The efficacy of systemic inflammatory response and oxidative stress in erectile dysfunction through multi-inflammatory index: a prospective cross-sectional analysis

Abstract

Abstract Background Systemic inflammation and oxidative stress increase the possibility of erectile dysfunction (ED) through a coordinated response to vascular endothelial damage. Aim The study aimed to evaluate the status of oxidative stress and systemic inflammation in ED. Methods The analysis was a prospective, cross-sectional, single-center study. The study included non-ED (n = 54) and ED (n = 104) groups. The study analyzed demographics, clinical outputs, oxidative stress (total antioxidant status [TAS], total oxidant status [TOS], oxidative stress index [OSI]), and an inflammatory condition (multi-inflammatory index 1 [MII-1], MII-2). Outcomes Oxidative stress and systemic inflammation were evaluated together in ED, which was evaluated with the help of the International Erectile Function Index (IIEF) scale. Results TAS significantly decreased in the ED group compared with the non-ED group (2.25 ± 0.83 mmol Trolox equivalents/L vs 1.45 ± 0.65 mmol Trolox equivalents/L; P = .001). TOS increased in the ED group (14.1 ± 6.2 μmol H2O2 equivalents/L) compared with non-ED group (11.05 ± 6.8 μmol H2O2 equivalents/L) (P = .002). OSI was as low as 0.74 ± 0.33 in the non-ED group and as high as 2.38 ± 0.85 in the ED group (P = .001). Both MII-1 (273 ± 398 vs 745 ± 1311; P = .012) and MII-2 (4.66 ± 5.02 vs 19.7 ± 29.4; P = .031) increased in the ED group compared with the non-ED group. IIEF was negatively correlated with MII-1 (r = −0.298; P = .009), MII-2 (r = −0.341; P = .006), and OSI (r = −0.387; P < .0001), while TAS had a strong positive correlation with the IIEF (r = 0.549; P = .0001). OSI was correlated with MII-1 (r = 0.304; P = .001) and MII-2 (r = 0.334; P = .001). OSI was the strongest parameter in predicting ED (P = .0001; area under the curve, 0.795; 95% confidence interval, 0.696-0.855). The cutoff was 0.71 at 80.5% sensitivity and 67.2% specificity. Clinical Implications OSI showed diagnostic potential for ED as an oxidative stress indicator, while MII-1 and MII-2 showed the effectiveness. Strengths and Limitations MIIs, a novel indicator of systemic inflammatory condition, were analyzed for the first time in patients with ED. The long-term diagnostic efficacy of these indices was lacking, as all patient data did not include long-term follow-up. Conclusion Considering their low cost and easy applicability compared with OSI, MIIs could be essential parameters in the follow-up for ED for physicians.