Associations between body mass index, waist circumference and erectile dysfunction: a systematic review and meta-analysis

Background: Growing evidence reports that obesity might play a role in erectile dysfunction (ED), but limited knowledge is available. We conducted a meta-analysis to estimate the prevalence of ED in overweight men and men with obesity.   Methods: We performed a systematic review up to 01/04/2019 to investigate the associations be-tween obesity and ED. Applying a random-effect model, we calculated the prevalence of ED, the odds ratio (OR) for the presence of ED by Body Mass Index (BMI) categories and the mean differ-ences between ED and controls in BMI and Waist Circumference (WC). Results: Among 3409 studies, we included 45 articles with 42,489 men (mean age=55 years). Taking normal weight men as reference, the prevalence of ED was significantly higher in overweight (OR=1.31; 95%CI: 1.13-1.51; I2=72%) and in men with obesity (OR=1.60; 95%CI: 1.29-1.98; I2=79%). Adjusting our analyses for potential confounders, the results were confirmed in men with obesity (OR=1.46; 95%CI: 1.24-1.72; I2=72%). ED was associated with significant higher values of BMI (MD=0.769; 95%CI: 0.565-0.973 Kg/m2; I2=78%) and WC (MD=5.251 cm; 95%CI: 1.295-9.208; I2=96%). Discussion: Considering the high prevalence of ED among men with obesity, clinicians should screen for this clinical condition in this population. Findings from the present study suggest that re-ducing adiposity is a crucial approach in patients with ED who are affected by obesity.