In the Journals Plus

Type 2 diabetes may cause erectile dysfunction

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January 6, 2019

A genetic predisposition for type 2 diabetes may be associated with erectile dysfunction, suggesting that diabetes can be a cause of erectile issues, according to findings published in the American Journal of Human Genetics.

“Erectile dysfunction affects at least one in five men over 60, yet up until now little has been known about its cause,” Anna Murray, PhD, associate professor in human genetics at the University of Exeter Medical School in England, said in a press release. “Our paper echoes recent findings that the cause can be genetic, and it goes further. We found that a genetic predisposition to type 2 diabetes is linked to erectile dysfunction. That may mean that if people can reduce their risk of diabetes through healthier lifestyles, they may also avoid developing erectile dysfunction.”

In a genome-wide association study, researchers from the University of Exeter and the University of Oxford analyzed data from more than 220,000 men across three cohorts, 6,000 of whom experienced erectile dysfunction using data from the UK Biobank, the Estonian Genome Center of the University of Tartu cohort and hospital-recruited Partners HealthCare Biobank.

In linkage disequilibrium score regression, the researchers identified erectile dysfunction to share the greatest genetic correlation with type 2 diabetes, limb fat mass and whole-body fat mass. In Mendelian randomization analyses, they evaluated the potential causal role of nine predefined cardiometabolic traits on erectile dysfunction risk, including type 2 diabetes, insulin resistance, systolic blood pressure, LDL cholesterol, smoking, alcohol consumption, BMI, coronary heart disease and education level. In the analyses, researchers found that each 1-log higher genetic risk for type 2 diabetes increased the risk for erectile dysfunction, with an OR of 1.11 (95% CI, 1.05-1.17). They noted that insulin resistance likely represented a mediating pathway, with an OR of 1.36 for erectile dysfunction per 1-standard deviation genetically elevated insulin resistance (95% CI, 1.01-1.84). Researchers also found that higher systolic BP was associated with higher risk for erectile dysfunction, whereas LDL cholesterol, smoking or alcohol consumption were not linked to the condition.

Genetic risk for CHD showed weak effects on the risk for erectile dysfunction, suggesting that pathways leading to CHD may be implicated in erectile dysfunction, the researchers wrote.

“By aggregating data from three cohorts, including 6,175 [erectile dysfunction]-affected case subjects of European ancestry, we identified a locus associated with [erectile dysfunction], with several lines of evidence suggesting SIM1, highly expressed in the hypothalamus, to be the causal gene at this locus,” the researchers wrote. “Our findings provide human genetic evidence in support of the key role of the hypothalamus in regulating male sexual function.”

The researchers noted that few clinical trials of diabetes have reported erectile dysfunction as an outcome of improved glucose control, limiting the conclusions that can be drawn about whether treatment of diabetes is likely to have an impact on erectile dysfunction risk.

“Our finding is important as diabetes is preventable and indeed one can now achieve ‘remission’ from diabetes with weight loss, as illustrated in recent clinical trials,” Michael Holmes, MBBS, MSc, PhD, MRCP, associate professor in the department of population health at the University of Oxford, said in the release. “This goes beyond finding a genetic link to erectile dysfunction to a message that is of widespread relevance to the general public, especially considering the burgeoning prevalence of diabetes.” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.