Type 2 diabetes mellitus is associated with an increased risk of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in men younger than 45 years, researchers reported.

Hong Jeng Yu, MD, of the College of Medicine, National Taiwan University, and colleagues compared voiding and erectile function in 226 men with type 2 diabetes and 183 healthy men with normal fasting blood glucose levels (controls).

The researchers evaluated subjects using the International Prostate Symtom Score (IPSS), the five-item versin of the International Index of Erectile Function questionnaire (IIEF-5), and measurements of flow rate and postvoid residual urine volume. The mean age of the subjects was 38.9 years in the diabetes group and 38.3 years in the control arm.

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Compared with controls, the diabetics had significant higher mean IPSS (6.1 vs. 4.1) and a 78% increased likelihood of having moderate to severe LUTS, the researchers reported in BJU International (2009; published online ahead of print).

Additionally, the diabetics had greater voiding volume (376 vs. 326 mL), worse IIEF-5 score (17.3 vs. 20), and a 3.5-fold greater likelihood of having ED. Of the 226 diabetics, 70 (31%), 60 (26.5%), and 23 (10.2%) reported mild, moderate, and severe ED, respectively.

The maximum flow rate and postvoid residual volume were similar between the two groups.

Moreover, 156 diabetics (69%) met criteria for metabolic syndrome, which often coexists with diabetes and has associations with LUTS, benign prostatic hyperplasia, and ED in elderly men, the authors noted. The mean age, duration of diabetes, glycosylated hemoglobin, IPSS, voided volume, maximum flow rate, and IIEF-5 score were similar between patients with and without metabolic syndrome.

As all of the men had diabetes, they were classified as having metabolic syndrome when they had two of the following criteria: BP of 130/85 mm Hg or higher and/or the use of an antihypertensive agent; triglyceride levels of 150 mg/dL or higher and/or use of a lipid-lower agent; HDL cholesterol level of 40 mg/dL or higher; and waist circumference of 90 cm or greater.

The study’s findings suggest that diabetes has a more predominant effect on LUTS and ED than other components of metabolic syndrome.