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Serum Nestafin-1 level in men with diabetes and erectile dysfunction correlates with generalized anxiety disorder-7: A prospective comparative study.

BACKGROUND
Current studies have suggested a close link between nesfatin-1, an appetite-related neuropeptide, and gonadal hormones.


OBJECTIVES
We investigated the association between nesfatin-1 serum level and ED severity in men with diabetes as well as generalized anxiety disorder-7 questionnaire (GAD-7), the patient health questionnaire-9 (PHQ-9), serum testosterone, kidney and liver functions, HbA1c and lipid profile.


MATERIALS AND METHODS
Seventy six participants between 30-60 years were enrolled, 25 ED patients with T2DM (group I), 21 with diabetes and preserved erectile function (group II) and 29 healthy controls (group III). ED status and severity were determined by the Arabic version of the international index of erectile function-5 (IIEF-5) for all the participants. Psychological wellbeing was checked by the generalized anxiety disorder-7 questionnaire (GAD-7) and the patient health questionnaire-9 (PHQ-9). Finally, participants were evaluated for serum Nesfatin-1, serum testosterone, kidney and liver functions, HbA1c, and lipid profile.


RESULTS
Serum nesfatin-1 levels were significantly lower in the groups I and II compared to the controls. The IIEF-5 scores had shown significant correlations with serum nesfatin-1, serum testosterone, GAD-7, PHQ-9, DBP, HbA1c, triglycerides, creatinine and albumin/creatinine ratio (ACR). ROC analysis revealed that serum Nesfatin-1 ≥ 0.62 ng/ml, serum testosterone ≥2.9ng/ml, GAD-7 score ≥7.5, PHQ-9 score ≥5, HBA1C ≥6.4%, triglycerides ≥ 144 mg/dL, creatinine ≥ 0.85mg/dL, and ACR ≥ 26.5 are useful predictors of ED in men with T2DM, and the AUC for those variables was respectively 0.83, 0.76, 1, 0.75,0.88, 0.72,0.67,and 0.77. Finally, a linear regression analysis revealed that GAD-7 was the only strong independent predictor of IIEF-5 (p<0.001).


DISCUSSION AND CONCLUSION
Nesfatin-1 can be used as a biomarker for severity of anxiety in ED patients with diabetes. Use of this molecule in treatment of diabetes and ED should be strengthened by larger studies. Psychiatric care must be offered to patients with diabetes and ED and low serum nesfatin-1 as they experience intense anxiety and depression. This article is protected by copyright. All rights reserved.