Low serum 25-hydroxyvitamin d level as a potential risk factor of erectile dysfunction in elderly men with moderate to severe lower urinary tract symptoms

Purpose: To evaluate the correlation between vitamin D level and erectile dysfunction (ED) in male lower urinary tract symptoms (LUTS) patients. Materials and Methods: We analyzed data from 534 male patients who were tested for LUTS from 2014 to 2017. LUTS severity was classified into mild (≤7) or moderate to severe (≥8) based on total IPSS scores. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D [25(OH)D] level of less than 20 ng/mL. The severity of ED was dichotomized into mild (≥17 points) or moderate to severe (≤16 points) depending on total IIEF-5 scores. The association of the serum 25(OH)D level with moderate to severe ED was assessed using logistic regression analysis. Results: In the entire cohort, moderate to severe ED was significantly associated with age ≥60 years (odds ratio [OR], 1.762; 95% confidence interval [CI], 1.011-3.073) and moderate to severe LUTS (OR, 2.075; 95% CI, 1.134-3.789), but not with serum 25(OH)D level (OR, 1.001; 95% CI, 0.979-1.023). Whereas, in the subgroup consisting of moderate to severe LUTS patients over 60 years (n=223), either low serum 25(OH)D level (OR, 0.944; 95% CI, 0.903-0.986) or vitamin D deficiency (OR, 2.949; 95% CI, 1.118-7.782) was the independent risk factor of moderate to severe ED as a result of each multivariate analysis. Conclusions: Low vitamin D status closely correlated with moderate to severe ED in elderly men with moderate to severe LUTS.