The indicative effects of apolipoproteins on organic erectile dysfunction: bridging Mendelian randomization and case-control study

Zhexin Zhang, Mo Yan, Yuezheng Li, Yang Pan, Shangren Wang, Mingming Xu, Hang Zhou, Xiaoqiang Liu
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Abstract

The existing research on the association between apolipoproteins (Apos) and erectile dysfunction (ED) primarily relies on observational studies and does not distinguish between organic and psychogenic causes when diagnosing ED. It is difficult to believe that Apos play a role in psychogenic ED. To address these issues, our study explored the causal relationship between lipoproteins and ED using Mendelian randomization (MR) analysis and differentiate between organic and psychogenic ED through the use of nocturnal penile tumescence and rigidity (NPTR) monitoring. Multivariate MR analysis revealed significant causal associations between high-density lipoprotein (HDL), Apo A1, and Apo B/A1 with ED (OR and 95% CI were 0.33 (0.14-0.78), 3.58 (1.52-8.43), and 0.30 (0.13-0.66)). we conducted statistical and analytical analyses on the data of 212 patients using multivariate analyses and receiver operating characteristic (ROC) curves. Patients with organic ED had significantly lower levels of HDL, Apo A1 and Apo A1/B, whereas patients with organic ED had considerably higher levels of Apo B and low-density lipoprotein (LDL). The diagnostic value of Apos in predicting the risk of organic ED was evaluated using ROC curves. The results indicated that Apo A1 and Apo A1/B demonstrated good predictive value. HDL, Apo A1, and Apo A1/B have been identified as risk factors for ED in our study. Furthermore, our research highlights the significance of Apo A1 and Apo A1/Apo B in the development of organic ED and suggests their potential use as indicators to assess the risks associated with organic ED.
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脂蛋白对器质性勃起功能障碍的指示作用:孟德尔随机化和病例对照研究的桥梁
关于脂蛋白(Apos)与勃起功能障碍(ED)之间关系的现有研究主要依赖于观察性研究,而且在诊断 ED 时并未区分器质性和精神性原因。很难相信脂蛋白在精神性 ED 中起作用。为了解决这些问题,我们的研究利用孟德尔随机化(MR)分析探讨了脂蛋白与 ED 之间的因果关系,并通过夜间阴茎膨胀和僵硬(NPTR)监测来区分器质性和精神性 ED。多变量 MR 分析显示,高密度脂蛋白 (HDL)、载脂蛋白 A1 和载脂蛋白 B/A1 与 ED 之间存在显著的因果关系(OR 和 95% CI 分别为 0.33 (0.14-0.78)、3.58 (1.52-8.43) 和 0.30 (0.13-0.66))。有器质性 ED 的患者高密度脂蛋白、载脂蛋白 A1 和载脂蛋白 A1/B 水平明显较低,而有器质性 ED 的患者载脂蛋白 B 和低密度脂蛋白 (LDL) 水平明显较高。使用 ROC 曲线评估了 Apos 在预测器质性 ED 风险方面的诊断价值。结果表明,载脂蛋白 A1 和载脂蛋白 A1/B 具有良好的预测价值。在我们的研究中,高密度脂蛋白、载脂蛋白 A1 和载脂蛋白 A1/B 被确定为 ED 的风险因素。此外,我们的研究强调了载脂蛋白 A1 和载脂蛋白 A1/Apo B 在器质性 ED 发展过程中的重要性,并建议将它们作为评估器质性 ED 相关风险的潜在指标。
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