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Hormonal Association and Sexual Dysfunction in Patients with Impaired Fasting Glucose: A Cross-Sectional and Longitudinal Study


Mario Maggi, MD, Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence, Viale Pieraccini, 6, Florence 50139, Italy. Tel: (39) 0554271415; Fax: (39) 0554271413; E-mail:


Introduction.  The category of impaired fasting glucose (IFG) denotes a state of nondiabetic hyperglycemia, considered a risk factor for the further development of diabetes mellitus (DM) and cardiovascular (CV) diseases.

Aim.  The aim of the present study is to evaluate the impact of IFG on sexual health in men. In addition, its effect on CV morbidity and mortality will also be addressed.

Methods.  A consecutive series of 3,451 men (mean age 57.3 ± 10.1 years) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (N = 1,687) was enrolled in a longitudinal study.

Main Outcome Measures.  Several clinical, biochemical (including testosterone), and instrumental (penile color Doppler ultrasound) factors were evaluated. IFG was defined by fasting glucose concentrations between 5.6 and 6.9 mmol/L (100–125 mg/dL). A higher threshold (6.1–6.9 mmol/L, 110–125 mg/dL) was also considered.

Results.  Among the patients studied, 747 (21.7%) had DM. In addition, 659 (19.1%) subjects were classified as IFG. Patients with IFG, however defined, more often had severe ED, reduced penile blood flow, and overt hypogonadism when compared with patients with normal glucose levels. In addition, men with ED and IFG show poorer blood pressure and lipid profile with an overall increase in CV risk. Unadjusted incidence of major adverse CV events was significantly associated with baseline DM, whereas there was a trend toward higher risk also for IFG, but this did not reach statistical significance. Conversely, both IFG and DM were significantly associated with a higher risk of fatal and nonfatal cerebral events.

Conclusions.  Checking glucose and testosterone levels is mandatory in subjects with ED because testosterone substitution in impotent IFG subjects might ameliorate not only their sexual life but also their overall health. Corona G, Rastrelli G, Balercia G, Lotti F, Sforza A, Monami M, Forti G, Mannucci E, and Maggi M. Hormonal association and sexual dysfunction in patients with impaired fasting glucose: A cross-sectional and longitudinal study. J Sex Med 2012;9:1669–1680.