Association of different insulin resistance surrogates with erectile dysfunction： a cross-sectional study

Purpose： Metabolic syndrome and obesity are more common among men who have erectile dysfunction (ED), and there is a strong association between insulin resistance (IR) and the development of these diseases. However, no research has studied an attachment between different IR surrogates and ED. As a result, we scrutinized their potential relationship Among individuals in general. Materials and Methods： The NHANES 2001-2004 dataset provided the basis for our analysis. We utilizedmultivariable logistic regression to investigate the link between ED and various IR surrogates (including the triglyceride glucose [TyG] index, homeostasis model assessment of insulin resistance [HOMA-IR] index, and triglyceride glucose-body mass [TyG-BMI]index). Additionally, we utilized smoothed curve fitting and threshold effect examination to assess curvilinear correlations and validate our findings. Subgroup analyses were conducted to identify sensitive populations, while the Receiver Operating Characteristic curve (ROC) study assessed the forecasting ability involving different IR surrogates for IR and ED. Results: When controlling potential covariates, both the TyG index and the HOMA-IR index demonstrated no significant association with ED. Conversely, the TyG-BMI index/10 exhibited a favorable correlation with ED (odds ratio [OR] = 1.03, 95% confidence interval [CI]: 1.01, 1.06; P < 0.05). Smooth curve fitting and threshold effect analysis revealed a curvilinear connection between the TyG-BMI index with ED, indicating a remarkable inflection point at 320.78. Subgroup analysis illustrated the interactive effects of age, marital status, and cardiovascular diseases (CVDs) on the connection that exists among the TyG-BMI index and ED (P for interaction > 0.05). Nonetheless, different IR surrogates showed no difference in predictive ability for ED: HOMA-IR (0.559, 95% CI: 0.53, 0.59) compared to TyG (0.604, 95% CI: 0.57, 0.63) and TyG-BMI (0.558, 95% CI: 0.53, 0.59). Conclusions： This research demonstrates a positive relationship between highlevels of the TyG-BMI index and ED among adults in the United States.