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Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study

International Journal of Impotence Research volume 28, pages 143–147 (2016)Cite this article

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Abstract

Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients <40 years of age, 677 male patients newly diagnosed with chronic osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44–5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED.

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References

  1. Ayta IA, McKinlay JB, Krane RJ . The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999; 84: 50–56.

    Article  CAS  PubMed  Google Scholar 

  2. Prins J, Blanker MH, Bohnen AM, Thomas S, Bosch JL . Prevalence of erectile dysfunction: a systematic review of population-based studies. Int J Impot Res 2002; 14: 422–432.

    Article  CAS  PubMed  Google Scholar 

  3. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

    Article  Google Scholar 

  4. Waldvogel FA, Medoff G, Swartz MN . Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. N Engl J Med 1970; 282: 198–206.

    Article  CAS  PubMed  Google Scholar 

  5. Chun J, Carson CC 3rd . Physician-patient dialogue and clinical evaluation of erectile dysfunction. Urol Clin North Am 2001; 28: 249–258, viii.

    Article  CAS  PubMed  Google Scholar 

  6. Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Vasiliadou C, Alexopoulos N et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J 2006; 27: 2640–2648.

    Article  CAS  PubMed  Google Scholar 

  7. Carek PJ, Dickerson LM, Sack JL . Diagnosis and management of osteomyelitis. Am Fam Physician 2001; 63: 2413–2420.

    CAS  PubMed  Google Scholar 

  8. Dirschl DR, Almekinders LC . Osteomyelitis. Common causes and treatment recommendations. Drugs 1993; 45: 29–43.

    Article  CAS  PubMed  Google Scholar 

  9. Lew DP, Waldvogel FA . Osteomyelitis. Lancet 2004; 364: 369–379.

    Article  CAS  PubMed  Google Scholar 

  10. Lin SY, Lin CL, Tseng CH, Wang IK, Wang SM, Huang CC et al. The association between chronic osteomyelitis and increased risk of diabetes mellitus: a population-based cohort study. Eur J Clin Microbiol Infect Dis 2014; 33: 1647–1652.

    Article  PubMed  Google Scholar 

  11. Hotamisligil GS . Inflammation and metabolic disorders. Nature 2006; 444: 860–867.

    Article  CAS  PubMed  Google Scholar 

  12. Fullilove S, Jellis J, Hughes SP, Remick DG, Friedland JS . Local and systemic concentrations of tumour necrosis factor-alpha, interleukin-6 and interleukin-8 in bacterial osteomyelitis. Trans R Soc Trop Med Hyg 2000; 94: 221–224.

    Article  CAS  PubMed  Google Scholar 

  13. Muneer A, Kalsi J, Nazareth I, Arya M . Erectile dysfunction. BMJ 2014; 348: g129.

    Article  PubMed  Google Scholar 

  14. Basson R, Rees P, Wang R, Montejo AL, Incrocci L . Sexual function in chronic illness. J Sex Med 2010; 7: 374–388.

    Article  PubMed  Google Scholar 

  15. Schouten BW, Bohnen AM, Dohle GR, Groeneveld FP, Willemsen S, Thomas S et al. Risk factors for deterioration of erectile function: the Krimpen study. Int J Androl 2009; 32: 166–175.

    Article  PubMed  Google Scholar 

  16. Javaroni V, Neves MF . Erectile dysfunction and hypertension: impact on cardiovascular risk and treatment. Int J Hypertens 2012; 2012: 627278.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Araujo AB, Durante R, Feldman HA, Goldstein I, McKinlay JB . The relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med 1998; 60: 458–465.

    Article  CAS  PubMed  Google Scholar 

  18. Vrentzos GE, Paraskevas KI, Mikhailidis DP . Dyslipidemia as a risk factor for erectile dysfunction. Curr Med Chem 2007; 14: 1765–1770.

    Article  CAS  PubMed  Google Scholar 

  19. Jung JH, Kam SC, Choi SM, Jae SU, Lee SH, Hyun JS . Sexual dysfunction in male stroke patients: correlation between brain lesions and sexual function. Urology 2008; 71: 99–103.

    Article  PubMed  Google Scholar 

  20. Arrellano-Valdez F, Urrutia-Osorio M, Arroyo C, Soto-Vega E . A comprehensive review of urologic complications in patients with diabetes. Springerplus 2014; 3: 549.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Suzuki E, Nishimatsu H, Oba S, Takahashi M, Homma Y . Chronic kidney disease and erectile dysfunction. World J Nephrol 2014; 3: 220–229.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Nair SP, Meghji S, Wilson M, Reddi K, White P, Henderson B . Bacterially induced bone destruction: mechanisms and misconceptions. Infect Immun 1996; 64: 2371–2380.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Ciampolini J, Harding KG . Pathophysiology of chronic bacterial osteomyelitis. Why do antibiotics fail so often? Postgrad Med J 2000; 76: 479–483.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Hsiao LC, Muo CH, Chen YC, Chou CY, Tseng CH, Chang KC . Increased risk of coronary heart disease in patients with chronic osteomyelitis: a population-based study in a cohort of 23 million. Heart 2014; 100: 1450–1454.

    Article  PubMed  Google Scholar 

  25. Tseng CH, Chen JH, Muo CH, Chang YJ, Sung FC, Hsu CY . Increased risk of ischaemic stroke amongst patients with chronic osteomyelitis: a population-based cohort study in Taiwan. Eur J Neurol 2014; 22: 633–639.

    Article  PubMed  Google Scholar 

  26. de Groot L, Posthumus MD, Kallenberg CG, Bijl M . Risk factors and early detection of atherosclerosis in rheumatoid arthritis. Eur J Clin Invest 2010; 40: 835–842.

    Article  PubMed  Google Scholar 

  27. Patel RV, Shelling ML, Prodanovich S, Federman DG, Kirsner RS . Psoriasis and vascular disease-risk factors and outcomes: a systematic review of the literature. J Gen Intern Med 2011; 26: 1036–1049.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Tonetti MS . Periodontitis and risk for atherosclerosis: an update on intervention trials. J Clin Periodontol 2009; 36: 15–19.

    Article  PubMed  Google Scholar 

  29. Stein RA . Endothelial dysfunction, erectile dysfunction, and coronary heart disease: the pathophysiologic and clinical linkage. Rev Urol 2003; 5 (Suppl 7): S21–S27.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019); China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM10501010037); NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039 -005); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan, and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. No additional external funding was received for this study.

Author contributions

Conception and design: Hsin-Yi Wang, Chih-Hao Chao and Chia-Hung Kao. Administrative support: Chia-Hung Kao. Data collection and assembly, data analysis and interpretation, manuscript writing and final approval of manuscript: all authors. The guarantor of the paper Chia-Hung Kao assumes responsibility for the integrity of the work as a whole.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

    H-Y Wang

  2. Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan

    H-Y Wang

  3. Division of Chest Medicine, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan

    C-H Chao

  4. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    C-L Lin

  5. College of Medicine, China Medical University, Taichung, Taiwan

    C-L Lin & C-H Tseng

  6. Department of Neurology, China Medical University Hospital, Taichung, Taiwan

    C-H Tseng

  7. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

    C-H Kao

  8. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    C-H Kao

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  1. H-Y Wang
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Correspondence to C-H Kao.

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Wang, HY., Chao, CH., Lin, CL. et al. Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study. Int J Impot Res 28, 143–147 (2016). https://doi.org/10.1038/ijir.2016.17

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