Association Between Inflammation Indicators (MLR, NLR, SII, SIRI, and AISI) and Erectile Dysfunction in US Adults: NHANES 2001-2004

Overview

Journal J Health Popul Nutr

Publisher Biomed Central

Specialties Nutritional Sciences
Public Health

Date 2024 Oct 27

PMID 39462407

Authors

Heng Liu

Huqiang Dong

MiXue Guo

Hongping Cheng

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to assess the relationship between multiple indicators of inflammation and erectile dysfunction through an analysis of data from the National Health and Nutrition Examination Survey (NHANES). This represents the first large-scale, cross-sectional investigation that explores this association by jointly analyzing various inflammatory markers.

Methods: We performed a cross-sectional analysis with NHANES data from 2001 to 2004. Erectile dysfunction (ED) was evaluated through a self-reported questionnaire and testosterone levels, while inflammatory markers were derived from standard blood test parameters. Our approach included multivariate logistic regression, subgroup analyses, generalized additive modeling (GAM), and smoothed curve fitting to evaluate the link between inflammatory markers (NLR, MLR, SII, SIRI, AISI) and ED. Additionally, we utilized receiver operating characteristic (ROC) curves to determine the diagnostic utility of these markers, comparing their area under the curve (AUC) values.

Results: A total of 3610 participants were included in this study, and the population-weighted ED patients were 18.91%. In the adjusted model, multiple logistic regression analysis showed a positive association between five inflammatory indicators (Ln-NLR, Ln-MLR, Ln-SII, Ln-SIRI, and Ln-AISI) and ED. Smoothed curve fitting showed a nonlinear positive correlation between the five inflammatory indicators and ED. Furthermore, subgroup analyses showed that this correlation was stronger in people older than 50 year. ROC curve analysis showed the highest diagnostic performance for the study outcome with MLR (AUC = 0.616, 95% CI: 0.5952-0.637), which was significantly better than SIRI, NLR, AISI, and SII.

Conclusion: MLR is potentially more effective than other biomarkers (NLR, SIRI, AISI, SII) in predicting ED. Men with elevated MLR levels should be particularly aware of their increased risk of developing ED.

References

Li L, Yao H, Dai W, Chen Y, Liu H, Ding W . A higher TyG index is related with a higher prevalence of erectile dysfunction in males between the ages 20-70 in the United States, according to a cross-sectional research. Front Endocrinol (Lausanne). 2022; 13:988257. PMC: 9497651. DOI: 10.3389/fendo.2022.988257. View

Najari B, Kashanian J . Erectile Dysfunction. JAMA. 2016; 316(17):1838. DOI: 10.1001/jama.2016.12284. View

Zhang H, Duan X, Zhang Y, Zhuang G, Cao D, Meng W . Association Between Monocyte-to-Lymphocyte Ratio and Hematoma Progression After Cerebral Contusion. Neurocrit Care. 2023; 40(3):953-963. PMC: 11147937. DOI: 10.1007/s12028-023-01857-4. View

Ma R, Cui L, Cai J, Yang N, Wang Y, Chen Q . Association between systemic immune inflammation index, systemic inflammation response index and adult psoriasis: evidence from NHANES. Front Immunol. 2024; 15:1323174. PMC: 10896999. DOI: 10.3389/fimmu.2024.1323174. View

Wang L, Li X, Liu M, Zhou H, Shao J . Association between monocyte-to-lymphocyte ratio and prostate cancer in the U.S. population: a population-based study. Front Cell Dev Biol. 2024; 12:1372731. PMC: 11026607. DOI: 10.3389/fcell.2024.1372731. View

Wang X, Xia L, Xu T, Zhang X, Zhu Z, Zhang M . Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome. Andrologia. 2015; 48(3):243-51. DOI: 10.1111/and.12437. View

Libby P . Molecular bases of the acute coronary syndromes. Circulation. 1995; 91(11):2844-50. DOI: 10.1161/01.cir.91.11.2844. View

Liu J, Liu X, Li Y, Quan J, Wei S, An S . The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis. Biosci Rep. 2018; 38(3). PMC: 6019380. DOI: 10.1042/BSR20180172. View

Liu C, Gao Y, Ji J, Sun C, Chen M . Association between inflammatory indexes and erectile dysfunction in U.S. adults: National Health and Nutrition Examination Survey 2001-2004. Sex Med. 2023; 11(4):qfad045. PMC: 10413424. DOI: 10.1093/sexmed/qfad045. View

10.

Ayta I, McKinlay J, Krane R . The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999; 84(1):50-6. DOI: 10.1046/j.1464-410x.1999.00142.x. View

11.

Machado G, Araujo G, Carpes C, Lech M, Mariani S, Valle F . Elevated neutrophil-to-lymphocyte ratio can predict procedural adverse events in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Coron Artery Dis. 2018; 30(1):20-25. DOI: 10.1097/MCA.0000000000000671. View

12.

Trepels T, Zeiher A, Fichtlscherer S . The endothelium and inflammation. Endothelium. 2006; 13(6):423-9. DOI: 10.1080/10623320601061862. View

13.

Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L . Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy. Int J Environ Res Public Health. 2015; 12(8):10009-19. PMC: 4555325. DOI: 10.3390/ijerph120810009. View

14.

Zinellu A, Paliogiannis P, Sotgiu E, Mellino S, Mangoni A, Zinellu E . Blood Cell Count Derived Inflammation Indexes in Patients with Idiopathic Pulmonary Fibrosis. Lung. 2020; 198(5):821-827. PMC: 7502432. DOI: 10.1007/s00408-020-00386-7. View

15.

Xiu J, Lin X, Chen Q, Yu P, Lu J, Yang Y . The aggregate index of systemic inflammation (AISI): a novel predictor for hypertension. Front Cardiovasc Med. 2023; 10:1163900. PMC: 10229810. DOI: 10.3389/fcvm.2023.1163900. View

16.

Wu C, Wu C, Lee C, Cheng C . Association between neutrophil percentage-to-albumin ratio (NPAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and long-term mortality in community-dwelling adults with heart failure: evidence from US NHANES 2005-2016. BMC Cardiovasc Disord. 2023; 23(1):312. PMC: 10286403. DOI: 10.1186/s12872-023-03316-6. View

17.

Xia Y, Xia C, Wu L, Li Z, Li H, Zhang J . Systemic Immune Inflammation Index (SII), System Inflammation Response Index (SIRI) and Risk of All-Cause Mortality and Cardiovascular Mortality: A 20-Year Follow-Up Cohort Study of 42,875 US Adults. J Clin Med. 2023; 12(3). PMC: 9918056. DOI: 10.3390/jcm12031128. View

18.

Wang J, Li H, Xu R, Lu T, Zhao J, Zhang P . The MLR, NLR, PLR and D-dimer are associated with clinical outcome in lung cancer patients treated with surgery. BMC Pulm Med. 2022; 22(1):104. PMC: 8957174. DOI: 10.1186/s12890-022-01901-7. View

19.

Kaufman J . Diagnosis of hypogonadism in ageing men. Rev Endocr Metab Disord. 2022; 23(6):1139-1150. DOI: 10.1007/s11154-022-09763-4. View

20.

Lin W, Wang H, Lin M . Relationship Between Systemic Inflammatory Response Index and Erectile Dysfunction: A Cross-sectional Study. Urology. 2023; 181:69-75. DOI: 10.1016/j.urology.2023.08.015. View