Erectile dysfunction in patients with nonalcoholic fatty liver disease

Background and study aims There is a lack of studies on erectile dysfunction (ED) in patients diagnosed with nonalcoholic fatty liver disease (NAFLD). The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients. Patients and methods We conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide. Results The mean age of the study population was 42.4 ± 7.7 years (79.1% ≥ 40 years). Of the 192 patients with NAFLD, 88 (45.8%) had ED, 28 (14.6%) had metabolic syndrome, 25 (13%) had type-2 diabetes mellitus (DM), and 131 (68.2%) had insulin resistance (IR). The mean level of serum testosterone was 3.17 ± 2.94 ng/mL, while the mean insulin resistance index was 2.9 ± 1.7. Mild ED (38.6%) was the most frequent grade of ED. Age ≥ 40 years (odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7–24.1; p- 0.006), IR (OR 5.9; 95% CI 1.7–20.6; p- 0.005), and low serum testosterone (OR 5.1; 95% CI 1.5–17.1; p- 0.009) were the predictors of ED. Conclusions ED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis.