The Patient's Comorbidity Burden Correlates with the Erectile Dysfunction Severity.
OBJECTIVE
To explore the potential relationship between erectile dysfunction (ED), low testosterone levels, and the Charlson Comorbidity Index (CCI).


MATERIAL AND METHODS
Cross-sectional study on patients referred to the andrology unit in 7 Spanish centers. The ED was diagnosed and graded using the International Index of Erectile Function (IIEF-5) score. Total testosterone, the prevalence of each comorbidity, and the CCI were compared between patients with different grades of ED. Besides, the correlation between total testosterone and the CCI score, the influence of each comorbidity, and the ED severity on the CCI was assessed in a multiple linear regression.


RESULTS
The study included 430 men with a mean age of 61 years. The mean CCI was 3.5, and mean total testosterone 15.2 nmol/L; 389 (91%) subjects had some grade of ED: 97 (23%) mild, 149 (35%) mild-to-moderate, 86 (20%) moderate, and 57 (13%) severe. The increase in ED severity was significantly associated with a decrease in total testosterone (P=.002), and an increase in the CCI score (P<.001). Testosterone levels were significantly lower in patients with obesity, diabetes, hypercholesterolemia, and hypertriglyceridemia (P<.05). However, only the prevalence of diabetes and hypertension was significantly associated with the severity of ED. The multivariate analysis including variables related to all assessed comorbidities, total testosterone levels, and the DE severity significantly predicted the CCI score (P<.001, R2=.426). The severity of ED significantly contributed to this model (P=.011), but total testosterone did not (P=.204).


CONCLUSIONS
The CCI is significantly associated with the ED severity, but it shows a weak correlation with the testosterone levels.
['García-Cruz|E|E|', 'Carrión|A|A|', 'Ajami|T|T|', 'Álvarez|M|M|', 'Correas|M Á|MÁ|', 'García|B|B|', 'García|J V|JV|', 'González|C|C|', 'Portillo|J A|JA|', 'Romero-Otero|J|J|', 'Simón|C|C|', 'Torremadé|J|J|', 'Vigués|F|F|', 'Alcaraz|A|A|']
D000368:Aged D000428:Alcohol Drinking D015897:Comorbidity D003430:Cross-Sectional Studies D003920:Diabetes Mellitus D050171:Dyslipidemias D007172:Erectile Dysfunction D006801:Humans D006973:Hypertension D007006:Hypogonadism D008297:Male D008875:Middle Aged D009765:Obesity D015995:Prevalence D012720:Severity of Illness Index D012907:Smoking D013030:Spain D013739:Testosterone
Comorbidity Erectile dysfunction Charlson Comorbidity Index Comorbilidad Disfunción eréctil Hipogonadismo Hypogonadism Índice de comorbilidad de Charlson