Background erectile dysfunction is associated with mortality, whereas the association between low testosterone (T) and higher mortality remains controversial. Sexual dysfunction and low T often coexist, but the relative importance of sexual symptoms versus low T in predicting mortality is not known. We studied the interrelationships between sex steroids and sexual symptoms with all-cause mortality in a large prospective cohort of European men. Design survival status was assessed in 1,788 community-dwelling men, aged 40-79, who participated in the European Male Ageing Study (EMAS). Sexual symptoms were evaluated via a validated questionnaire (EMAS-SFQ). Sex steroids were measured by mass spectrometry. Cox proportional hazard models were used to study the association between hormones, sexual symptoms and mortality. Results about 420 (25.3%) men died during a mean follow-up of 12.6 +/- 3.1 years. Total T levels were similar in both groups, but free T was lower in those who died. Men with three sexual symptoms (erectile dysfunction, reduced morning erections and lower libido) had a higher mortality risk compared with men with none of these symptoms (adjusted hazard ratio (HR) and 95% confidence intervals: 1.75 (1.28-2.40, P = 0.001)). Particularly, erectile dysfunction and poor morning erections, but not lower libido, were associated with increased mortality (HR 1.40 (1.13-1.74, P = 0.002), 1.28 (1.04-1.59, P = 0.023) and 1.12 (0.90-1.39, P = 0.312), respectively). Further adjusting for total T, free T or oestradiol did not influence the observed risk. Conclusions sexual symptoms, in particular erectile dysfunction, predict all-cause mortality independently of sex steroids and can be an early warning sign of a poor health status.

Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status / Antonio, Leen; Wu, Frederick C W; Moors, Hannes; Matheï, Cathy; Huhtaniemi, Ilpo T; Rastrelli, Giulia; Dejaeger, Marian; O'Neill, Terence W; Pye, Stephen R; Forti, Gianni; Maggi, Mario; Casanueva, Felipe F; Slowikowska-Hilczer, Jolanta; Punab, Margus; Tournoy, Jos; Vanderschueren, Dirk. - In: AGE AND AGEING. - ISSN 0002-0729. - ELETTRONICO. - 51:(In corso di stampa), pp. 0-0. [10.1093/ageing/afac094]

Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status

Rastrelli, Giulia;Forti, Gianni;Maggi, Mario;
In corso di stampa

Abstract

Background erectile dysfunction is associated with mortality, whereas the association between low testosterone (T) and higher mortality remains controversial. Sexual dysfunction and low T often coexist, but the relative importance of sexual symptoms versus low T in predicting mortality is not known. We studied the interrelationships between sex steroids and sexual symptoms with all-cause mortality in a large prospective cohort of European men. Design survival status was assessed in 1,788 community-dwelling men, aged 40-79, who participated in the European Male Ageing Study (EMAS). Sexual symptoms were evaluated via a validated questionnaire (EMAS-SFQ). Sex steroids were measured by mass spectrometry. Cox proportional hazard models were used to study the association between hormones, sexual symptoms and mortality. Results about 420 (25.3%) men died during a mean follow-up of 12.6 +/- 3.1 years. Total T levels were similar in both groups, but free T was lower in those who died. Men with three sexual symptoms (erectile dysfunction, reduced morning erections and lower libido) had a higher mortality risk compared with men with none of these symptoms (adjusted hazard ratio (HR) and 95% confidence intervals: 1.75 (1.28-2.40, P = 0.001)). Particularly, erectile dysfunction and poor morning erections, but not lower libido, were associated with increased mortality (HR 1.40 (1.13-1.74, P = 0.002), 1.28 (1.04-1.59, P = 0.023) and 1.12 (0.90-1.39, P = 0.312), respectively). Further adjusting for total T, free T or oestradiol did not influence the observed risk. Conclusions sexual symptoms, in particular erectile dysfunction, predict all-cause mortality independently of sex steroids and can be an early warning sign of a poor health status.
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Antonio, Leen; Wu, Frederick C W; Moors, Hannes; Matheï, Cathy; Huhtaniemi, Ilpo T; Rastrelli, Giulia; Dejaeger, Marian; O'Neill, Terence W; Pye, Stephen R; Forti, Gianni; Maggi, Mario; Casanueva, Felipe F; Slowikowska-Hilczer, Jolanta; Punab, Margus; Tournoy, Jos; Vanderschueren, Dirk
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2158/1285696
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