The relationship between oxidative balance score and erectile dysfunction in the U.S. male adult population

Abstract

Oxidative stress strongly influences the pathophysiology of erectile dysfunction (ED). In this study, we used the oxidative balance score (OBS), a composite index, to measure the effects of oxidative stress triggered by diet and lifestyle factors. Here, we conducted a cross-sectional study to determine the statistical relationship between OBS and ED among adult males in the U.S. The data from 3318 participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2004 were analyzed. Weighted logistic regression was used to correct for confounding factors and acquire nationwide representative estimates. Generalized additive modeling was used to explore the nonlinear relationship. We also supplemented subgroup and sensitivity analysis to examine the robustness of the main results. Multivariate logistic regression indicated a consistent negative linear association between OBS and ED across all participants [OR (95% CI) = 0.96 (0.94, 0.98)]. After categorizing OBS into tertiles, participants in the highest tertile had 43% lower odds of having ED than those in the lowest tertile [OR (95% CI) = 0.57 (0.37, 0.87)]. The generalized additive model also visualized the linear trend of this association. Furthermore, this linear relationship remained relatively consistent, regardless of whether subgroup or sensitivity analyses were performed. Our findings suggest that adopting a lifestyle and diet pattern that promotes favorable OBS may effectively protect against the development of ED, regardless of the underlying causes.

Keywords: Cross-sectional study; Erectile dysfunction; Oxidative balance score; Oxidative stress.

Figure 1

Flow diagram of the inclusion and exclusion of study participants.

Figure 2

Graphics of smooth curve fittings between the OBS and ED. Blue bands represent the 95% CI from the fit. The solid red line represents the smooth curve fit between variables. This model was adjusted for age, race, poverty income ratio, education and marital status, hypertension, diabetes, cardiovascular disease, hypercholesterolemia and chronic kidney disease.

Figure 3

Subgroup and interaction analysis of the relationship between OBS and ED. Each stratification was adjusted for age, race, poverty income ratio, education and marital status, hypertension, diabetes, cardiovascular disease, hypercholesterolemia and chronic kidney disease, except the stratification factor itself. In the subgroup of race, the group of other Hispanic have no estimate because the model cannot converge.