The role of socioeconomic status and oxidative balance score in erectile dysfunction: A cross-sectional study

BACKGROUND: Erectile dysfunction (ED) is a complex disorder of biopsychosocial etiology. Approximately 3%–77 % of adult men worldwide are more or less affected by ED. OBJECTIVE: This cross-sectional study investigated the association between ED and socioeconomic status (SES) based on a nationally representative adult male population. METHODS: The poverty income ratio (PIR), which refers to household income ratio to the established poverty line, was used to assess SES. Oxidative stress related to diet and lifestyle was reflected by oxidative balance score (OBS). Erectile function was evaluated using a questionnaire. Based on the results of the questionnaire, participants were divided into two groups of those without ED (always or almost always be able to erect and keep erection, usually be able to erect and keep erection) and with ED (sometimes be able to erect and keep erection, never be able to erect and keep erection). Multivariate logistic regression, multiple models, and restricted cubic spline (RCS) were used to analyze and describe the interaction between ED, OBS, and SES. RESULTS: Compared with men without ED, those with ED were more likely to be older in age (43.98 vs 37.74, P＜0.0001), and less educated (P < 0.001), and with a ratio of family income to poverty less than 3.5 (P = 0.02), higher BMI (30.11 vs 27.84, P＜0.0001), lower OBS (21.71 vs 23.17, P = 0.04), having habit of smoking (P = 0.04), with diabetes (P＜0.0001), and with hypertension (P = 0.003). Participants with higher PIR were more likely to report good erectile function than those with lower PIR through multivariate analysis (OR = 0.49, 95 % CI = 0.31–0.78, P = 0.005). The RCS model revealed a negative non-linear correlation of PIR with ED when PIR ≤3.89. It is interesting to note that PIR was＞3.89 showed a positive non-linear relationship with ED. CONCLUSION: The social determinants of health and intake of oxidants and antioxidants were considered as risk factors for ED and could be studied as a research focus in the future.