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Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

Chen YG, Lin TY, Lin CL, Dai MS, Ho CL, Kao CH - Medicine (Baltimore) (2015)

Bottom Line: Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism.This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011.Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Internal Medicine, Division of Hematology/Oncology (Y-GC, M-SD, C-LH); Department of Internal Medicine, Division of Infectious Diseases and Tropical Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei (T-YL); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine (C-LL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine (C-HK); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).

ABSTRACT
Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

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Cummulative incidence comparison of organic erectile dysfunction for patients with (dashed line) or without (solid line) thalassemia disease.
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Figure 1: Cummulative incidence comparison of organic erectile dysfunction for patients with (dashed line) or without (solid line) thalassemia disease.

Mentions: The mean follow-up years were 7.27 (SD = 3.51) and 7.22 (SD = 3.48) for the thalassemia cohort and the nonthalassemia cohort, respectively (data not shown). Figure 1 shows that the cumulative incidence of organic and psychogenic ED was higher in the thalassemia cohort than in the nonthalassemia cohort by 1.88% (log-rank test P < .001) at the end of follow-up. The overall incidence of organic ED was 4.73-fold higher in the thalassemia cohort than in the nonthalassemia cohort (2.81 and 0.59 per 1000 person-years, respectively), with an adjusted HR (aHR) of 4.56 (95% CI = 1.88–11.1) (Table 2). The organic ED incidence increased with age and with comorbidity in both cohorts. The age-specific thalassemia to nonthalassemia relative risk was the greater for all age group (aHR = 4.76; 95% CI = 1.24–18.2 for aged 20–49 years; aHR = 4.29; 95% CI = 1.31–14.1 for aged ≥50 years). Among patients with comorbidities, thalassemia men had a higher risk of organic ED than did the nonthalassemia cohort (aHR = 5.06; 95% CI = 1.86–13.7). Furthermore, relative to those patients without thalassemia and aged 20 to 49 years, patients with thalassemia and aged ≥50 years were 17.7-fold more likely to develop organic ED (95% CI = 4.27–73.5) (Table 3). Compared with patients without thalassemia and without comorbidities, cases with thalassemia and with comorbidities were 7.12-fold more likely to develop organic ED (95% CI = 2.17–23.3).


Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

Chen YG, Lin TY, Lin CL, Dai MS, Ho CL, Kao CH - Medicine (Baltimore) (2015)

Cummulative incidence comparison of organic erectile dysfunction for patients with (dashed line) or without (solid line) thalassemia disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554026&req=5

Figure 1: Cummulative incidence comparison of organic erectile dysfunction for patients with (dashed line) or without (solid line) thalassemia disease.
Mentions: The mean follow-up years were 7.27 (SD = 3.51) and 7.22 (SD = 3.48) for the thalassemia cohort and the nonthalassemia cohort, respectively (data not shown). Figure 1 shows that the cumulative incidence of organic and psychogenic ED was higher in the thalassemia cohort than in the nonthalassemia cohort by 1.88% (log-rank test P < .001) at the end of follow-up. The overall incidence of organic ED was 4.73-fold higher in the thalassemia cohort than in the nonthalassemia cohort (2.81 and 0.59 per 1000 person-years, respectively), with an adjusted HR (aHR) of 4.56 (95% CI = 1.88–11.1) (Table 2). The organic ED incidence increased with age and with comorbidity in both cohorts. The age-specific thalassemia to nonthalassemia relative risk was the greater for all age group (aHR = 4.76; 95% CI = 1.24–18.2 for aged 20–49 years; aHR = 4.29; 95% CI = 1.31–14.1 for aged ≥50 years). Among patients with comorbidities, thalassemia men had a higher risk of organic ED than did the nonthalassemia cohort (aHR = 5.06; 95% CI = 1.86–13.7). Furthermore, relative to those patients without thalassemia and aged 20 to 49 years, patients with thalassemia and aged ≥50 years were 17.7-fold more likely to develop organic ED (95% CI = 4.27–73.5) (Table 3). Compared with patients without thalassemia and without comorbidities, cases with thalassemia and with comorbidities were 7.12-fold more likely to develop organic ED (95% CI = 2.17–23.3).

Bottom Line: Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism.This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011.Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Internal Medicine, Division of Hematology/Oncology (Y-GC, M-SD, C-LH); Department of Internal Medicine, Division of Infectious Diseases and Tropical Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei (T-YL); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine (C-LL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine (C-HK); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).

ABSTRACT
Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

Show MeSH
Related in: MedlinePlus