A detailed examination of all participants’ medical histories was conducted and consisted of the following:
All enrollees underwent a comprehensive reproductive system examination to assess testicular and penile development. The erectile function of all participants was assessed with the 5-item International Index of Erectile Function (IIEF-5).24 (link) Scores between 22 and 25 were assessed as non-ED, 17 to 21 as mild, 12 to 16 as mild to moderate, 8 to 11 as moderate, and 1 to 7 as severe ED.25 (link) We used the audiovisual sexual stimulation and RigiScan test with oral phosphodiesterase 5 inhibitors to assess penile rigidity and tumescence to preliminarily screen for and rule out psychogenic ED. The definition of a typical result is based on the Chinese population criteria proposed by basal stiffness >60% sustained ≥8.75 min, average event stiffness of tip ≥43.5% and base ≥50.5%, and average maximum stiffness of tip ≥62.5% and base ≥67.5%.26 (link)
Venous blood samples were collected from all participants between 8am and 10 am after a 12-hour overnight fast to measure fasting blood glucose, total cholesterol, total triglycerides, B12, HCY, FA, and Hp-IgG titer. Serum B12, FA, and HCY levels were determined by chemiluminescence immunoassay (ADVIA Centaur XP; Siemens Medical Diagnostics). Hp-IgG titers were quantified by enzyme-linked immunosorbent assay with commercially available kits (Abnova), following the manufacturer’s guidelines.
All enrollees underwent a comprehensive reproductive system examination to assess testicular and penile development. The erectile function of all participants was assessed with the 5-item International Index of Erectile Function (IIEF-5).24 (link) Scores between 22 and 25 were assessed as non-ED, 17 to 21 as mild, 12 to 16 as mild to moderate, 8 to 11 as moderate, and 1 to 7 as severe ED.25 (link) We used the audiovisual sexual stimulation and RigiScan test with oral phosphodiesterase 5 inhibitors to assess penile rigidity and tumescence to preliminarily screen for and rule out psychogenic ED. The definition of a typical result is based on the Chinese population criteria proposed by basal stiffness >60% sustained ≥8.75 min, average event stiffness of tip ≥43.5% and base ≥50.5%, and average maximum stiffness of tip ≥62.5% and base ≥67.5%.26 (link)
Venous blood samples were collected from all participants between 8
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