Erectile dysfunction severity is associated with increased circulating concentrations of Interleukin-6 and soluble E-selectin in patients with type-2 diabetes mellitus.
Araña Rosaínz, MJ(1); Fragas Valdés, R(2); Estevez Baez, M(1); Garcia Alvarez, CT(1); Orlandi Gonzalez, N(1)
(1)Instituto Nacional de Endocrinologia (2)Hospital “Cmdte. Manuel Fajardo”, La Habana, Cuba.
Introduction: Inflammation and endothelial dysfunction are involved in diabetes mellitus type 2 (DM-2), and seem to contribute to erectile dysfunction (ED). Obesity and metabolic syndrome (MS), risk factors of ED, also share an inflammatory background, and have been associated with hypogonadism (HG) in patients with DM-2 and ED.
Objectives: To evaluate the relation of circulating Interleukin-6 (IL-6) and soluble adhesion molecules and ED severity in men with DM-2, and to determine the association among these markers and MS, HG and penile nerve conduction abnormalities in these patients.
Materials and Methods: 103 patients with DM-2 presenting for symptomatic ED were included (mean age: 49.0±7 years). Hormonal and biochemical parameters were studied along with measurement of serum IL-6, soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E-selectin (sES). ED severity was graded with the five-item version of the International Index of Erectile Function. MS was defined according to WHO criteria and HG as total testosterone (TT) <10.4 nmol/L. Sensory tests were used to detect penile nerve abnormalities.
Results: ED severity correlated with IL-6 (r = 0.41, p = 0.01) and sES (r = 0.71, p < 0.001) levels, but not sICAM-1(r = 0.27, p = 0.067). HG was significantly associated with increments in the number of criteria for MS (x²=11.1, p = 0.011), and ED severity (x²=12.4, p = 0.029). TT inversely correlated with waist circumference (r = -0.33, p = 0.019) and patients with low TT trend to have higher sES levels. Penile quantitative sensory tests demonstrate an abnormal response mainly in patients with moderate/severe ED and high serum concentrations of either IL-6 or sES.
Conclusions: Our study demonstrates in patients with DM-2 and moderate/severe ED, correlative increments in IL-6 and sES concentrations, suggesting that low-grade inflammation underlies, and is probably perpetuated by, the metabolic and hormonal derangements generally associated with DM-2 and ED.
