Aims: 

Evaluation to what extent erectile dysfunction (ED) in young patients suffering from visceral obesity but with no organic vessel disease is associated with vascular dysfunction, and, further on, to what extent a 3 months weight reduction (orlistat + dynamic training + diet) influences these two dysfunctions, laboratory findings, esp. adiponectine, leptin and TNFalfa levels, and whether there is a correlation between these parameters.

Methods and results: 

67 patients have been enrolled to the study. Based on the International Index of Erectile Function (IIEF), 32 patients were identified with mild or moderate ED. Data gathered form that cohort (EO) were compared to those from the obese cohort without ED (NO) and from a healthy control cohort (n=20) to evaluate the effect of weight reduction on the EO cohort. Out of the parameters, adiponectine (p<0.05), TNFalfa (p<0.05), vascular function measured by FMD (p<0.05), waist/hip ratio (p<0.05) showed a difference between the two obese cohorts. After 3 months of treatment resulting in significant weight reduction (p<0.05) ED (16.47±2.98 vs. 25.22±2.44, p<0.01) showed a significant improvement; vascular function (4.23±0.54 vs. 6.29 ± 0.95%, p<0.01), leptin (4.9±3.4 vs. 6.7±5.2 ng/mL, p<0.05), adiponectine (5.3±2.03 vs. 8.08±0.32 mg/mL, p<0.01), TNFalfa levels (26±6.97 vs. 15.5±6.02 pg/mL, p<0.01), waist/hip ratio (p<0.05) and triglicerid levels (p<0.05) showed a significant change. Only adiponectine showed a positive correlation to ED.

Conclusions: 

ED occurs in a high percentage with visceral obesity. Out of the beneficial, significant parameter changes caused by weight reduction, only waist/hip ratio and adiponectine, TNFalfa levels showed a correlation to ED and vascular dysfunction, proving the casual role of visceral obesity in ED. Adiponectine plays an essential role in the development of both vascular and erectile dysfunction.