There is an increased risk for erectile dysfunction (ED) in patients with gout compared with the general population, according to findings from a systematic review published in Rheumatology International.
To assess the relationship between gout and risk for erectile dysfunction, researchers searched the literature from databases, including Embase, Medline, Scopus, Web of Science, and Cochrane, from study inception to April 2019. A total of 8 studies (3 cross-sectional and 5 cohort) published in 2010 or later with 355,761 participants were included in the meta-analysis. Of these participants, 85,067 had gout. The studies were conducted in England, Taiwan, the United States of America, and Korea.
Using a random effects model, patients with vs without gout had increased risk for ED (relative risk [RR], 1.20; 95% CI, 1.10-1.31; heterogeneity, P =.000; I2, 75.8%). To evaluate the quality of these results, each study was removed and the risk was recalculated; the RRs ranged from 1.16 (95% CI, 1.11-1.21) to 1.23 (95% CI, 1.13-1.34). Using subgroup analyses, the investigators observed similar ED rates among men aged <50 vs >50 years (RR, 1.21; 95% CI, 1.10-1.34 and RR, 1.20; 95% CI, 1.06-1.35; P <.001 for both, respectively).
Risk for ED varied based on study location, with significant risk observed in Taiwan (RR, 1.21; P =0.000) and England (RR, 1.18; P =.01), but not in the United States (RR, 1.72; P =.24) or Korea (RR, 0.62; P >.05). Investigators observed a variation in the calculated risk on the basis of study design. A significant correlation between elevated risk for ED and gout was reported in the cohort studies (RR, 1.22; 95% CI, 1.12-1.32; P =.000) but not in the cross-sectional studies (RR, 1.34; 95% CI, 0.56-3.22; P =.51). No publication bias was reported (Begg test, P >|z|=.902; Egger test, P >|t|=.521).
Study limitations included potential selection or recall bias, the lack of information on duration and treatment of gout, and the fact that difference in risk for ED between acute and chronic gout was not considered.
These data indicated that patients with gout vs the general population had increased risk for ED.
“…erectile function should be assessed when clinicians manage patients with gout and provide corresponding specific therapies for patients with gout when necessary, the investigators concluded.
Luo L, Xiang Q, Deng Y, et al. Gout is associated with elevated risk of erectile dysfunction: a systemic review and meta-analysis. Rheumatol Int. 2019;39:1527-1535.