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Metabolisches Syndrom und erektile Dysfunktion

Epidemiologische und pathogenetische Zusammenhänge

Metabolic syndrome and erectile dysfunction

Epidemiologic associations and pathogenetic links

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Zusammenfassung

Der Zusammenhang zwischen einer erektilen Dysfunktion (ED) und den traditionellen Risikofaktoren einer Atherosklerose wie Dyslipidämie, Hypertonie, gestörter Glukosetoleranz und Adipositas ist in zahllosen Untersuchungen belegt worden. Wenn mehrere Risikofaktoren gleichzeitig vorliegen, wie das beim metabolischen Syndrom der Fall ist, ist das Risiko für die Entwicklung einer ED und Atherosklerose besonders hoch. In einer jüngsten Studie wurde ein linearer Zusammenhang zwischen der Zahl der Risikofaktoren und der Häufigkeit einer ED festgestellt. Das pathogenetische Bindeglied zwischen einer ED und atherosklerotischen Erkrankungen ist nach neueren Erkenntnissen in einer Funktionsstörung des Endothels zu sehen. Eine endotheliale Dysfunktion ist durch eine verringerte Verfügbarkeit von Stickstoffmonoxid (NO) und einen proinflammatorischen, prothrombotischen und proliferativen Phänotyp gekennzeichnet. Da eine ED oft Jahre vor der klinischen Manifestation einer Herz-Kreislauf-Erkrankung auftritt, sollte sie als Warnzeichen einer beginnenden Atherosklerose und als Aufforderung an Arzt und Patient verstanden werden, geeignete präventive Maßnahmen und eine Herz-Kreislauf-Diagnostik einzuleiten.

Abstract

There is abundant evidence for the association between erectile dysfunction (ED) and the traditional atherosclerotic risk factors, such as dyslipidemia, hypertension, glucose intolerance, and obesity, that make up the metabolic syndrome. Recent findings have demonstrated a linear relationship between the number of these risk factors and the prevalence of ED. There is also growing evidence that endothelial dysfunction characterized by decreased bioavailability of nitrogen monoxide (NO) and a proinflammatory, prothrombotic, and proliferative phenotype is the common pathogenetic pathway linking ED to peripheral vascular diseases. Since ED often occurs several years before any clinical manifestation of systemic cardiovascular disease, ED should be seen as a warning of early atherosclerotic disease and an opportunity for doctor and patient to initiate preventive measures.

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Interessenkonflikt

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Vereinzelt Vorträge bei Veranstaltungen der Fa. Lilly.

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Authors and Affiliations

  1. Lilly Deutschland GmbH, Medizinische Abteilung, Bad Homburg, Deutschland

    M. Manning & H. Büttner

  2. Teutoburger-Wald-Klinik, Teutoburger-Wald-Str. 33, 49214, Bad Rothenfelde, Deutschland

    A. Wirth

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  1. A. Wirth
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  2. M. Manning
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  3. H. Büttner
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Correspondence to A. Wirth.

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Wirth, A., Manning, M. & Büttner, H. Metabolisches Syndrom und erektile Dysfunktion. Urologe 46, 287–292 (2007). https://doi.org/10.1007/s00120-006-1244-y

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