Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Usefulness of serum fetuin-A level as a marker of erectile dysfunction


This study aimed to evaluate the correlation between serum levels of fetuin-A and the presence and severity of erectile dysfunction (ED) in Egyptian population. The study was performed on 60 ED patients and 20 age—matched healthy controls. A comprehensive medical history and complete physical examination were obtained and performed in all participants. ED and its severity were assessed via International Index of Erectile Function (IIEF-5). Doppler ultrasound, fasting blood glucose level, complete lipid profile, serum total testosterone (TT) and serum fetuin-A were performed. Our results revealed that there were no statistically significant differences between the ED group and the controls regarding body mass index, fetal bovine serum, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride (TG). However, IIEF-5 and serum TT levels were significantly lower in ED patients than controls. Regarding serum fetuin-A, our data demonstrated that ED patients had significantly lower serum fetuin-A levels than controls. In addition, patients with severe ED had lower fetuin-A levels than moderate and mild ED (P<0.001). Serum fetuin-A levels are positively correlated with cholesterol, LDL, TG and IIEF-5 and negatively correlated with HDL. In conclusion, serum fetuin-A level could be a potentially useful and sensitive biomarker for ED diagnosis.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1
Figure 2
Figure 3
Figure 4


  1. 1

    Smith LJ, Mulhall JP, Deveci S, Monaghan N, Reid MC . “Sex after seventy: a pilot study of sexual function in older persons”. J Sex Med 2007; 4: 1247–1253.

    Article  Google Scholar 

  2. 2

    Maaroos PH, Palomaki A, Hartikainen J . Erectile dysfunction, physical activity, and metabolic syndrome: differences in markers of atherosclerosis. BMC Cardiovasc Disord 2011; 11: 36–44.

    Article  Google Scholar 

  3. 3

    Shaeer O, Shaeer K . The Global Online Sexuality Survey (GOSS) erectile dysfunction among Arabic-speaking Internet users in the Middle East. J Sex Med 2011; 8: 2152–2160.

    Article  Google Scholar 

  4. 4

    Bivalacqua TJ, Champion HC, Hellstrom WJG, Kadowitz PJ . “Pharmacotherapy for erectile dysfunction,”. Trends Pharmacol Sci 2000; 21: 484–489.

    CAS  Article  Google Scholar 

  5. 5

    Lue TF . “Erectile dysfunction,”. N Engl J Med 2000; 342: 1802–1813.

    CAS  Article  Google Scholar 

  6. 6

    Dean RC, Lue TF . Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am 2005; 32: 379–395.

    Article  PubMed Central  Google Scholar 

  7. 7

    Anderson K, Stief C . Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanism. Am J Cardiol 2000; 86: 23F–26F.

    Article  Google Scholar 

  8. 8

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

    PubMed  PubMed Central  Google Scholar 

  9. 9

    Billups KL . Sexual dysfunction and cardiovascular disease: integrative concepts and strategies. Am J Cardiol 2005; 96: 57–61.

    Article  Google Scholar 

  10. 10

    Yao F, Huang Y, Zhang Y, Dong Y, Ma H, Deng C et al. Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. Int J Androl 2012; 35: 653–659.

    CAS  Article  Google Scholar 

  11. 11

    Pedersen KO . Fetuin, a New Globulin Isolated from Serum. Nature 1944; 154: 575–575.

    CAS  Article  Google Scholar 

  12. 12

    Xu Y, Xu M, Bi Y, Song A, Huang Y, Liu Y et al. Serum fetuin-A is correlated with metabolic syndrome in middle-aged and elderly Chinese. Atherosclerosis 2011; 216: 180–186.

    CAS  Article  Google Scholar 

  13. 13

    Nangami GN, Watson K, Parker-Johnson K, Okereke KO, Sakwe A, Thompson P et al. “Fetuin-A (ð¼2HS-glycoprotein) is a serum chemo-attractant that also promotes invasion of tumor cells through Matrigel,”. Biochem Biophys Res Commun 2013; 438: 660–665.

    CAS  Article  Google Scholar 

  14. 14

    Wojtysiak-Duma B, Malecha Jędraszek A, Burska A, Duma D, Donica H . Serum fetuin-A levels in patients with type 2 diabetes mellitus. Ann UMCS Sect DDD 2010; 2: 93–99.

    Google Scholar 

  15. 15

    Singh M, Sharma PK, Garg VK, Mondal SC, Singh AK, Kumar N . Role of fetuin-A in atherosclerosis associated with diabetic patients. J Pharm Pharmacol 2012; 64: 1703–1708.

    Article  Google Scholar 

  16. 16

    Merx MW, Schafer C, Westenfeld R, Brandenburg V, Hidajat S, Weber C et al. Myocardial stiffness, cardiac remodeling, and diastolic dysfunction in calcification-prone fetuin-adeficient mice. J Am Soc Nephrol 2005; 16: 3357–3364.

    CAS  Article  Google Scholar 

  17. 17

    Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña 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.

    CAS  Article  PubMed Central  Google Scholar 

  18. 18

    Lue TF . Erectile dysfunction. N Engl J Med 2000; 342: 1802–1813.

    CAS  Article  Google Scholar 

  19. 19

    WHO. Developing sexual health programmes. A framework for action. 2002. Available at:

  20. 20

    Kirby M, Jackson G, Simonsen U . Endothelial dysfunction links erectile dysfunction to heart disease. Int J Clin Pract 2005; 59: 225–229.

    CAS  Article  Google Scholar 

  21. 21

    Akalin N, Altiparmak MR, Trabulus S, Ataman R, Ayan F, Yetik H et al. Correlation of clinical effects with levels of fetuin-A, FGF-23 and intact parathyroid in peritoneal dialysis patients. Int J Biomed Adv Res 2015; 6: 488–494.

    CAS  Article  Google Scholar 

  22. 22

    Song A, Xu M, Bi Y, Xu Y, Huang Y, Li M et al. Serum fetuin-A associates with type 2 diabetes and insulin resistance in Chinese adults. PLoS One 2011; 6: e19228.

    CAS  Article  PubMed Central  Google Scholar 

  23. 23

    Naito C, Hashimoto M, Watanabe K, Shirai R, Takahashi Y, Kojima M et al. Facilitatory effects of fetuin-A on atherosclerosis. Atherosclerosis 2016; 246: 344–351.

    CAS  Article  Google Scholar 

  24. 24

    Lim P, Moutereau S, Simon T, Gallet R, Probst V, Ferrieres J et al. Usefulness of fetuin-A and C-reactive protein concentrations for prediction of outcome in acute coronary syndromes (from the French Registry of Acute ST-Elevation Non-ST-Elevation Myocardial Infarction [FAST-MI]). Am J Cardiol 2013; 111: 31–37.

    CAS  Article  Google Scholar 

  25. 25

    Kadoglou NP, Kottas G, Lampropoulos S, Vitta I, Liapis CD . Serum levels of fetuin-A, osteoprotegerin and osteopontin in patients with coronary artery disease: effects of statin (HMGCoA-reductase inhibitor) therapy. Clin Drug Invest 2014; 34: 165–171.

    CAS  Article  Google Scholar 

  26. 26

    Sun Q, Cornelis MC, Manson JE, Hu FB . Plasma levels of fetuin-A and hepatic enzymes and risk of type 2 diabetes in women in the U.S. Diabetes 2013; 62: 49–55.

    CAS  Article  Google Scholar 

  27. 27

    Schoppet M, Rauner M, Benner J, Chapurlat R, Hofbauer LC, Szulc P . Serum fetuin-A levels and abdominal aortic calcification in healthy men — The STRAMBOstudy. Bone 2015; 79: 196–202.

    CAS  Article  Google Scholar 

  28. 28

    Karabakan M, Bozkurt A, Gunay M, Aktas BK, Hirik E, Aydın M et al. Association between serum fetuin-A level and erectile function. Andrologia 2015; 48: 787–792.

    Article  Google Scholar 

  29. 29

    Yin L, Cai WJ, Zhu LY, Li J, Su XH, Wang XL et al. Association of plasma Fetuin-A and clinical characteristics in patients with new-onset type 2 diabetes mellitus. Int J. Clin Exp Med 2015; 8: 991–999.

    CAS  Google Scholar 

  30. 30

    Khalil H, Faizehalkuobaili . Elevated fetuin - A level associated with an atherogenic lipid profile in type 2 diabetes. Int J Pharm Sci 2013; 4: 266–269.

    Google Scholar 

  31. 31

    Mare'chal C, Schlieper G, Nguyen P, Kruger T, Coche E, Robert A et al. Serum fetuin-a levels are associated with vascular calcifications and predict cardiovascular events in renal transplant recipients. Clin J Am Soc Nephrol 2011; 6: 974–985.

    CAS  Article  Google Scholar 

  32. 32

    Gulhan I, Bozkaya G, Oztekin D, Uyar I, Kebapcilar AG, Pamuk B . Serum Fetuin-A levels in women with polycystic ovary syndrome. Arch Gynecol Obstet 2012; 286: 1473–1476.

    CAS  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to A I Mansour.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kandeel, W., El-Shaer, W., Sebaey, A. et al. Usefulness of serum fetuin-A level as a marker of erectile dysfunction. Int J Impot Res 29, 189–193 (2017).

Download citation


Quick links