Yüksek Homosistein Seviyelerinin Erektil Disfonksiyon Süresi ve Şiddeti Üzerine Etkileri

Amaç: Yüksek serum homosistein düzeyleri ile erektil disfonksiyon (ED) şiddeti, süresi ve aynı zamanda vasküler patoloji içeren diabetes mellitus (DM), aterosklerotik kalp hastalığı (ASKH), metabolik sendrom, hipertansiyon gibi hastalıklarla olan ilişkisini klinik ve laboratuvar değerleri ile göstermeyi amaçladık. Gereç ve Yöntem: ED şikayeti ile başvuran 82 hasta, serum homosistein değerlerine göre, 15 μmol/L’den düşük hastalar (Grup 1) ve 15 μmol/L’den yüksek hastalar (Grup 2) olarak iki gruba ayrıldı. Her iki grup yaş, ED süresi ve şiddeti, eşlik eden sistemik hastalıklar öyküsü DM, ASKH, hipertansiyon ve laboratuvar [açlık kan şekeri, total kolesterol, yüksek yoğunluklu lipoprotein (HDL), düşük yoğunluklu lipoprotein (LDL), çok düşük yoğunluklu lipoprotein (VLDL), trigliserit, total testosteron] değerleri açısından karşılaştırıldı. Hastaların ED şiddeti Uluslararası Erektil Fonksiyon İndeksi anketinin kısa formu ile değerlendirildi. Bulgular: Grup 2 hastalarda ED şiddeti ve süresi ortalaması, Grup 1 hastalara göre istatistiksel anlamlı olarak daha uzundu. Grup 2’de, DM ve ASKH eşlik eden hasta oranı Grup 1’e göre anlamlı yüksek iken hipertansiyon oranı açısından gruplar benzerdi. Laboratuvar değerleri açısından, her iki grup, serum total kolesterol ve HDL değerleri açısından benzerken, LDL, VLDL, trigliserit değerleri açısından izlenen fark istatistiksel açıdan Grup 1 lehine anlamlı idi. Sonuç: ED’nin temel nedenlerinden biri olan endotelyal disfonksiyonun tanı ve takibi için biyokimyasal belirteçlerin rolü birçok çalışmada incelenmiştir. Bu amaç doğrultusunda ilgi gören ve ED ile ilişkisi araştırılan parametrelerden bir tanesi de serum homosistein seviyeleridir. Homosistein, ED için varsayılan bir risk faktörü olmaya devam etmektedir. Bulgular daha fazla olgu sayılı çalışmalarla desteklenirse, ED gelişiminin ve ilerlemesinin önlenmesinde ve medikal tedavi yanıtının takibinde bir belirteç olarak katkı sağlayabilir.

The Effects of High Homocystein Levels on Duration and Severity of Erectile Dysfunction

Objectives: We aimed to demonstrate the relationship between high serum homocysteine levels and severity, duration of erectile dysfunction (ED), also the diseases including vascular pathologies like diabetes mellitus (DM), atherosclerotic heart disease (ASHD), hypertension, and metabolic syndrome with clinical and laboratory values. Materials and Methods: Eighty-two patients admitted with ED were divided into two groups based on serum homocysteine values, as patients with a homocysteine value of less than 15 μmol/L (Group 1) and patients with a homocysteine value of more than 15 μmol/L (Group 2). Both groups were compared in terms of age, duration and severity of ED, history of concomitant systemic diseases like DM, ASHD, hypertension and laboratory values [fasting blood sugar, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), triglyceride, total testosterone] values. The severity of ED in patients was evaluated with the short form of the International Index of Erectile Function questionnaire. Results: Severity and duration of ED were statistically more significant in the patients in Group 2 than in the patients in Group 1. While the ratio of patients with DM and ASHD was significantly higher in Group 2 than in Group 1, the groups were similar for ratio of hypertension. In terms of laboratory values, both groups were similar for serum total cholesterol and HDL while the difference observed for LDL, VLDL and triglyceride was statistically significant in favor of Group 1. Conclusion: The role of biochemical markers in the diagnosis and follow-up of endothelial dysfunction, which is one of the main causes of ED, has been investigated in many studies. For this purpose, one of the parameters that has been investigated for its relationship with ED is serum homocysteine level. Homocysteine remains as a putative risk factor for ED. If results are supported by studies with larger number of cases, it may contribute as a marker in the prevention of ED development and progression and also in the follow-up of medical treatment response.

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