• Luca Boeri, Paolo Capogrosso, Filippo Pederzoli, Eugenio Ventimiglia, Nicola Frego, Francesco Chierigo, Emanuele Montanari, Francesco Montorsi, and Andrea Salonia.
• IRCCS Ospedale San Raffaele, Division of Experimental Oncology/Unit of Urology, URI, Milan, Italy; IRCCS Fondazione Ca' Granda-Ospedale Maggiore Policlinico, Department of Urology, University of Milan, Milan, Italy.
• J Sex Med. 2018 Aug 1; 15 (8): 1117-1124.

IntroductionThe association between prediabetes (PreDM) and erectile dysfunction (ED) has been analyzed scantly.AimTo assess the association between PreDM and erectile function (EF) in a cohort of white European men with ED.MethodsDemographic, clinical, and laboratory data from 372 consecutive men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients were invited to complete the International Index of Erectile Function (IIEF)-EF domain questionnaire. The EF domain was categorized according to Cappelleri's criteria. Men were defined as having PreDM according to the criteria defined by the American Diabetes Association (2015). Descriptive statistics and logistic regression models tested the association between clinical variables and PreDM status and severe ED.Main Outcome MeasuresWe assessed the prevalence of PreDM in our cohort of men with ED and the potential association of PreDM and sexual health within the same cohort.ResultsOf 372 men, +PreDM was found in 86 (23.1%) patients. Men with +PreDM had lower total testosterone (tT), higher triglycerides, and higher total cholesterol values (all P < .03) than those without PreDM. Likewise, +PreDM patients had a higher rate of CCI ≥1 (P = .03) and more frequently had severe ED (P = .013) compared with -PreDM. Age (OR 1.03; P = .01); lower tT (OR 0.81; P = .02); and severe ED (OR 3.37; P = .004) were associated with +PreDM status, after accounting for BMI, CCI, alcohol consumption, and cigarette smoking. Similarly, age (OR 1.02; P = .02) and +PreDM (OR 2.02; P = .02) were associated with severe ED, after accounting for other clinical variables.Clinical ImplicationsIdentifying +PreDM status in ED men is clinically relevant in order to adopt preventive strategies to attempt and reduce risk of developing DM and subsequent cardiovascular diseases.Strengths & LimitationsTo our knowledge, this is the first study evaluating the prevalence of unrecognized PreDM and the association of PreDM and ED severity in a real-life setting. Limitations are the retrospective nature of the cross-sectional study and the lack of haemodynamic parameters for every patient.Conclusions1 in 5 men seeking medical help for new-onset ED showed glucose values suggestive for unrecognized PreDM and +PreDM status was associated with worse hormonal and metabolic profiles, along with a higher risk of severe ED than -PreDM. Boeri L, Capogrosso P, Perderzoli F, et al. Unrecognized prediabetes is highly prevalent in men with erectile dysfunction-results from a cross-sectional study. J Sex Med 2018;15:1117-1124.Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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