Evidence map›Paper›PMID 31509565›Full record

ArticlePloS one2019

Male sexual dysfunction in obesity: The role of sex hormones and small fibre neuropathy.

Jan Hoong Ho, Safwaan Adam, Shazli Azmi, Maryam Ferdousi, Yifen Liu, Alise Kalteniece, Shaishav S Dhage, Brian G Keevil, Akheel A Syed, Basil J Ammori and 4 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. ICNPReports (MDPI) · 2026
    Article
  3. Review
  4. Review
  5. Observational
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 3 countries.

Jan Hoong HoDepartment of Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Safwaan AdamDepartment of Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom.ORCID 0000-0001-8004-1897
Shazli AzmiCardiovascular Research Group, The University of Manchester, Manchester, United Kingdom.
Maryam FerdousiCardiovascular Research Group, The University of Manchester, Manchester, United Kingdom.ORCID 0000-0002-7989-8233
Yifen LiuCardiovascular Research Group, The University of Manchester, Manchester, United Kingdom.
Alise KaltenieceCardiovascular Research Group, The University of Manchester, Manchester, United Kingdom.
Shaishav S DhageDepartment of Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Brian G KeevilDepartment of Biochemistry, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.ORCID 0000-0002-0684-9318
Akheel A SyedDepartment of Diabetes & Endocrinology, Salford Royal NHS Foundation Trust, Salford, United Kingdom.ORCID 0000-0001-8696-7121
Basil J AmmoriDepartment of Surgery, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
Tomás AhernDepartment of Endocrinology, Our Lady of Lourdes Hospital, RCSI Hospital Group, Drogheda, Ireland.
Rachelle DonnCardiovascular Research Group, The University of Manchester, Manchester, United Kingdom.
Rayaz A MalikCardiovascular Research Group, The University of Manchester, Manchester, United Kingdom.
Handrean SoranDepartment of Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom.ORCID 0000-0003-1714-5014
University of Manchester · GBSalford Royal NHS Foundation Trust · GBManchester University NHS Foundation Trust · GBOur Lady of Lourdes Hospital · IE

Funding

Department of HealthWellcome Trust
6 · The paper itself

Abstract

contextMultiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal in men with obesity and this abnormality is often the focus of management in clinical practice. The role of small fibre neuropathy in obesity-related sexual dysfunction is not well established.

objectiveWe aimed to investigate the relationship between sexual function, sex hormone levels and small nerve fibre morphology in men with severe obesity. MATERIALS AND

methodsA prospective study of 29 men with severe obesity was undertaken. Sexual function was assessed using the European Male Ageing Study Sexual Function Questionnaire. Small nerve fibre morphology was quantified using corneal confocal microscopy. Sex hormone levels were measured by mass spectrophotometry.

resultsErectile dysfunction was present in 72% of the cohort with a higher prevalence of diabetes among the symptomatic group (88% vs 38%, p = 0.006). Corneal nerve fibre length (CNFL) and corneal nerve fibre density (CNFD) were both significantly lower in participants with erectile dysfunction compared to those without (p = 0.039 and p = 0.048 respectively). The erectile function score correlated with CNFL (r = -0.418, p = 0.034) and CNFD (r = -0.411, p = 0.037). Total testosterone and calculated free testosterone levels did not differ significantly between men with or without erectile dysfunction (median 8.8 nmol/L vs 9.0 nmol/L, p = 0.914; and median 176 pmol/L vs 179 pmol/L, p = 0.351 respectively), infrequent sexual thoughts (median 8.1 nmol/L vs 9.2 nmol/L, p = 0.650; and median 184 pmol/L, vs 176 pmol/L, p = 0.619 respectively) and decreased morning erections (median 9.0 nmol/L vs 8.8 nmol/L, p = 0.655; and median 170 pmol/L vs 193 pmol/L, p = 0.278 respectively).

conclusionSexual dysfunction is highly prevalent in men with severe obesity. We found an association between small fibre neuropathy with erectile dysfunction with presence of diabetes a likely a significant contributing factor. We found no associations between testosterone levels with sexual symptoms (including frequency of sexual thoughts). The influence of small nerve fibre neuropathy on response to therapeutic interventions and whether interventions that improve small fibre neuropathy can improve erectile function in this population merits further study.

Indexed as

AdultErectile DysfunctionGonadal Steroid HormonesHumansMaleMass SpectrometryMicroscopy, ConfocalMiddle AgedObesityPrevalenceProspective StudiesSmall Fiber NeuropathySurveys and QuestionnairesUnited KingdomGonadal Steroid Hormones

Identifiers

PMID31509565
PMCPMC6738611
OpenAlexW2973061664

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.