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Ceramide test in patients with erectile dysfunction to assess cardiovascular risk

J Sex Med. 2025 Oct 5;22(10):1750-1756. doi: 10.1093/jsxmed/qdaf182.

ABSTRACT

BACKGROUND: Erectile dysfunction (ED) is a known precursor and sequela of cardiovascular disease (CVD), with ED severity predicting CVD severity.

AIM: This study aimed to evaluate the utility of ceramide levels in patients with ED.

METHODS: We initiated ceramide testing in all patients with ED. We retrospectively analyzed ceramide levels from electronic records and stratified by severity of symptoms using the erectile function domain of the International Index of Erectile Function (IIEF).

OUTCOMES: The study aimed to determine whether abnormal ceramide levels were associated with ED severity and increased cardiovascular risk.

RESULTS: Three hundred and fifty-four patients were reviewed, of whom 253 (71.5%) had moderate or higher ED. A statistically significant difference in abnormal ceramide values was found in patients with moderate to severe symptoms, and the odds of getting an abnormal ceramide test were increased based on the IIEF scoring alone (odds ratio [OR] 2.3 [1.04-5.12]; P-value = .034).

CLINICAL IMPLICATIONS: Serum ceramide testing could be beneficial in identifying cardiovascular risk in men with ED, potentially prompting cardiac referrals and lifestyle modifications.

STRENGTHS AND LIMITATIONS: The strengths of this study include a large sample size and the use of a well-established scale, while the limitations include the retrospective nature of the study and the need for further research to validate the findings.

CONCLUSION: Patients undergoing management for ED may benefit from serum ceramide testing and subsequent cardiac referral.

PMID:41046349 | DOI:10.1093/jsxmed/qdaf182

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