抗糖尿病药物对勃起功能障碍的影响：

系统综述与荟萃分析

Effects of Anti-Diabetic Drugs on Erectile Dysfunction:

A Systematic Review and Meta-Analysis

——《糖尿病、代谢综合征与肥胖》2025年第18卷 ——

<Diabetes, Metabolic Syndrome and Obesity> Volume 18, 2025

【摘要】背景：勃起功能障碍 (ED) 被认为是糖尿病 (DM) 的并发症之一，影响约 35%至75%的糖尿病患者。研究表明，抗糖尿病药物可能有助于缓解糖尿病患者的 ED，但不同类别药物的作用机制尚不清楚。目的：本研究旨在探讨不同抗糖尿病药物对ED的影响。材料与方法：本研究遵循系统综述和荟萃分析的优选报告项目 (PRISMA) 指南，开展了一项系统综述和荟萃分析，重点关注抗糖尿病药物与ED之间关联的临床研究。从 PubMed、Embase 和 Cochrane Library 数据库中检索相关研究。使用Review Manager 5.4.1进行荟萃分析和亚组分析，并使用Stata 15.1进行敏感性分析，以确保结果的稳健性。结果：初步检索到3,906篇跨数据库的文献。在筛选了3906篇文章的标题和摘要，并对其中30篇文章进行全文审阅后，我们最终选择了三项研究进行分析。我们最重要的发现是，胰高血糖素样肽-1受体激动剂（GLP-1RAs）在改善糖尿病患者的勃起功能障碍方面优于二甲双胍（Z=2.41，P=0.02），且在BMI较高或肥胖的患者中效果尤为显著（Z=2.26，P=0.02）。这表明GLP-1RAs可能为该患者群体提供一种有前景的治疗选择。此外，噻唑烷二酮类药物也可增强性功能，但其安全性和有效性尚需进一步证实。阿卡波糖、胰岛素和钠-葡萄糖协同转运蛋白2抑制剂（SGLT-2i）也显示出对治疗勃起功能障碍（ED）产生积极影响的潜力，但还需要更多研究来确定其有效性。最后，二甲双胍和磺酰脲类药物对勃起功能障碍（ED）的影响仍不确定，现有研究的证据不一。结论：总而言之，GLP-1RAs在改善糖尿病患者勃起功能障碍方面优于二甲双胍。其他抗糖尿病药物也显示出增强该人群勃起功能的潜力，但需要进一步开展广泛的临床试验，以解决知识空白和安全问题。

【关键词】抗糖尿病药物，勃起功能障碍，肥胖，胰高血糖素样肽-1受体激动剂，血管内皮功能

[Abstract] Background: Erectile dysfunction (ED) is considered one of the complications of diabetes mellitus (DM), affecting about 35–75% of diabetic patients. Studies suggest that anti-diabetic drugs could potentially alleviate ED in diabetics, yet the effects of different drug classes remain unknown. Objective: Our study aims to investigate the influence of various anti-diabetic drugs on ED. Materials and Methods: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review and meta-analysis were carried out, focusing on clinical research linking anti-diabetic drugs and ED. Relevant studies were sought from PubMed, Embase, and Cochrane Library databases. Review Manager 5.4.1 facilitated meta-analysis and subgroup analysis, while Stata 15.1 was employed for sensitivity analysis to ensure result robustness. Results: An initial search yielded 3,906 articles across databases. After screening the titles and abstracts of 3,906 articles and performing a full-text review of 30 selected articles, we selected three studies for analysis ultimately. Our most significant finding is that glucagon-like peptide-1 receptor agonists (GLP-1RAs) show an advantage over metformin in improving erectile dysfunction in diabetic patients (Z = 2.41, P = 0.02), with a particularly notable effect observed in patients with higher BMI or obesity (Z = 2.26, P = 0.02). This suggests that GLP-1RAs may offer a promising therapeutic option for this patient population. Additionally, thiazolidinediones may enhance sexual function, although their safety and efficacy require further confirmation. Acarbose, insulin, and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) also show potential for positively impacting ED, but more research is needed to establish their efficacy. Finally, the impact of metformin and sulfonylureas on ED remains uncertain, with mixed evidence from existing studies. Conclusion: In conclusion, GLP-1RAs demonstrate an advantage over metformin in improving erectile dysfunction in diabetic patients. Other antidiabetic drugs also show potential for enhancing erectile function in this population, but further extensive clinical trials are needed to address knowledge gaps and safety concerns.

[Key words] anti-diabetic drugs, erectile dysfunction, obesity, glucagon-like peptide-1 receptor agonists, vascular endothelial function

论文原文：Bo Yang, Huiqun Cheng, Yu Hu, et al. (2025). Effects of Anti-Diabetic Drugs on Erectile Dysfunction: A Systematic Review and Meta-Analysis. Diabetes, Metabolic Syndrome and Obesity, Volume 18, Pages 467–478.

https://doi.org/10.2147/DMSO.S503216

（需要英文原文的朋友，请联系微信：millerdeng95或iacmsp）