Hyperhomocysteinemia Is a Risk Factor for Erectile Dysfunction in Men with Adult-Onset Diabetes Mellitus

Objectives: Hyperhomocysteinemia (HHcy) is associated with cardiovascular disease such as coronary arteriosclerosis and stroke. However, its role in the development of vasculogenic erectile dysfunction (ED) is still putative. In this study, we evaluated the relationship between plasma total homocysteine (tHcy) and the presence of vasculogenic ED in men with adult-onset diabetes mellitus. Methods: This was a case-control study of 97 adult-onset diabetics with vasculogenic ED and 97 concurrently sampled control diabetics, who were free from ED. We obtained risk estimates of odds ratios (ORs), both crude and adjusted, using logistic regression models. We then determined cardiovascular risk factors and HbA1c levels in both groups of patients. Results: Plasma tHcy was significantly higher in cases compared with controls. The mean ± standard deviation plasma tHcy in cases was 11.2 ± 3.5 μmol/L versus 8.8 ± 2.6 μmol/L in controls (P <0.001). Moreover, those with HHcy had 5.2 times the odds of vasculogenic ED compared with men without HHcy (OR 5.2, 95% confidence interval, 1.4 to 18.9). Although the risk of ED did not vary significantly according to body mass index, serum cholesterol, triglycerides, C-reactive protein, and blood HbA1c levels, it was significantly affected by smoking status and hypertension. Conclusions: High plasma tHcy appears to be associated with ED in patient with adult-onset diabetes mellitus.