| Background:The prevalence rate of Diabetes mellitus (DM) is rising in the world,and DM has become one of the global public health problems affecting to human health seriously. Diabetes mellitus is a major cause of the death, disability and medical expenses increased in most country in the world. Erectile dysfunction(ED)is a common complication of DM. DM is the most common cause for organic erectile dysfunction. The incidence of ED in patients with DM are higher and the onset is earlier than in patients without DM.ED even becomes the first symptom of DM. In recent years, with the development of molecular biology technology, homocysteine (Hcy) has been widely studied as an independent risk factor for atherosclerosis. Homocysteine is an intermediate metabolite of methionine, and closely correlated with the incidence of cardiac and cerebral vascular diseases as well as endothelial injury and vasculopathy in DM.Till recently, we could find fewer literatures about studies on the relationship between Hcy and the DMED。The only studies found in Chinese research groups are limited to animal experiments, other than clinical studies. This study was designed to investigate the role of Hcy in the occurrence of DMED by exploring the relationship between the incidence of ED and Hcy level in patients with incipient type 2 diabetes mellitus, so as to explore its role in the pathogenesis of ED and look for predictive value of serum markers of ED,providing new ideas for later clinical intervention..Objective:In order to figure out the relationship between serum homocysteine(Hcy) level and erectile dysfunction in newly diagnosed type 2 diabetic patients,so as to explore the prediction and diagnostic value of ED,and to explore the factors affecting the erectile function in type 2 diabetic patients, we designed this project.Method:The subjects included married male patients at the age of 35-70 years that were hospitalized or presented at the out-patient clinic newly diagnosed as type 2 diabetes mellitus. The patients were diagnosed based on 1999 WHO diagnostic criteria for diabetes mellitus. The patients with other diseases causing erectile dysfunction or with disease history and medication history affecting the level of the measured indicators were ruled out. According to the International Index of Erectile Function-5 (IIEF-5) score identification of erectile dysfunction.This study was assigned into three groups:①30 patients with incipient diabetes mellitus complicated with ED and they were classified as the DM with ED group②33 patients with incipient diabetes mellitus uncomplicated with ED were collected over the same period, which were classified as the DM without ED group③30 married healthy males were classified as the normal control group.The general information, medical history information, information checkup and biochemical indicators were collected in all subjects.Serum total homocysteine (tHcy) was measured by Protein-specific immune analyzer nephelometry in all subjects. HbAlc, blood lipids, uric acid, fibrinogen, hormone and other biochemical indicators were measured by automatic biochemical analyzer in all subjects. Immunoturbidimetric assay used measured 24h urinary microalbumin. All data were processed by statistic package deal SPSS13.0. Analysis of variance was used to the numerical variables of three groups.χ2 test was used to classification variables. The analysis of Spearman correlation was used influencing factors of IIEF-5 score. P value less than 0.05 was considered statistically significant. Result:1. Hcy levels in the type 2 DM with ED group were higher than that in the DM without ED group (p<0.05), and were significantly higher than that in the control group (p<0.01).2. IIEF-5 scores of newly diagnosed type 2 DM patients were negatively correlated with tHcy, age, smoking, BMI, HbA1C and fasting blood glucos (rs-0.574,-0.413,-0.231,-0.242,-0.274,-0.371,P 0.006,0.014,0.017,0.015,0.027,0.031), and were positively correlated with HDL-C(rs 0.275,P 0.013). Hcy was positively correlated with BMI, fasting blood glucose, HbAlC (rs were 0.323,0.227 and 0.354, and p were 0.003,0.024,0.011, respectively).Conclusion:1. The pathogenesis of diabetic erectile dysfunction is involved with multiple factors and segments. Hcy may be a new risk factor for erectile dysfunction and involved in the pathogenesis of ED.2. Age, smoking, BMI, HbA1C, fasting plasma glucose are risk factors for diabetic erectile dysfunction with type 2 diabetes. Control blood sugar levels, maintaining a normal body weight and good living habits in patients with type 2 diabetes have positive clinical significance to preventand improve the erectile dysfunction.
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