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Medline ® Abstract for Reference 17

of 'Treatment of male sexual dysfunction'

17
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Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial.
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Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D'Andrea F, D'Armiento M, Giugliano D
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JAMA. 2004;291(24):2978.
 
CONTEXT: Healthy lifestyle factors are associated with maintenance of erectile function in men.
OBJECTIVE: To determine the effect of weight loss and increased physical activity on erectile and endothelial functions in obese men.
DESIGN, SETTING, AND PATIENTS: Randomized, single-blind trial of 110 obese men (body mass index>or =30) aged 35 to 55 years, without diabetes, hypertension, or hyperlipidemia, who had erectile dysfunction that was determined by having a score of 21 or less on the International Index of Erectile Function (IIEF). The study was conducted from October 2000 to October 2003 at a university hospital in Italy.
INTERVENTIONS: The 55 men randomly assigned to the intervention group received detailed advice about how to achieve a loss of 10% or more in their total body weight by reducing caloric intake and increasing their level of physical activity. Men in the control group (n = 55) were given general information about healthy food choices and exercise.
MAIN OUTCOMES MEASURES: Erectile function score, levels of cholesterol and triglycerides, circulating levels of interleukin 6, interleukin 8, and C-reactive protein, and endothelial function as assessed by vascular responses to l-arginine.
RESULTS: After 2 years, body mass index decreased more in the intervention group (from a mean [SD]of 36.9 [2.5]to 31.2 [2.1]) than in the control group (from 36.4 [2.3]to 35.7 [2.5]) (P<.001), as did serum concentrations of interleukin 6 (P =.03), and C-reactive protein (P =.02). The mean (SD) level of physical activity increased more in the intervention group (from 48 [10]to 195 [36]min/wk; P<.001) than in the control group (from 51 [9]to 84 [28]min/wk; P<.001). The mean (SD) IIEF score improved in the intervention group (from 13.9 [4.0]to 17 [5]; P<.001), but remained stable in the control group (from 13.5 [4.0]to 13.6 [4.1]; P =.89). Seventeen men in the intervention group and 3 in the control group (P =.001) reported an IIEF score of 22 or higher. In multivariate analyses, changes in body mass index (P =.02), physical activity (P =.02), and C-reactive protein (P =.03) were independently associated with changes in IIEF score.
CONCLUSION: Lifestyle changes are associated with improvement in sexual function in about one third of obese men with erectile dysfunction at baseline.
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Center for Obesity Management, Second University of Naples, Naples, Italy. katherine.esposito@unina2.it
PMID