University of Oulu

Chen Y, Li J, Li T, et al. Association between homocysteine, vitamin B₁₂, folic acid and erectile dysfunction: a cross-sectional study in China, BMJ Open 2019;9:e023003. doi: 10.1136/bmjopen-2018-023003

Association between homocysteine, vitamin B₁₂, folic acid and erectile dysfunction : a cross-sectional study in China

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Author: Chen, Yang1,2,3; Li, Jie2,4; Li, Tianyu1,2,3;
Organizations: 1Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
2Center for Genomicand Personalized Medicine, Guangxi Medical University, Nanning, China
3Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
4Department of Reproduction, The Guangxi Zhuang Autonomous Region Family Planning Research Center, Nanning, China
5School of Public Health, Guangxi Medical University, Nanning, China
6Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: BMJ, 2019
Publish Date: 2020-04-16


Objectives: Erectile dysfunction (ED) affects up to 53.4% of men aged 30–80 years. In this study, we aimed to examine the association between homocysteine (HCY), vitamin B₁₂ (B12), folic acid (FA) and ED.

Design: Cross-sectional study.

Setting: Guangxi, China.

Participants: A total of 1381 participants who completed questionnaires were included, between September 2009 and December 2009.

Measures: ED was evaluated by the International Index of Erectile Function scores. Also, the values of HCY, B12 and FA were acquired. Then, regression and between-group analyses were performed.

Results: No association between FA and ED was found. Significant correlations between HCY and ED were found—the relationships between these two parameters were most notable in men aged over 60 years and in men living alone (bachelors or bachelorhood). B12 levels were higher in men with ED (718.53±234.37 pg/mL vs 688.74±229.68, p=0.015). Using multinomial logistic regression analyses, B12 levels were related to mild ED (multivariate adjusted analysis: OR 1.620, 95% CI 1.141 to 2.300, p=0.007), especially among men aged 40–49 years (OR 2.907, 95% CI 1.402 to 6.026, p=0.004).

Conclusions: We report, for the first time, a relationship between B12 levels and ED. We also found specific cohorts of men for whom the relationship between HCY levels and ED is most prominent. Further studies are required to elucidate the mechanisms underlying these relationships—these may ultimately result in new therapies for ED.

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Series: BMJ open
ISSN: 2044-6055
ISSN-E: 2044-6055
ISSN-L: 2044-6055
Volume: 9
Issue: 5
Article number: e023003
DOI: 10.1136/bmjopen-2018-023003
Type of Publication: A1 Journal article – refereed
Field of Science: 3111 Biomedicine
3121 General medicine, internal medicine and other clinical medicine
Funding: This study was funded by National Natural Science Foundation of China (81770759, 81370857), and Innovation Project of Guangxi Graduate Education (YCBZ2017037).
Copyright information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: