Vitamin D and Erectile Dysfunction

Alessandra Barassi1,*, Raffaele Pezzilli2, Clara Anna Linda Damele1, Rossana Stefanelli3, Giovanni M Colpi4, Massimiliano M Corsi Romanelli5, GianVico Melzi d'Eril1

1Laboratorio di Analisi, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, 2Dipartimento di Malattie dell’Apparato Digerente e Medicina Interna, Ospedale Sant'Orsola-Malpighi, Alma Mater Studiorum, Università degli Studi di Bologna, Bologna, 3Laboratorio di Analisi, Ospedale San Paolo, 4ISES – Istituto per la Sterilità e la Sessualità, 5Unità Operativa Medicina di Laboratorio -1 Patologia Clinica, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy

Introduction: Endothelial dysfunction has been demonstrated to play an important role in pathogenesis of erectile dysfunction (ED) and vitamin D deficiency is deemed to promote endothelial dysfunctions.

Objectives: We aimed to evaluate the status of serum vitamin D in a group of patients with ED.

Methods: Diagnosis and severity of ED was based on the International Index of Erectile Function Score (IIEF-5) and its aetiology was classified as arteriogenic (A-ED), nonarteriogenic (NA-ED) and borderline (BL-ED) with penile echo-colour Doppler in basal condition and after intracaversous injection of prostaglandin E1. Serum vitamin D levels were measured using by radioimmunoassay (RIA) double antibody assay and serum PTH levels were measured using 1-84 PTH chemiluminescence immunoassay (DiaSorin, Italy).

Results: Fifty patients were classified as A-ED, 65 as NA-ED and 28 as ED-BL, for a total of 143 cases. Mean vitamin D level was 21.3 ng/mL; vitamin D deficiency (<20 ng/mL) was present in 45.9% and only 20.2% had optimal vitamin D levels. Patients with severe/complete ED had vitamin D level significantly lower (p=0.02) than those with mild ED. Vitamin level was negatively correlated with PTH and the correlation was more marked in subjects with vitamin D deficiency. Vitamin D deficiency in A-ED was significantly lower (p=0.01) than in NA-ED patients. Penile echo-colour-Doppler revealed that A-ED (PSV≤25 cm/sec) was more frequent in those with vitamin D deficiency as compared to those with vitamin >20 ng/dL (45%vs24%; p<0.05) and in the same population median PSV values were lower (26vs38; p<0.001) in vitamin D subjects.

Conclusion: Our study shows that a significant proportion of ED patients has a vitamin D deficiency and that this condition is more frequent in patients with the arteriogenic etiology. Low levels of vitamin D might increase the ED risk by promoting endothelial dysfunction. Men with ED should be analyzed for vitamin D levels and particularly to A-ED patients with a low level a vitamin D supplementation is suggested.

Keywords: Biomarker, Other organ