No significant differences in hormone levels were identified between patients and controls, but patients with hypogonadism presented the site a higher prevalence of MS.Diabetes mellitus, arterial hypertension, dyslipidaemia, obesity, and tobacco use are well known risk factors for cardiovascular disease because they are associated with endothelial dysfunction and the development of premature atherosclerosis. This endothelial dysfunction produces ED, due to reduced nitric oxide production and reduced vascular distensibility which inhibits an adequate erection during sexual intercourse [4, 12, 13]. ED has been linked in various studies with CD and MS [5, 6, 13].In our study, patients with ED have a much higher prevalence of MS than the control group.

These results are consistent with other results found in the literature which have shown that MS is strongly associated with ED [14�C16]. We have observed that the MS criteria most frequently recorded in patients with ED were abdominal obesity and systolic and diastolic hypertension. These results are similar to those published by Bal et al., who reported that higher blood pressure, fasting glucose, and abdominal perimeter were the risk factors that best predicted the onset of ED [15]. Patients with ED and MS have a reduced elasticity in large arteries, resulting in a higher flow pressure and more arterial hypertension. Patients with ED and MS show a higher risk of cardiovascular events [17]. Some biochemical mediators have been measured in patients with suspected endothelial dysfunction [6, 9, 18].

In our study, we have observed that patients with ED had higher levels of C-reactive protein but not higher levels of fibrinogen and D-dimer or a higher erythrocyte sedimentation rate. A statistically significant negative linear correlation between IIEF score and C-reactive protein levels was found, which means that high levels of this mediator are related to the severity of ED. Elevated C-reactive protein levels in patients with ED have been found in patients with endothelial dysfunction [8].In some patients with ED, the risk for CD and MS is associated with a deficit in testosterone levels [19, 20]. In our study, no significant differences were found in total, free, or bioavailable testosterone levels in patients with ED or Carfilzomib the controls. Patients were divided into two groups according to their levels of total testosterone (lower than 3.5ng/mL and higher to 3.5ng/mL), and the prevalence of MS and ED in these two groups was analysed. Patients with hypogonadism did not present with higher rates of ED, but they did demonstrate a higher prevalence of MS.