Association between leucocyte telomere length and erectile dysfunction in US adults: a secondary study based on 2001-2002 NHANES data

Abstract

Objective: We aimed to explore the association between the leucocyte telomere length (LTL) and erectile dysfunction (ED) among a nationally representative sample of US adults.

Design: Secondary population-based study.

Setting: The National Health and Nutrition Examination Survey (NHANES) (2001-2002).

Participants: A total of 1694 male participants were extracted from the NHANES database for 2001-2002.

Primary and secondary outcome measures: The primary focus of the study was to determine the association between the LTL and ED, using multivariate logistic regression and restricted cubic spline models for examination. The secondary outcome measures involved conducting stratified subgroup analyses to exclude interactions of different variables with the LTL.

Results: Participants with ED had shorter LTLs than those without ED (p<0.05). After adjusting for confounding factors, compared with the reference lowest LTL quartile, the ORs and 95% CIs for the second, third and fourth LTL quartiles were (OR 1.51; 95% CI 1.01 to 2.26), (OR 1.79; 95% CI 1.24 to 2.58) and (OR 1.25; 95% CI 0.74 to 2.11), respectively. In addition, restricted cubic splines showed an inverted J-curve relationship between the LTL and ED. At an LTL of 1.037, the curve showed an inflection point. The ORs (95% CI) of ED on the left and right sides of the inflection point were (OR 1.99; 95% CI 0.39 to 10.20; p=0.385) and (OR 0.17; 95% CI 0.03 to 0.90; p=0.039).

Conclusion: Our results demonstrated an inverted J-curve relationship between the LTL and ED. When the LTL was ≥1.037, the incidence of ED decreased with increasing LTL.

Keywords: Erectile dysfunction; MOLECULAR BIOLOGY; PUBLIC HEALTH.

Figure 1

Restricted cubic spline of association between the LTL and the prevalence of ED (adjusted for age, race/ethnicity, education level, smoking status, PIR, vigorous activity, moderate activity, alcohol consumption status, hypertension, diabetes, CVD, CKD, hyperlipidaemia and ED medications). CVD, cardiovascular disease; CKD, chronic kidney disease; ED, erectile dysfunction; LTL, leucocyte telomere length; PIR, poverty income ratio.

Figure 2

Multivariable logistic regression associations between LTL and ED by subgroup analysis (adjusted for age, race/ethnicity, education level, smoking status, PIR, vigorous activity, moderate activity, alcohol consumption status, hypertension, diabetes, CVD, CKD, hyperlipidemia and ED medications). When they were not the strata variables, results are survey weighted. BMI, body mass index; CVD, cardiovascular disease; CKD, chronic kidney disease; ED, erectile dysfunction; LTL, leucocyte telomere length; PIR, poverty income ratio.