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Causal effects of gut microbiota on the risk of erectile dysfunction: a Mendelian randomization study

Abstract

Erectile dysfunction ranks among the prevalent sexual disorders in men. Several studies have indicated a potential link between gut microbiota and erectile dysfunction. To validate this potential association, we were to screen statistical data from genome-wide association studies of gut microbiota and erectile dysfunction. p values of less than 1 × 10−5 were set as the threshold for screening instrumental variables that were strongly associated with gut microbiota. At the same time, in order to obtain more convincing findings, we further excluded instrumental variables with possible chain imbalance, instrumental variables with the presence of palindromes, instrumental variables with F-statistics less than 10, and instrumental variables associated with risk factors for erectile dysfunction. Five methods including inverse-variance weighted method, weighted median method, weighted mode, Mendelian randomization egger method and Mendelian randomization pleiotropy residual sum and outlier test were then used to analyse the 2591 instrumental variables obtained from the screening. We identified correlations between six gut microbiota and the risk of erectile dysfunction. The genus Ruminococcaceae UCG-013 exhibited an inverse association with the risk of developing erectile dysfunction (0.79 (0.65–0.97), P = 0.0214). Conversely, the genus Tyzzerella3 (1.13 (1.02–1.26), P = 0.0225), genus Erysipelotrichaceae UCG-003 (1.18 (1.01–1.38), P = 0.0412), genus LachnospiraceaeNC2004group (1.19 (1.03–1.37), P = 0.0191), genus Oscillibacter (1.23 (1.08–1.41), P = 0.0022), and family Lachnospiraceae (1.26 (1.05–1.52), P = 0.0123) demonstrated positive associations with an increased risk of erectile dysfunction. These sensitivity analyses of the gut microbiota were consistent. This study demonstrated a possible causal relationship between gut microbiota and erectile dysfunction risk through Mendelian randomization analysis, providing new potential possibilities for the prevention and treatment of erectile dysfunction.

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Fig. 1
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Fig. 4: Radial plots from six nominally significant gut microbiota taxa associated with erectile dysfunction.

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The original contributions presented in the study are included in the article/ Supplementary Material. Further inquiries can be directed to the corresponding authors.

References

  1. NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. JAMA. 1993;270:83–90.

    Article  Google Scholar 

  2. Corona G, Lee DM, Forti G, O’Connor DB, Maggi M, O’Neill TW, et al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med. 2010;7:1362–80.

    Article  PubMed  Google Scholar 

  3. Russo GI, Bongiorno D, Bonomo C, Musso N, Stefani S, Sokolakis I, et al. The relationship between the gut microbiota, benign prostatic hyperplasia, and erectile dysfunction. Int J Impot Res. 2023;35:350–5.

    Article  CAS  PubMed  Google Scholar 

  4. Lee CJ, Sears CL, Maruthur N. Gut microbiome and its role in obesity and insulin resistance. Ann NY Acad Sci. 2020;1461:37–52.

    Article  PubMed  Google Scholar 

  5. Maynard CL, Elson CO, Hatton RD, Weaver CT. Reciprocal interactions of the intestinal microbiota and immune system. Nature. 2012;489:231–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Fan Y, Pedersen O. Gut microbiota in human metabolic health and disease. Nat Rev Microbiol. 2021;19:55–71.

    Article  CAS  PubMed  Google Scholar 

  7. Miyauchi E, Shimokawa C, Steimle A, Desai MS, Ohno H. The impact of the gut microbiome on extra-intestinal autoimmune diseases. Nat Rev Immunol. 2023;23:9–23.

    Article  CAS  PubMed  Google Scholar 

  8. Davey Smith G, Phillips AN. Correlation without a cause: an epidemiological odyssey. Int J Epidemiol. 2020;49:4–14.

    Article  PubMed  Google Scholar 

  9. Lawlor DA, Harbord RM, Sterne JA, Timpson N, Davey Smith G. Mendelian randomization: using genes as instruments for making causal inferences in epidemiology. Stat Med. 2008;27:1133–63.

    Article  PubMed  Google Scholar 

  10. Bowden J, Holmes MV. Meta-analysis and Mendelian randomization: a review. Res Synth Methods. 2019;10:486–96.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kurilshikov A, Medina-Gomez C, Bacigalupe R, Radjabzadeh D, Wang J, Demirkan A, et al. Large-scale association analyses identify host factors influencing human gut microbiome composition. Nat Genet. 2021;53:156–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Bovijn J, Jackson L, Censin J, Chen CY, Laisk T, Laber S, et al. GWAS identifies risk locus for erectile dysfunction and implicates hypothalamic neurobiology and diabetes in etiology. Am J Hum Genet. 2019;104:157–63.

    Article  CAS  PubMed  Google Scholar 

  13. Burgess S, Thompson SG. Avoiding bias from weak instruments in Mendelian randomization studies. Int J Epidemiol. 2011;40:755–64.

    Article  PubMed  Google Scholar 

  14. Emdin CA, Khera AV, Kathiresan S. Mendelian randomization. Jama. 2017;318:1925–6.

    Article  PubMed  Google Scholar 

  15. Zhang Y, Zhang X, Chen D, Lu J, Gong Q, Fang J, et al. Causal associations between gut microbiome and cardiovascular disease: A Mendelian randomization study. Front Cardiovasc Med. 2022;9:971376.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Burgess S, Butterworth A, Thompson SG. Mendelian randomization analysis with multiple genetic variants using summarized data. Genet Epidemiol. 2013;37:658–65.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bowden J, Davey Smith G, Haycock PC, Burgess S. Consistent estimation in Mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol. 2016;40:304–14.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hartwig FP, Davey Smith G, Bowden J. Robust inference in summary data Mendelian randomization via the zero modal pleiotropy assumption. Int J Epidemiol. 2017;46:1985–98.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Burgess S, Thompson SG. Interpreting findings from Mendelian randomization using the MR-Egger method. Eur J Epidemiol. 2017;32:377–89.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Verbanck M, Chen CY, Neale B, Do R. Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases. Nat Genet. 2018;50:693–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Burgess S. Sample size and power calculations in Mendelian randomization with a single instrumental variable and a binary outcome. Int J Epidemiol. 2014;43:922–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. VanderWeele TJ, Mathur MB. Some desirable properties of the bonferroni correction: is the bonferroni correction really so bad? Am J Epidemiol. 2019;188:617–8.

    Article  PubMed  Google Scholar 

  23. Okamoto T, Hatakeyama S, Imai A, Yamamoto H, Yoneyama T, Mori K, et al. The association between gut microbiome and erectile dysfunction: a community-based cross-sectional study in Japan. Int Urol Nephrol. 2020;52:1421–8.

    Article  CAS  PubMed  Google Scholar 

  24. Vicentini FA, Keenan CM, Wallace LE, Woods C, Cavin JB, Flockton AR, et al. Intestinal microbiota shapes gut physiology and regulates enteric neurons and glia. Microbiome. 2021;9:210.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Malesza IJ, Malesza M, Walkowiak J, Mussin N, Walkowiak D, Aringazina R, et al. High-fat, western-style diet, systemic inflammation, and gut microbiota: a narrative review. Cells. 2021;10:3164.

  26. Leblhuber F, Ehrlich D, Steiner K, Geisler S, Fuchs D, Lanser L, et al. The immunopathogenesis of Alzheimer’s disease is related to the composition of gut microbiota. Nutrients. 2021;13:361.

  27. Mirji G, Worth A, Bhat SA, El Sayed M, Kannan T, Goldman AR, et al. The microbiome-derived metabolite TMAO drives immune activation and boosts responses to immune checkpoint blockade in pancreatic cancer. Sci Immunol. 2022;7:eabn0704.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Praveenraj SS, Sonali S, Anand N, Tousif HA, Vichitra C, Kalyan M, et al. The role of a gut microbial-derived metabolite, trimethylamine N-oxide (TMAO), in neurological disorders. Mol Neurobiol. 2022;59:6684–700.

    Article  CAS  PubMed  Google Scholar 

  29. Wang Y, Xie Z. Exploring the role of gut microbiome in male reproduction. Andrology. 2022;10:441–50.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank MiBioGen and IEU for providing GWAS summary datasets.

Funding

This work was supported the Young/Middle aged Talent Cultivation Project that was funded by the Fujian Provincial Health and Family Planning Commission and Xiamen Health and Family Planning Commission (No. 2021GGB028).

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Contributions

RX and XW designed the study, contributed to the data analysis, and wrote the manuscript. SL, LL and YZ contributed to the data analysis and data interpretation. QF and GL contributed to manuscript writing and revision of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xin-Jun Wang.

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Xu, R., Liu, S., Li, LY. et al. Causal effects of gut microbiota on the risk of erectile dysfunction: a Mendelian randomization study. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00824-7

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