Role of the Triglyceride-Glucose Index as a Predictor of Therapeutic Response to Tadalafil in Patients With Erectile Dysfunction

Abstract

Introduction: The triglyceride-glucose (TyG) index is an easily calculable indicator of endothelial dysfunction. We aimed to evaluate the effect of the TyG index on treatment response in patients using tadalafil for the treatment of erectile dysfunction (ED).

Methods: The data of patients who used tadalafil for ED in our urology clinic between January 2018 and January 2023 were reviewed. The patients completed the 5-item International Index of Erectile Function (IIEF-5) questionnaire before treatment and in the 3rd month of treatment. Response to tadalafil treatment was accepted as an increase in IIEF category. Patients were divided into 2 groups according to treatment response. Factors affecting response to treatment were evaluated with a multivariate analysis.

Results: Of the 134 patients included in the study, 99 (73.3%) responded to tadalafil treatment. Mean age and body mass index (BMI) of the patient group responding to treatment were significantly lower than in the untreated group. The rates of diabetes mellitus (DM) and metabolic syndrome (MetS) were significantly lower in the group responding to treatment. Fasting glucose, triglyceride and total cholesterol values were significantly lower in the group responding to treatment than in the treatment-resistant group. The TyG index was 130.0 (102.0–180.0) in the group responding to treatment and 245.0 (182.0–320.0) in the treatment-resistant group (p=0.001). In the multivariate analysis, age, BMI, DM, MetS, and TyG index were affecting treatment response.

Conclusion: A high TyG index negatively affects the response to treatment in patients using tadalafil for ED. In addition, age, BMI, presence of DM and MetS are other factors affecting the response to treatment.

Zusammenfassung

Einleitung: Der Triglycerid-Glukose (TyG) -Index ist ein leicht zu berechnender Indikator für endotheliale Dysfunktion. Unser Ziel war es, den Einfluss des TyG-Index auf die Behandlungsantwort bei Patienten zu bewerten, die Tadalafil zur Behandlung von erektiler Dysfunktion (ED) verwenden.

Methoden: Die Daten von Patienten, die zwischen Januar 2018 und Januar 2023 Tadalafil zur Behandlung von ED in unserer Urologieklinik verwendet haben, wurden überprüft. Die Patienten haben den 5-Item International Index of Erectile Function (IIEF-5) Fragebogen vor der Behandlung und im 3. Monat der Behandlung ausgefüllt. Eine Antwort auf die Tadalafil-Behandlung wurde als eine Erhöhung der IIEF-Kategorie akzeptiert. Die Patienten wurden in 2 Gruppen eingeteilt, je nach Behandlungsantwort. Faktoren, die die Behandlungsantwort beeinflussen, wurden mit multivariater Analyse bewertet.

Ergebnisse: Von den 134 in die Studie eingeschlossenen Patienten reagierten 99 (73,3 %) auf die Tadalafil-Behandlung. Das durchschnittliche Alter und der Body-Mass-Index (BMI) der Patientengruppe, die auf die Behandlung ansprach, waren signifikant niedriger als in der unbehandelten Gruppe. Die Raten von Diabetes Mellitus (DM) und metabolischem Syndrom (MetS) waren in der behandlungsansprechenden Gruppe signifikant niedriger. Nüchternblutzucker-, Triglycerid- und Gesamtcholesterinwerte waren in der behandlungsansprechenden Gruppe signifikant niedriger als in der behandlungsresistenten Gruppe. Der TyG-Index betrug 130,0 (102,0–180,0) in der behandlungsansprechenden Gruppe und 245,0 (182,0–320,0) in der behandlungsresistenten Gruppe (p=0,001). In der multivariaten Analyse beeinflussten Alter, BMI, DM, MetS und TyG-Index die Behandlungsantwort.

Schlussfolgerung: Ein hoher TyG-Index wirkt sich negativ auf die Behandlungsantwort bei Patienten aus, die Tadalafil zur Behandlung von ED verwenden. Darüber hinaus sind Alter, BMI, das Vorhandensein von DM und MetS weitere Faktoren, die die Behandlungsantwort beeinflussen.

Keywords

endothelial dysfunction - erectile dysfunction - tadalafil - triglyceride-glucose index

Schlüsselwörter

endotheliale Dysfunktion - erektile Dysfunktion - Tadalafil - Triglycerid-Glukose-Index

Publication History

Received: 20 March 2024

Accepted: 19 June 2024

Article published online:
24 July 2024

• References

• 1 McCabe MP, Sharlip ID, Atalla E. et al. Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015. J Sex Med 2016; 13: 135-143
• 2 Feldman HA, Goldstein I, Hatzichristou DG. et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54-61
• 3 Lee JW, Park HJ, Park NC. Serum High-Sensitivity C-Reactive Protein Levels and Response to 5 mg Tadalafil Once Daily in Patients With Erectile Dysfunction and Diabetes. Korean J Urol 2013; 54: 858-864
• 4 Hill MA, Yang Y, Zhang L. et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism 2021; 119: 154766
• 5 Ding X, Wang X, Wu J. et al. Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies. Cardiovasc Diabetol 2021; 20: 76
• 6 Liu X, Tan Z, Huang Y. et al. Relationship between the triglyceride-glucose index and risk of cardiovascular diseases and mortality in the general population: a systematic review and meta-analysis. Cardiovasc Diabetol 2022; 21: 124
• 7 Yilmaz M, Karaaslan M, Tonyali S. et al. Triglyceride-Glucose Index (TyG) is associated with erectile dysfunction: A cross-sectional study. Andrology 2021; 9: 238-244
• 8 Dishy V, Sofowora G, Harris PA. et al. The effect of sildenafil on nitric oxide-mediated vasodilation in healthy men. Clin Pharmacol Ther 2001; 70: 270-279
• 9 Baran C, Karakanlı MÜ, Culha MG. et al. Is there a relationship between mean platelet volume and response to treatment with daily tadalafil in patients with erectile dysfunction?. Andrologia 2022; 54: e14601
• 10 Goldfischer ER, Kim ED, Seftel AD. et al. Impact of low testosterone on response to treatment with tadalafil 5 mg once daily for erectile dysfunction. Urology 2014; 83: 1326-1333
• 11 Turunc TDSGS, Peskircioglu L. The assessment of Turkish validation with 5 question version of International Index of Erectile Function (IIEF-5). Turkish J Urol 2007; 33: 45-49
• 12 Rosen RC, Allen KR, Ni X. et al. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol 2011; 60: 1010-1016
• 13 Smith JA, Kessler A, Morales A. et al. Age as a predictor of the onset and resolution of erectile dysfunction in a prospective cohort of men. J Sex Med 2019; 16: 1945-1951
• 14 Johnson AR, Jarow JP. Effect of age on response to tadalafil in men with erectile dysfunction. J Urol 2021; 205: 445-450
• 15 Smith JA, Anderson P, Morales A. et al. The impact of obesity on the therapeutic response to tadalafil in men with erectile dysfunction. J Sex Med 2020; 17: 477-483
• 16 Johnson AR, Lee SW, Jarow JP. Effect of body mass index on response to tadalafil in men with erectile dysfunction. Urology 2022; 158: 176-182
• 17 Wen J, Wang A, Liu G. et al. Elevated triglyceride-glucose (TyG) index predicts incidence of Prediabetes: a prospective cohort study in China. Lipids in Health and Disease 2020; 19
• 18 Li L, Yao H, Dai W. et al. A higher TyG index is related with a higher prevalence of erectile dysfunction in males between the ages 20–70 in the United States, according to a cross-sectional research. Front Endocrinol (Lausanne) 2022; 13: 988257