Association Between Body Size and Composition and Erectile Dysfunction in Older Men: Osteoporotic Fractures in Men Study

Authors

  • Pranav S. Garimella MD, MPH,

    Corresponding author
    • Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
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  • Misti L. Paudel MPH,

    1. Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
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  • Kristine E. Ensrud MD, MPH,

    1. Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
    2. Department of Medicine, University of Minnesota, Minneapolis, Minnesota
    3. Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
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  • Lynn M. Marshall ScD,

    1. Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon
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  • Brent C. Taylor PhD, MPH,

    1. Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
    2. Department of Medicine, University of Minnesota, Minneapolis, Minnesota
    3. Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
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  • Howard A. Fink MD, MPH,

    1. Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
    2. Department of Medicine, University of Minnesota, Minneapolis, Minnesota
    3. Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, Minneapolis, Minnesota
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  • for the Osteoporotic Fractures in Men (MrOS) Research Group


Address correspondence to Dr. Pranav S. Garimella, Division of Nephrology, Tufts Medical Center, 800 Washington Street, Box 391, Boston, MA 02111. E-mail: pgarimella@tuftsmedicalcenter.org

Abstract

Objectives

To examine the association between body size and composition and erectile dysfunction (ED) in older men.

Design

Cross-sectional analysis of the Osteoporotic Fractures in Men study.

Setting

Six U.S. clinical sites.

Participants

Community-dwelling men aged 65 and older.

Measurements

Body composition measures using anthropometry (body weight, body mass index (BMI)) and dual X-ray absorptiometry (total body fat percentage, trunk fat percentage, ratio of trunk and total body fat). ED was assessed using the single-item Massachusetts Male Aging Study (MMAS) scale and the five-item International Index of Erectile Function questionnaire (IIEF-5).

Results

In men completing the MMAS scale (n = 4,108), prevalence of complete ED was 42%. In sexually active men completing the IIEF-5 questionnaire (n = 1,659), prevalence of moderate to severe ED was 56%. In multivariate-adjusted analyses reporting prevalence ratios (PRs) and 95% confidence intervals (CIs), the prevalence of MMAS-defined complete ED was significantly greater in men in the highest quartile of body weight (PR = 1.24, 95% CI = 1.16–1.34), total body fat percentage (PR = 1.25, 95% CI = 1.13–1.40), and trunk fat percentage (PR = 1.24, 95% CI = 1.15–1.38), and was greater in men with a BMI greater than 30.0 kg/m2 than in those with BMI of 22.0 to 24.9 kg/m2 (PR = 1.17, 95% CI = 1.05–1.31). Associations appeared similar for IIEF-5–defined moderate to severe ED in analyses adjusted for age and study site.

Conclusion

In a cohort of older men, high body weight, BMI, and total body fat percentage were independently associated with greater prevalence of moderate to severe and complete ED. Future studies should investigate whether interventions to promote weight loss and fat loss will improve erectile function in older men.

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