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Erectile dysfunction in patients with plaque psoriasis: the relation of depression and cardiovascular factors

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Abstract

Psoriasis is a chronic inflammatory skin disease and seems to be associated with erectile dysfunction (ED). ED is a predictor of future cardiovascular disease. It is important to identify ED early and investigate cardiovascular problems in psoriasis patients. The sample consisted of 191 psoriasis patients and 191 healthy men. One hundred and one of 191 (52.9%) patients with psoriasis were indicative of ED, compared with 40.3% in control group, reflecting an age-adjusted odds ratio of 1.965 in favor of the psoriasis group. A univariate analysis in the psoriasis group indicated that age, hypertension, hyperlipidemia, diabetes mellitus and depressive symptoms were the risk factors for ED. The multivariate logistic regression model indicated that increasing age, hypertension, hyperlipidemia and depressive symptoms were independent risk factors for ED in psoriasis. The more severe depressive symptoms increased the risk of ED and especially moderate–severe ED. The diagnosis of ED may help prevent emotional and physical discomfort in men and aid in identifying reversible cardiovascular risk factors. Screening of ED may become a part of routine care in the management of psoriasis patients.

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References

  1. Christophers E . Psoriasis—epidemiology and clinical spectrum. Clin Exp Dermatol 2001; 26: 314–320.

    Article  CAS  PubMed  Google Scholar 

  2. Farber EM, Nall L . Epidemiology: natural history and genetics. In: Roenigk HH, Maibach HI (eds). Psoriasis. Marcel Dekker: New York, NY, USA, 1998, pp 107–157.

    Google Scholar 

  3. Goulding JM, Price CL, Defty CL, Hulangamuwa CS, Bader E, Ahmed I . Erectile dysfunction in patients with psoriasis: increased prevalence, an unmet need, and a chance to intervene. Br J Dermatol 2011; 164: 103–109.

    Article  CAS  PubMed  Google Scholar 

  4. Meeuwis KA, de Hullu JA, van de Nieuwenhof HP, Evers AW, Massuger LF, van de Kerkhof PC et al. Quality of life and sexual health in patients with genital psoriasis. Br J Dermatol 2011; 164: 1247–1255.

    Article  CAS  PubMed  Google Scholar 

  5. Chung SD, Keller JJ, Chu TW, Lin HC . Psoriasis and the risk of erectile dysfunction: a population-based case-control study. J Sex Med 2012; 9: 130–135.

    Article  PubMed  Google Scholar 

  6. Cabete J, Torres T, Vilarinho T, Ferreira A, Selores M . Erectile dysfunction in psoriasis patients. Eur J Dermatol 2014; 24: 482–486.

    PubMed  Google Scholar 

  7. Molina-Leyva A, Jimenez-Moleon JJ, Naranjo-Sintes R, Ruiz-Carrascosa JC . Sexual dysfunction in psoriasis: a systematic review. J Eur Acad Dermatol Venereol 2015; 29: 649–655.

    Article  CAS  PubMed  Google Scholar 

  8. Tasliyurt T, Bilir Y, Sahin S, Seckin HY, Kaya SU, Sivgin H et al. Erectile dysfunction in patients with psoriasis: potential impact of the metabolic syndrome. Eur Rev Med Pharmacol Sci 2014; 18: 581–586.

    CAS  PubMed  Google Scholar 

  9. Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294: 2996–3002.

    Article  CAS  PubMed  Google Scholar 

  10. Hare DL, Toukhsati SR, Johansson P, Jaarsma T . Depression and cardiovascular disease: a clinical review. Eur Heart J 2014; 35: 1365–1372.

    Article  PubMed  Google Scholar 

  11. Miner M, Nehra A, Jackson G, Bhasin S, Billups K, Burnett AL et al. All men with vasculogenic erectile dysfunction require a cardiovascular workup. Am J Med 2014; 127: 174–182.

    Article  PubMed  Google Scholar 

  12. Yamada T HK, Umematsu H, Suzuki R, Kadowaki T . Erectile dysfunction and cardiovascular events in diabetic men: a meta-analysis of observational studies. PLoS One 2012; 7: e43673.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Vlachopoulos CV, Terentes-Printzios DG, Ioakeimidis NK, Aznaouridis KA, Stefanadis CI . Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circ Cardiovasc Qual Outcomes 2013; 6: 99–109.

    Article  PubMed  Google Scholar 

  14. Watts GF, Chew KK, Stuckey BG . The erectile-endothelial dysfunction nexus: new opportunities for cardiovascular risk prevention. Nat Clin Pract Cardiovasc Med 2007; 4: 263–273.

    Article  CAS  PubMed  Google Scholar 

  15. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  PubMed  Google Scholar 

  16. Radloff LS . The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 3: 385–401.

    Article  Google Scholar 

  17. Cho MJ, Nam JJ, Suh GH . Prevalence of symptoms of depression in a nationwide sample of Korean adults. Psychiatry Res 1998; 81: 341–352.

    Article  CAS  PubMed  Google Scholar 

  18. Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB . Risk of myocardial infarction in patients with psoriasis. JAMA 2006; 296: 1735–1741.

    Article  CAS  PubMed  Google Scholar 

  19. Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB, Gelfand JM . Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol 2006; 55: 829–835.

    Article  PubMed  Google Scholar 

  20. Miller IM, Ellervik C, Yazdanyar S, Jemec GB . Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. J Am Acad Dermatol 2013; 69: 1014–1024.

    Article  PubMed  Google Scholar 

  21. Sterry W, Strober BE, Menter A, International Psoriasis C. Obesity in psoriasis: the metabolic, clinical and therapeutic implications. Report of an interdisciplinary conference and review. Br J Dermatol 2007; 157: 649–655.

    Article  CAS  PubMed  Google Scholar 

  22. Herron MD, Hinckley M, Hoffman MS, Papenfuss J, Hansen CB, Callis KP et al. Impact of obesity and smoking on psoriasis presentation and management. Arch Dermatol 2005; 141: 1527–1534.

    Article  PubMed  Google Scholar 

  23. Zhang C, Zhu KJ, Zheng HF, Cui Y, Zhou FS, Chen YL et al. The effect of overweight and obesity on psoriasis patients in Chinese Han population: a hospital-based study. J Eur Acad Dermatol Venereol 2011; 25: 87–91.

    Article  CAS  PubMed  Google Scholar 

  24. Armstrong AW, Harskamp CT, Armstrong EJ . Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatol 2013; 149: 84–91.

    Article  PubMed  Google Scholar 

  25. Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol 2007; 157: 68–73.

    Article  CAS  PubMed  Google Scholar 

  26. Sampogna F, Gisondi P, Tabolli S, Abeni D, IDIMPRoVE investigators. Impairment of sexual life in patients with psoriasis. Dermatology 2007; 214: 144–150.

    Article  PubMed  Google Scholar 

  27. Chen YJ, Chen CC, Lin MW, Chen TJ, Li CY, Hwang CY et al. Increased risk of sexual dysfunction in male patients with psoriasis: a nationwide population-based follow-up study. J Sex Med 2013; 10: 1212–1218.

    Article  PubMed  Google Scholar 

  28. Meuleman EJ, Diemont WL . Investigation of erectile dysfunction. Diagnostic testing for vascular factors in erectile dysfunction. Urol Clin North Am 1995; 22: 803–819.

    CAS  PubMed  Google Scholar 

  29. Kimball AB, Guerin A, Latremouille-Viau D, Yu AP, Gupta S, Bao Y et al. Coronary heart disease and stroke risk in patients with psoriasis: retrospective analysis. Am J Med 2010; 123: 350–357.

    Article  PubMed  Google Scholar 

  30. Bhutani T, Patel T, Koo B, Nguyen T, Hong J, Koo J . A prospective, interventional assessment of psoriasis quality of life using a nonskin-specific validated instrument that allows comparison with other major medical conditions. J Am Acad Dermatol 2013; 69: e79–e88.

    Article  PubMed  Google Scholar 

  31. Hackett G, Kell P, Ralph D, Dean J, Price D, Speakman M et al. British Society for Sexual Medicine guidelines on the management of erectile dysfunction. J Sex Med 2008; 5: 1841–1865.

    Article  PubMed  Google Scholar 

  32. Jackson G, Rosen RC, Kloner RA, Kostis JB . The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 2006; 3: 28–36, discussion 36.

    Article  CAS  PubMed  Google Scholar 

  33. Jackson G, Boon N, Eardley I, Kirby M, Dean J, Hackett G et al. Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus. Int J Clin Pract 2010; 64: 848–857.

    Article  CAS  PubMed  Google Scholar 

  34. Atlantis E, Sullivan T . Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med 2012; 9: 1497–1507.

    Article  PubMed  Google Scholar 

  35. Bandini E, Fisher AD, Corona G, Ricca V, Monami M, Boddi V et al. Severe depressive symptoms and cardiovascular risk in subjects with erectile dysfunction. J Sex Med 2010; 7: 3477–3486.

    Article  PubMed  Google Scholar 

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Correspondence to B Yang.

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Ji, S., Zang, Z., Ma, H. et al. Erectile dysfunction in patients with plaque psoriasis: the relation of depression and cardiovascular factors. Int J Impot Res 28, 96–100 (2016). https://doi.org/10.1038/ijir.2016.6

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