The association between sociodemographic, clinical factors, hand grip strength and erectile dysfunction among men with metabolic syndrome attending primary care clinics

Erectile dysfunction (ED) is a serious health problem and an independent predictor for cardiovascular diseases (CVD). The prevalence increases with age, but little is known about the relationship between physical fitness and ED especially among men with high risk of CVD. Hence, this study aimed to determine the prevalence of ED among men with Metabolic Syndrome (MetS) and its association with hand-grip strength in which is a measurement of physical fitness and muscle strength. A cross-sectional study was conducted among Malaysian men aged > 40 years who had their follow-up between 1st June 2021 and 30th October 2021 at an institutional primary care clinic in Gombak district, Selangor, Malaysia. The participants were recruited via simple random sampling. Data on sociodemographic, comorbidities, anthropometry, clinical examinations including hand-grip strength (HGS) and blood chemical profiles were collected. While a validated English and Malay versions of the 5-item International Index of Erectile Function (IIEF-5) were used to assess presence of ED. Multiple logistic regression analysis were conducted to determine the association between sociodemographic, comorbidities, blood chemical profiles, and HGS with ED.There were 334 participants recruited in the study. The mean age was 58.8 (±8.84) years old, with majority were Malays (95.2%, n= 318) and married (98.8 %, n=33O). The overall prevalence of self-reported ED was 79% (95% confidence interval [Cl]: 0.75-0.84). Multivariable analysis showed that ED was associated with elderly aged > 60 years (odds ratio [OR] 3.27, 95% CI: 1.60-6.69), low HGS (OR 15.34, 95% CI: 5.64-41.81) and high total cholesterol (OR 0.36, 95% CI: 0.16-0.78). ED was highly prevalent among Malaysian men aged > 40 years with MetS. Being older than 60 years of age and low HGS are associated with higher risk of ED. Robust screening of ED among men with Mets and intervention to improve muscle strength and physical fitness may be warranted.