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Abstract Number: 160

All Men with Gout Should be Screened for Erectile Dysfunction

Naomi Schlesinger1, Diane C. Radvanski2 and John Kostis3, 1Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, 2Department of Medicine, Division of Rheumatology, Robert Wood Johnson Medical School, New Brunswick, NJ, 3Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: gout

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Session Information

Title: Metabolic and Crystal Arthropathies: Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose

Erectile dysfunction   (ED)   is common   in the general population. The likelihood   of   ED   increases progressively with age; however, it   is not an inevitable consequence of aging.   The importance of cardiovascular disease (CVD), as an underlying cause of ED is well established.  Patients who present with ED have an increased rate of CVD and   silent coronary artery disease (CAD). ED and gout share common risk factors such as age, metabolic syndrome, hyperuricemia and inflammation. 

Our aim was to determine whether men with gout may have an increased prevalence of ED as compared to men without gout.

Methods

In   this   cross sectional study,   men   aged   18-89    presenting   to the Rheumatology clinic between 8/26/10 and   5/13/2013,   were asked to participate.  The presence of ED was determined   by   filling out a Sexual Health Inventory in Men (SHIM). SHIM  scores correlate with ED severity:  22-25  Normal erectile function (no ED); SHIM score ≤ 21 ED and a score of  ≤ 10   denotes  severe   ED.  The patient’s history, physical examination and recent laboratory studies   were reviewed as well.

Descriptive statistics and subgroup analyses were used to summarize the data.  We used chi-square tests for independence to compare categorical variables. 

Results

201 men completed the SHIM questionnaires; 83 had gout.   A significantly greater proportion of gout patients had   ED (n=63; 76%) compared with patients without gout (n=61; 52 %) (p= 0.0007).  A significantly greater proportion of gout patients (43%)   had   severe   ED compared with patients without gout (30%)  (p=0.007).  The mean SHIM score of all patients was 16.88 (SD±-0.83).   Gout patients had an average SHIM score of 14.38 (SD±1.01) versus 18.53 (SD± 0.964) in patients without gout (p < 0.0001).   In a multivariate analysis the association between gout and ED remained statistically significant even after adjusting for age (p=0.0009), hypertension, LDL, GFR, obesity, depression (p=0.0154) and diabetes (p=0.0085).

Conclusion

ED   is present   in most men with gout and is frequently severe.   Increasing awareness of the presence of ED in gout patients should in turn lead to earlier medical attention and  treatment for this distressing condition   as well as evaluation of possible silent CAD.   We propose that all men with gout   be routinely screened   for ED.


Disclosure:

N. Schlesinger,

Novartis Pharmaceutical Corporation,

2,

Takeda,

8,

Sobi,

9,

Astra Zeneca ,

9;

D. C. Radvanski,
None;

J. Kostis,
None.

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