Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Higher serum albumin levels as a potential indicator for reduced risk of erectile dysfunction: evidence from NHANES study
1Department of Urology, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian, China
DOI: 10.22514/jomh.2025.082 Vol.21,Issue 6,June 2025 pp.70-80
Submitted: 22 December 2024 Accepted: 06 February 2025
Published: 30 June 2025
*Corresponding Author(s): Ruoyun Xie E-mail: xry0793@fjmu.edu.cn
† These authors contributed equally.
Background: While blood albumin levels indicate organ function, their relationship to erectile dysfunction (ED) is unclear. The purpose of this study is to look at the association between serum albumin levels and ED in the general population. Methods: This cross-sectional research involved subjects from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004. The study employed weighted multivariable regression, performed subgroup analyses and applied restricted cubic spline (RCS) analyses. Results: Of the 3413 adults involved in this study, 868 (25.45%) indicated experiencing ED. A weighted multivariable logistic regression model indicated a negative association between serum albumin levels and ED (odds ratio (OR), 0.92; 95% confidence interval (CI), 0.88–0.96). Serum albumin and ED were consistently associated across subgroups. Sensitivity analyses, which excluded individuals with albumin levels below 35 g/L, also indicated a connection between serum albumin and ED (OR, 0.82; 95% CI, 0.79–0.85). Similarly, a stricter definition of ED yielded an association (OR, 0.92; 95% CI, 0.86–0.97), even after additional adjustments for sex hormones. Conclusions: Higher serum albumin levels are significantly associated with a reduced risk of ED, suggesting that serum albumin may serve as a potential biomarker for assessing ED risk.
Serum albumin; Erectile dysfunction; Sexual dysfunction; NHANES
Xiaobao Chen,Junwei Lin,Binhong Liu,Lingjun Liu,Wei Jiang,Ruoyun Xie. Higher serum albumin levels as a potential indicator for reduced risk of erectile dysfunction: evidence from NHANES study. Journal of Men's Health. 2025. 21(6);70-80.
[1] Hadisuyatmana S, Malik G, Efendi F, Reisenhofer S, Boyd J. The experiences and barriers in addressing type 2 diabetes mellitus-associated erectile dysfunction: a mixed method systematic review. Systematic Reviews. 2023; 12: 138.
[2] Terentes-Printzios D, Ioakeimidis N, Rokkas K, Vlachopoulos C. Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nature Reviews Cardiology. 2022; 19: 59–74.
[3] Zang G, Sun X, Sun Y, Zhao Y, Dong Y, Pang K, et al. Chronic liver diseases and erectile dysfunction. Frontiers in Public Health. 2023; 10: 1092353.
[4] Mules TC, Swaminathan A, Hirschfeld E, Borichevsky GM, Frampton CM, Day AS, et al. The impact of disease activity on sexual and erectile dysfunction in patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2023; 29: 1244–1254.
[5] Romano L, Granata L, Fusco F, Napolitano L, Cerbone R, Priadko K, et al. Sexual dysfunction in patients with chronic gastrointestinal and liver diseases: a neglected issue. Sexual Medicine Reviews. 2022; 10: 620–631.
[6] Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. Journal of the American College of Cardiology. 2011; 58: 1378–1385.
[7] Türk S, Karalezli G, Tonbul HZ, Yildiz M, Altintepe L, Yildiz A, et al. Erectile dysfunction and the effects of sildenafil treatment in patients on haemodialysis and continuous ambulatory peritoneal dialysis. Nephrology Dialysis Transplantation. 2001; 16: 1818–1822.
[8] Muneer A, Kalsi J, Nazareth I, Arya M. Erectile dysfunction. The BMJ. 2014; 348: g129.
[9] Rosen RC, Wing R, Schneider S, Gendrano N 3rd. Epidemiology of erectile dysfunction: the role of medical comorbidities and lifestyle factors. Urologic Clinics of North America. 2005; 32: 403–417, v.
[10] Ma Y, Ran F, Xin M, Gou X, Wang X, Wu X. Albumin-bound kynurenic acid is an appropriate endogenous biomarker for assessment of the renal tubular OATs-MRP4 channel. Journal of Pharmaceutical Analysis. 2023; 13: 1205–1220.
[11] Ibrahim JP, Butcher NJ, Kothapalli A, Subasic CN, Blanchfield JT, Whittaker AK, et al. Utilization of endogenous albumin trafficking pathways in the lungs has potential to modestly increase the lung interstitial access and absorption of drug delivery systems after inhaled administration. Expert Opinion on Drug Delivery. 2023; 20: 1145–1155.
[12] Bender KI, Lutsevich NF, Lutsevich AN, Kupchikov VV. Endogenous metabolites as modulators of the transport of drugs by serum albumin. Farmakologiia i Toksikologiia. 1990; 53: 72–80. (In Russian)
[13] Toda K, Miwa Y, Kuriyama S, Fukushima H, Shiraki M, Murakami N, et al. Erectile dysfunction in patients with chronic viral liver disease: its relevance to protein malnutrition. Journal of Gastroenterology. 2005; 40: 894–900.
[14] Fakhry M, Mahfouz H, Abdelazeem K, AbdelSabour M, Shaheen N, Fathy A, et al. Prevalence and risk factors of erectile dysfunction in cirrhotic patients: an observational study. Arab Journal of Urology. 2023; 22: 6–12.
[15] Cilli M, Ulutas KT. A practical and applicable new index as an indicator of inflammation in the diagnosis of erectile dysfunction: c-reactive protein-to-albumin ratio. Prague Medical Report. 2023; 124: 435–443.
[16] Kim M, Kim SY, Rou WS, Hwang SW, Lee BS. Erectile dysfunction in patients with liver disease related to chronic hepatitis B. Clinical and Molecular Hepatology. 2015; 21: 352–357.
[17] Ghanem YM, Zahran ARM, Younan DN, Zeitoun MH, El Feky AY. Prevalence of erectile dysfunction among Egyptian male patients with type 2 diabetes mellitus. Diabetology & Metabolic Syndrome. 2021; 15: 949–953.
[18] Fukui M, Tanaka M, Okada H, Iwase H, Mineoka Y, Senmaru T, et al. Five-item version of the international index of erectile function correlated with albuminuria and subclinical atherosclerosis in men with type 2 diabetes. Journal of Atherosclerosis and Thrombosis. 2011; 18: 991–997.
[19] Zhuang R, Liao J, Giri M, Wen J, Guo S. Relationship between dietary protein, serum albumin, and mortality in asthmatic populations: a cohort study. Frontiers in Immunology. 2024; 15: 1396740.
[20] Yuan J, Cheng Y, Han X, Zhu N, Ma W, Li J, et al. Association between C-reactive protein/albumin ratio and all-cause mortality in patients with stroke: evidence from NHANES cohort study. Nutrition, Metabolism and Cardiovascular Diseases. 2024; 34: 2305–2314.
[21] Derby CA, Araujo AB, Johannes CB, Feldman HA, McKinlay JB. Measurement of erectile dysfunction in population-based studies: the use of a single question self-assessment in the Massachusetts Male Aging Study. International Journal of Impotence Research. 2000; 12: 197–204.
[22] Farag YMK, Guallar E, Zhao D, Kalyani RR, Blaha MJ, Feldman DI, et al. Vitamin D deficiency is independently associated with greater prevalence of erectile dysfunction: the National Health and Nutrition Examination Survey (NHANES) 2001–2004. Atherosclerosis. 2016; 252: 61–67.
[23] Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, et al.; CKD-EPI Investigators. Estimating glomerular filtration rate from serum creatinine and cystatin C. The New England Journal of Medicine. 2012; 367: 20–29.
[24] Ragab A, Ahmed MH, Reda Sayed A, EldinAbdelbary DAK, GamalEl Din SF. Serum nesfatin-1 level in men with diabetes and erectile dysfunction correlates with generalized anxiety disorder-7: a prospective comparative study. Andrology. 2023; 11: 307–315.
[25] Belinskaia DA, Jenkins RO, Goncharov NV. Serum albumin in health and disease: from comparative biochemistry to translational medicine. International Journal of Molecular Sciences. 2023; 24: 13725.
[26] Zhang CL, Gao MQ, Jiang XC, Pan X, Zhang XY, Li Y, et al. Research progress and value of albumin-related inflammatory markers in the prognosis of non-small cell lung cancer: a review of clinical evidence. Annals of Medicine. 2023; 55: 1294–1307.
[27] Dell’Atti L. Current treatment options for erectile dysfunction in kidney transplant recipients. Sexual Medicine Reviews. 2024; 12: 442–448.
[28] Yuan P, Chen Y, Sun T, Cui L, Wei Y, Li T, et al. Exploring potential genes and mechanisms linking erectile dysfunction and depression. Frontiers in Endocrinology. 2023; 14: 1221043.
[29] Köhler TS, Kloner RA, Rosen RC, Burnett AL, Blaha MJ, Ganz P, et al. The Princeton IV consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clinic Proceedings. 2024; 99: 1500–1517.
[30] Cao J, Qiu W, Yu Y, Li N, Wu H, Chen Z. The association between serum albumin and depression in chronic liver disease may differ by liver histology. BMC Psychiatry. 2022; 22: 5.
[31] Colaci M, Malatino L, Antonelli A, Fallahi P, Giuggioli D, Ferri C. Endocrine disorders associated with hepatitis C virus chronic infection. Reviews in Endocrine and Metabolic Disorders. 2018; 19: 397–403.
[32] Costa MR, Ponciano VC, Costa TR, de Oliveira AM, Gomes CP, de Oliveira EC. Prevalence and factors associated with erectile dysfunction in patients with chronic kidney disease on conservative treatment. International Journal of Impotence Research. 2017; 29: 219–224.
[33] Demir S, Barlas İŞ. An independent indicator of erectile dysfunction is C-reactive protein/albumin ratio. Andrologia. 2021; 53: e14073.
[34] Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, et al. Erectile dysfunction and diabetes: a melting pot of circumstances and treatments. Diabetes/Metabolism Research and Reviews. 2022; 38: e3494.
[35] Pitta RM, Kaufmann O, Louzada ACS, Astolfi RH, de Lima Queiroga L, Ritti Dias RM, et al. The association between physical activity and erectile dysfunction: a cross-sectional study in 20,789 Brazilian men. PLOS One. 2022; 17: e0276963.
[36] Duca Y, Calogero AE, Cannarella R, Giacone F, Mongioi LM, Condorelli RA, et al. Erectile dysfunction, physical activity and physical exercise: recommendations for clinical practice. Andrologia. 2019; 51: e13264.
[37] Narinx N, David K, Walravens J, Vermeersch P, Claessens F, Fiers T, et al. Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology. Cellular and Molecular Life Sciences. 2022; 79: 543.
[38] Czub MP, Venkataramany BS, Majorek KA, Handing KB, Porebski PJ, Beeram SR, et al. Testosterone meets albumin - the molecular mechanism of sex hormone transport by serum albumins. Chemical Science. 2018; 10: 1607–1618.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.
SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)
Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.
Scopus: CiteScore 1.1 (2024) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (https://kanalregister.hkdir.no/publiseringskanaler/Forside).
Top