The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 15
Slide Session
OS-END-22 Endocrinology
Factors Infl uencing Erectile Dysfunction in Patients with Diabetes
Dong Hyun KIM1, Chang Won LEE1, Ja Young Park1, Taek Jun LEE1, Jung Man KIM1, Jun Ouk HA1, Young Hoon KIM1
Busan St. Mary`s Medical Center, Korea1
Background: Erectile dysfunction(ED) is prevalent among patients with diabetes mellitus. ED coud be caused by astherosclerosis of the internal iliac arteries, the smaller vessels supplying the penis, neural damage, certain medications, a defi ciency of testosterone and psychologic problems. The goal of this study was to analyze the relationship between ED and medical conditions including atunomic neuropathy in diabetic patients.
Methods: In this cross sectional study, 215 patients were enrolled. Erectile function in patients were assessed by the International Index of Erectile Function(IIEF5) ques- tionnaire. ED was also classified into four severity levels, range from none(25~30), mild(19~24), moderate(7~18), severe(0~6). We obtained age, weight, blood pressure, International prostate symptom score and Overactive Bladder Symptom Score by ques- tionnaire in all-commers. In diabetic patients, we checked chronic complication status, brachial-ankle pulse wave velocity(baPWV, VP-1000, Colin, Japan) and diabetic cardiac autonomic neuropathy(DiCAN, Medicore, seoul, Korea). Data were expressed as means
± standard error. Independent t-test or chi-square test were used to make comparisons between groups, and Spearman correlation for correlation analysis.(Table.1)
Result: Patients with ED are higher at diabetes group than controls. ED is correlated with that age, bladder dysfunction(OBSS questionnaire) and benign prostatic hyperplasia(IPSS questionnaire). In diabetes patient, prevalence of ED is associated with baPWV, duration of diabetes, HbA1c, microalbuminuria, retinopathy, macrovascular complication. But, not correlated with diabetic cardiac autonomic neuropathy(DiCAN). (Table 2.)
Conclusion: The prevalence of ED is higher in diabetic patients. The autonomic neu- ropathy symptoms such as bladder dysfunction and benign prostatic hyperplasia are correlated with ED. In patients with diabetes, ED is correlated with increased baPWV, prolonged duration of diabetes, high HbA1c value, and chronic complications execpt cardiac autonomic neuropathy.
OS-END-23 Endocrinology
The Relationship Between Testosterone and Homa-R Levels in Overweight Patients
Yıldız OKUTURLAR1, Meral MERT2, Özlem SOYLUK2, Özlem HARMANKAYA1, Pinar KARAKAYA2, Samet SAYILAN1, Didem ACARER1, A. Baki KUMBASAR1
Internal Medicine, Bakirköy Dr. Sadi Konuk Research and Training Hospital, Turkey1, Endocrinology and Metabolism, Bakirköy Dr. Sadi Konuk Research and Training Hospital, Turkey2
Background: It was shown that there is a correlation between low testosterone level and insulin resistance. Insulin resistance is related with metabolic syndrome and type 2 diabetes which represent a risk factor for cardiovascular disease. Obesity has become an important public health problem and it is known that it has an adverse effect on re- productive system and fertility. In our study it was aimed to investigate the relation be- tween testosterone level and insulin resistance in overweight male and female patients.
Methods: In our study total number of 2699 female and 377 male patients who admitted to our hospital because of weight problem and had BMI>25 were evaluated retrospectively. Correlation analyses between total testosterone level and parameters like fasting blood glucose, insulin level, A1c and HOMA values were performed.
Results: While average age was 41.38±12.50 years in female patients it was detected 39.15±13.73 years for male patients. While negative correlations were found between testosterone level and age, testosterone level and glucose, testosterone level and A1c in the female group there were no correlations between testosterone level and HOMA, testosterone level and insulin in the same group. Whereas in the male group negative correlations were found between testosterone level and glucose, testosterone level and insulin, testosterone level and A1c and testosterone level and HOMA in the male group (Table 1).
Conclusions: The correlation between testosterone level and insulin was reported in female patients with polycystic ovary syndrome. In our study glucose and A1c levels may increase while testosterone level decreases in both male and female groups. In addition to this fi nding insulin level and HOMA also increases with the decrease of testosterone in male patients. This may be explaned by the metabolic effect of testos- terone.
OS-END-24 Endocrinology
G Protein-Coupled Estrogen Receptor-1 is Involved in the Protective Effect of Protocatechuic Aldehyde Against Endothelial Dysfunction
ByungSoo KONG1, EunJig LEE1 Yonsei University, College of Medicine, Korea1
Protocatechuic aldehyde (PCA), a phenolic aldehyde, has therapeutic potency against atherosclerosis. Although PCA is known to inhibit the migration and proliferation of vascular smooth muscle cells and intravascular thrombosis, the underlying mecha- nism remains unclear. In this study, we investigated the protective effect of PCA on endothelial cells and injured vessels in vivo in association with G protein-coupled estrogen receptor-1 (GPER-1). With PCA treatment, cAMP production was increased in HUVECs, while GPER-1 expression was increased in both HUVECs and a rat aortic explant. PCA and G1, a GPER-1 agonist, reduced H2O2 stimulated ROS production in HUVECs, whereas, G15, a GPER-1 antagonist, increased ROS production further.
These elevations were inhibited by co-treatment with PCA or G1. TNFa stimulated the expression of infl ammatory markers (VCAM-1, ICAM-1 and CD40), phospho-NF-κ B, phospho-p38 and HIF-1a; however, co-treatment with PCA or G1 down-regulated this expression signifi cantly. Likewise, increased expression of infl ammatory markers by treatment with G15 was inhibited by co-treatment with PCA. In re-endothelization, aortic ring sprouting and neointima formation assay, rat aortas treated with PCA or G1 showed accelerated re-endothelization of the endothelium and reduced sprouting and neointima formation. However, aortas from G15-treated rats showed decelerated re-endothelization and increased sprouting and neointima formation. The effects of G15 were restored by co-treatment with PCA or G1. Also, in the endothelia of these aortas, PCA and G1 increased CD31 and GPER-1 and decreased VCAM-1 and CD40 expression. In contrast, the opposite effect was observed in G15-treated endothelium.
These results suggest that GPER-1 might mediate the protective effect of PCA on the endothelium.
