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Abstract Erectile dysfunction (ED) is characterized as the inability to achieve or maintain an erection to complete sexual intercourse or another chosen sexual activity sufficiently. It is known that ED is more widespread in patients with type 2 diabetes mellitus and metabolic syndrome. In a pathophysiological cascade responsible for endothelial dysfunction plays a role an impaired vascular nitric oxide (NO) synthesis and impaired vasodilatation through increased inflammation and oxidative stress. Erectile dysfunction (ED) and cardiovascular diseases have the same risk factors as hypertension, diabetes mellitus, hypercholesterolemia and smoking. The severity of erectile dysfunction correlates with the cardiovascular risk of patients and represents the early symptom of generalized atherosclerosis. ED can also be considered as a marker of early subclinical coronary artery damage and thus as an independent predictor of future cardiovascular events. NO bioavailability may be decreased by suppressed endothelial nitric oxide synthase (eNOS) expression and/or activity or by increased NO scavenging, for example, by superoxide formed during increased oxidative stress. Oxidative stress is a key pathogenic factor in the development of diabetic complications. During chronic hyperglycemia, advanced glycation end products (AGEs) are formed. AGEs bind covalently to the vascular collagen leading to thickening of the vascular wall, decreased elasticity, endothelial dysfunction and atherosclerosis. Summary 77 ROS are involved in many mechanisms of initiation or maintenance of functional and structural damage to cells and the entire organism. Increased oxidative stress and expression of inflammatory markers are seen in patients with diabetic ED. Endoglin, which is a 180 kDa homodimeric integral membrane glycoprotein, is involved in the regulation of endothelial function, serving as a receptor for the transforming growth factor-beta superfamily involved in the atherosclerotic processes. A soluble form of endoglin (S-endoglin), formed by the cleavage of the extracellular domain of the entire endoglin molecule, has been also suggested as a marker of endothelial dysfunction. S-endoglin was found to be increased in the serum of patients with type 2 DM and positively correlated with the severity of diabetic vascular changes. The current study aimed to investigate the relation between Erectile dysfunction in smokers and non smokers and endothelial dysfunction marker, endoglin. It is a prospective randomized study was conducted on 60 men suffering from Erectile dysfunction and attended to the Andrology Clinic in Menoufia University Hospital after obtaining consent from each patient. The studied patients were classified into three groups as follows: group I: consisting of smoker men suffering from Erectile dysfunction, group II: consisting of non-smoker men suffering from Erectile dysfunction and group III: consisting of apparently healthy volunteers’ men without Erectile dysfunction matched age and sex. Summary 78 The studied subjects were divided into three groups: group I: Consisting of 30 smoker men suffering from erectile dysfunction. group II: Consisting of 30 non-smoker men suffering from erectile dysfunction. group III: Consisting of 30 apparently healthy age matched non smoker volunteers. Ethical consideration: The Ethical Committee of the Faculty of Medicine, University Hospital, approved the study (record number: 122020DERMA). A written informed consent was obtained from each participant after simple and clear explanation of the research objectives. Inclusion Criteria: men suffering from erectile dysfunction, smokers and non-smokers. Exclusion criteria: patients with a clear psychogenic ED, testosterone deficiency, acute inflammatory diseases, renal or hepatic insufficiency were excluded from the study. All Patients and controls were subjected to the following: The medical history includes the patient’s name, age, and smoking index. Sexual history and severity of ED as determined by the IIEF-5 questionnaire The IIEF-5 questionnaire was completed by patients and participants. The IIEF-5 questionnaire has a maximum score of 25 points. The following score is used to describe erectile function: Normal function (21-25 points), mild erectile dysfunction (16-20 Summary 79 points), moderate erectile dysfunction (11-15 points), and severe erectile dysfunction (11-15 points) are the four categories of erectile dysfunction (less than 10 points). Full clinical examination: General examination and local genital examination to exclude mechanical causes of erectile dysfunction as pyronie‘s disease and signs of hypoandrogenism. Biochemical parameters: serum glucose, triacylglycerids, glycated hemoglobin (HbA1c), and serum Endoglin (ng/ml) The current findings can be summarized as follows: Age, history of disease, sexual history, BMI, presence of metabolic syndrome, Systolic and diastolic blood pressure, triglyceride and Hg A1C, Endoglin level were significantly higher in cases (Smoker ED patient& Non smoker ED patient) than control group. There was non-significant difference between cases and control groups regarding waist circumference. There was a significantly higher endoglin level in ED patients than the control group (groups I and II). The levels of endoglin and ILEF had a negative relationship . Smokers had greater serum endoglin levels than non smokers . The level of endoglin and the smoking index had a negative relationship . The amount of serum endoglin was found to have a significant positive connection with BMI, waist circumference, and systolic and diastolic blood pressure. |