assess causal effects. Causal estimates were represented as odds ratios (OR) with 95% confidence intervals (CI).
RESULTS: Results from the case-control study revealed that, when compared with the control group, levels of LDL-C, TG, UA, LDL-C/HDL-C, TG/HDL-C, and TC/HDL-C in the ED group were significantly elevated (P < 0.01), while HDL-C was significantly decreased (P < 0.01) in the ED group. Multivariate logistic regression analysis indicated LDL-C/HDL-C as a risk factor for both the incidence and severity of ED (P < 0.001). Two-sample MR analysis demonstrated no significant causal correlation between lipid parameters-LDL-C (OR, 0.98, 95% CI, 0.88-1.08, P = 0.616), HDL-C (OR, 1.07, 95% CI: 0.96-1.19, P = 0.249), TC (OR, 1.07, 95% CI, 0.96-1.18, P = 0.208), TG (OR, 0.98, 95% CI, 0.80-1.13, P = 0.579) -and an increased risk of ED (all P > 0.05).
CONCLUSIONS: The case-control analysis ascertained a significant association between LDL-C, HDL-C, LDL-C/HDL-C, and ED and its severity. However, results from the MR study do not support a causal role of lipid parameters in ED.
METHODS: The case-control study encompassed 186 young ED patients (ages 20-40) and 186 healthy controls. Lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL ratio, TG/HDL ratio, and LDL-C/HDL-C ratio, were assessed in all participants. The International Index of Erectile Function (IIEF-5) scores were collected for all participants to evaluate erectile status. Multivariate logistic regression analysis was utilized to appraise the association of lipid-related parameters with ED. Single-nucleotide polymorphisms (SNPs) significantly correlated with lipid parameters (TC, TG, LDL-C, HDL-C) were selected from genome-wide association studies (GWAS) as instrumental variables (IV) (P < 5.0 × 10-8). Summary data for ED was gathered from a GWAS with a sample size of (n = 17,353 cases/28,210 controls). The inverse variance weighted (IVW) method was employed as the primary mendelian randomization (MR) analysis method to assess causal effects. Causal estimates were represented as odds ratios (OR) with 95% confidence intervals (CI).
RESULTS: Results from the case-control study revealed that, when compared with the control group, levels of LDL-C, TG, UA, LDL-C/HDL-C, TG/HDL-C, and TC/HDL-C in the ED group were significantly elevated (P < 0.01), while HDL-C was significantly decreased (P < 0.01) in the ED group. Multivariate logistic regression analysis indicated LDL-C/HDL-C as a risk factor for both the incidence and severity of ED (P < 0.001). Two-sample MR analysis demonstrated no significant causal correlation between lipid parameters-LDL-C (OR, 0.98, 95% CI, 0.88-1.08, P = 0.616), HDL-C (OR, 1.07, 95% CI: 0.96-1.19, P = 0.249), TC (OR, 1.07, 95% CI, 0.96-1.18, P = 0.208), TG (OR, 0.98, 95% CI, 0.80-1.13, P = 0.579) -and an increased risk of ED (all P > 0.05).
CONCLUSIONS: The case-control analysis ascertained a significant association between LDL-C, HDL-C, LDL-C/HDL-C, and ED and its severity. However, results from the MR study do not support a causal role of lipid parameters in ED.
摘要：
目的：脂质参数已被证明对心血管疾病具有显着的预测价值，但很少有研究评估其与年轻男性勃起功能障碍（ED）的相关性。
方法：病例对照研究包括186名年轻ED患者（20-40岁）和186名健康对照。脂质参数,包括总胆固醇（TC），甘油三酯（TG），低密度脂蛋白胆固醇（LDL-C），高密度脂蛋白胆固醇（HDL-C），TC/HDL比值,TG/HDL比值,LDL-C/HDL-C比值，在所有参与者中进行评估。收集所有参与者的国际勃起功能指数（IIEF-5）评分以评估勃起状态。采用多因素logistic回归分析评价血脂相关参数与ED的相关性。单核苷酸多态性（SNPs）与血脂参数（TC，TG,LDL-C,HDL-C）从全基因组关联研究（GWAS）中选择作为工具变量（IV）（P<5.0×10-8）。ED的汇总数据来自GWAS，样本量为（n=17,353例/28,210例对照）。采用逆方差加权（IVW）方法作为主要的孟德尔随机化（MR）分析方法来评估因果效应。因果估计以比值比（OR）和95%置信区间（CI）表示。
结果：病例对照研究结果显示，与对照组相比，LDL-C水平，TG,UA,LDL-C/HDL-C,TG/HDL-C,ED组TC/HDL-C明显升高(P<0.01),ED组HDL-C明显下降(P<0.01)。多因素logistic回归分析显示LDL-C/HDL-C是ED发生率和严重程度的危险因素(P<0.001)。两样本MR分析显示血脂参数-LDL-C之间没有显着的因果关系（OR，0.98，95%CI，0.88-1.08，P=0.616），HDL-C(OR,1.07，95%CI：0.96-1.19，P=0.249），TC(或,1.07，95%CI，0.96-1.18，P=0.208），TG(或,0.98，95％CI，0.80-1.13，P=0.579）-并增加ED的风险（均P>0.05）。
结论：病例对照分析确定LDL-C之间存在显着关联，HDL-C,LDL-C/HDL-C,和ED及其严重程度。然而,MR研究的结果不支持血脂参数在ED中的因果关系.
方法：病例对照研究包括186名年轻ED患者（20-40岁）和186名健康对照。脂质参数,包括总胆固醇（TC），甘油三酯（TG），低密度脂蛋白胆固醇（LDL-C），高密度脂蛋白胆固醇（HDL-C），TC/HDL比值,TG/HDL比值,LDL-C/HDL-C比值，在所有参与者中进行评估。收集所有参与者的国际勃起功能指数（IIEF-5）评分以评估勃起状态。采用多因素logistic回归分析评价血脂相关参数与ED的相关性。单核苷酸多态性（SNPs）与血脂参数（TC，TG,LDL-C,HDL-C）从全基因组关联研究（GWAS）中选择作为工具变量（IV）（P<5.0×10-8）。ED的汇总数据来自GWAS，样本量为（n=17,353例/28,210例对照）。采用逆方差加权（IVW）方法作为主要的孟德尔随机化（MR）分析方法来评估因果效应。因果估计以比值比（OR）和95%置信区间（CI）表示。
结果：病例对照研究结果显示，与对照组相比，LDL-C水平，TG,UA,LDL-C/HDL-C,TG/HDL-C,ED组TC/HDL-C明显升高(P<0.01),ED组HDL-C明显下降(P<0.01)。多因素logistic回归分析显示LDL-C/HDL-C是ED发生率和严重程度的危险因素(P<0.001)。两样本MR分析显示血脂参数-LDL-C之间没有显着的因果关系（OR，0.98，95%CI，0.88-1.08，P=0.616），HDL-C(OR,1.07，95%CI：0.96-1.19，P=0.249），TC(或,1.07，95%CI，0.96-1.18，P=0.208），TG(或,0.98，95％CI，0.80-1.13，P=0.579）-并增加ED的风险（均P>0.05）。
结论：病例对照分析确定LDL-C之间存在显着关联，HDL-C,LDL-C/HDL-C,和ED及其严重程度。然而,MR研究的结果不支持血脂参数在ED中的因果关系.
