Liver fibrosis is associated with men’s health care symptoms, especially erectile dysfunction and lower urinary tract symptoms

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PURPOSE: The prevalence of liver dysfunction among men has been steadily increasing in recent decades. Among the various non-invasive assessment tools available, the Fibrosis-4 (FIB-4) Index has emerged as a particularly valuable and widely adopted scoring system for evaluating liver fibrosis. This study investigated the relationship between liver fibrosis evaluated by the FIB-4 Index and male health care parameters. MATERIALS AND METHODS: Participants were assessed using standardized questionnaires, including the International Prostate Symptom Score (IPSS) for lower urinary tract symptoms (LUTS), the Sexual Health Inventory for Men (SHIM) and EHS (Erection Hardness Score) for erectile function, and the AMS (Aging Males Symptoms rating scale) for late onset hypogonadism. Endocrinological parameters, including dehydroepiandrosterone sulfate (DHEA-S), insulin-like growth factor 1 (IGF-1), total testosterone and cortisol levels, as well as metabolic factors, including hemoglobin A1c (HbA1c) and triglyceride level, were evaluated as potential confounders. RESULTS: The patient age was 50.62±0.24 years. The analysis revealed significant associations between higher FIB-4 Index quintiles and worsening sexual function and LUTS. Among endocrine factors, DHEA-S and IGF-1 exhibited decreasing trends with higher FIB-4 Index values, whereas cortisol showed an increasing trend. Surprisingly, no significant association was observed between FIB-4 Index and testosterone levels. HbA1c increased, but triglycerides did not correlate with FIB-4. Multiple regression confirmed IPSS and SHIM scores were independently linked to the FIB-4 Index (p<0.05). CONCLUSIONS: These findings highlight the importance of hepatic assessment in men with erectile dysfunction and LUTS, supporting a multidisciplinary approach to care.

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