The association of phenotypic age acceleration with erectile dysfunction among adult males in the United States: A cross-sectional study based on NHANES 2001-2004 database

Objective The purpose of this study is to examine the relationship between phenotypic age acceleration (PhenoAgeAccel) and erectile dysfunction (ED) in US males, utilizing data from the National Health and Nutrition Examination Survey (NHANES) collected between 2001 and 2004. Methods This study explored the relationship between PhenoAgeAccel and ED by analyzing a sample reflecting the male population of the United States (n = 1,977; NHANES 2001–2004). Phenotypic age (PA) is calculated using nine blood-based biomarkers. PhenoAgeAccel was calculated by extracting the residuals and regressing the phenotypic age on the chronological age (CA). The evaluation of ED was based on a single-item measure of self-reported erection problems derived from the Massachusetts Male Aging Study. This research used multivariable logistic models to examine the connection between PhenoAgeAccel and ED. Additionally, it included subgroup and interaction analyses to assess variations among different groups. Smoothed curve fitting and generalized additive modelling (GAM) were also employed to analyze the data further. Results The study cohort comprised 1,977 subjects, of whom 559 were diagnosed with ED and 1,418 were not. The weighted multivariate logistic regression model indicated that there was a 3% higher probability of ED for each unit increase in PhenoAgeAccel (OR: 1.03, 95% CI: 1.01–1.06) after accounting for all covariates. The results of the subgroup analysis were consistent across all categories, indicating a significant positive correlation between PhenoAgeAccel and ED. The results of the interaction tests demonstrated that the positive correlation between PhenoAgeAccel and ED remained consistent, with all interaction p-values exceeding 0.05. Additionally, a non-linear relationship was identified between PhenoAgeAccel and ED, whereby an elevated PhenoAgeAccel was associated with a progressive increase in the risk of ED, exhibiting a J-shaped curve (inflection point: -0.86, p < 0.05). Conclusions The findings of our study indicate that an increase in PhenoAgeAccel may be associated with an elevated risk of developing ED. Consequently, PhenoAgeAccel represents a promising biomarker for the early identification of individuals at risk for ED, with significant implications for the management of men's health and the implementation of public health nutrition strategies.