The role of the atherogenic index of plasma in response to once-daily tadalafil in men with erectile dysfunction
Abstract
BACKGROUND: Erectile dysfunction (ED) significantly affects quality of life, and phosphodiesterase type 5 inhibitors, including tadalafil, are main treatment options. Treatment response varies, and vasculometabolic disturbances may reduce responsiveness.
METHODS: In this prospective single-centre cohort study, men aged ≥40 years with ED initiating tadalafil 5 mg once daily were followed for 12 weeks. AIP was calculated as log₁₀(triglycerides/HDL-C) after conversion to mmol/L. The primary outcome was a ≥4-point increase in IIEF-EF. Firth penalised logistic regression and ROC analyses were performed.
RESULTS: Among 134 men, the response rate was 73.1%. Nonresponders had higher baseline AIP (0.196 ± 0.271 vs 0.070 ± 0.224, p = 0.008), higher BMI (28.8 ± 4.19 vs 27.4 ± 3.28 kg/m², p = 0.042), and higher prevalence of DM (30.6% vs 12.2%, p = 0.013). Each 0.1-unit AIP increase was independently associated with nonresponse (adjusted OR 1.20, 95% CI 1.01-1.44, p = 0.036), as was DM (adjusted OR 3.39, 95% CI 1.15-10.45, p = 0.027). ROC analysis yielded an AUC of 0.650 (95% CI 0.540-0.760, p = 0.008), with an optimal cutoff of 0.130.
CONCLUSION: Higher baseline AIP was independently associated with nonresponse to once-daily tadalafil in men with ED, suggesting AIP may offer additional prognostic information, though further validation is needed.
The atherogenic index of plasma (AIP), derived from routine lipid measurements, may provide simple pretreatment information in men with…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 134 participants or records.
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