Hyperuricemia Is an Independent Risk Factor of the Erectile Dysfunction: a Systematic Review and Meta-analysis

Abstract Background and Aims: Serum uric acid can affect endothelial function, and hyperuricemia-induced endothelial dysfunction is involved in the pathogenesis of cardiovascular diseases. As endothelial dysfunction is also a main pathogenic mechanism of erectile dysfunction (ED), the present study aims to evaluate the relationship between hyperuricemia and ED via systemic review and meta-analysis.Methods: Five cohort studies and five cross-sectional studies on hyperuricemia and ED, including a total of 454256 participants, were recruited. Odds ratio (OR) and the 95% confidence intervals (CI) were adopted to estimate the relationship between hyperuricemia and ED. Overall risk were effects of urate-lowering therapy (ULT) analyzed. In addition, subgroup analyses on study design, populations, age stratification and the object were conducted.Results: In the patients with hyperuricemia, the risk of ED was 1.55-fold higher than (pooled OR=1.55, 95%CI (1.24,1.94)) the non-hyperuricemia counterparts. urate-lowing therapy (ULT) in these hyperuricemia patients reduced the risk of ED by 27% (OR=1.27, 95%CI (1.14,1.41)). After subgroup analysis and meta-regression, the association between hyperuricemia and ED remained significant apart from in the ≥55y subgroup.Conclusions: Hyperuricemia is an independent risk factor of ED, while ULT can reduce the risk of ED in hyperuricemia. This study suggests that hyperuricemia-associated endothelial dysfunction may also underlie the pathogenesis of ED in these patients.