Objectives: Given some of the shared organic and psychogenic pathophysiologic mechanisms in tinnitus and erectile dysfunction (ED), we hypothesized that newly-onset tinnitus may be associated with ED. This study aims to explore the relationship between these two medical conditions using a nationwide population-based database. Design: A case-control study Setting: Taiwan Participants: We retrieved data from Taiwan’s National Health Insurance Dataset, 19,329 patients with ED and 19,329 propensity score-matched patients without ED (controls). Main outcome measures: The diagnosis date was the date of the first ED claim for ED, which was the index date for cases. We defined the date of the control patient’s first utilization of ambulatory care during the index year of their matched case as their index date. Tinnitus during a one-year period before the index date was the exposure of interest. Results: Of the 38,658 sampled patients, 1247 (3.23%) had been diagnosed with tinnitus within the year prior to the index date, 792 (4.10%) among cases and 455 (2.35%) among controls. Multiple logistic regression analysis showed that cases were more likely to have had a prior tinnitus diagnosis compared to controls (OR=1.772; 95% CI=1.577-1.992; p<0.001). After adjusting for co-morbid medical disorders and social economic factors, cases were more likely than controls to have a prior diagnosis of tinnitus (OR=1.779, 95% CI=1.582-2.001, p<0.001). Conclusions: This investigation detected a novel association between ED and newly-onset tinnitus. Physicians should be alert to the possibility of developing ED in patients treated for tinnitus.
Background and Purpose: The risk for stroke is higher in patients with diabetes by hyperglycemia induced oxidative stress and is commonly associated with diabetic cystopathy. We hypothesized glucagon-like peptide-1 receptor agonist exendin-4 (Ex-4) with hypoglycemic effect and neuroprotection may attenuate global cerebral ischemia (IR) induced brain and bladder injury in diabetic rats. Experimental Approach: Ten minutes of bilateral carotid artery occlusion combined with hemorrhage-induced hypotension (30 mmHg) (IR) was induced in female Wistar rats with streptozotocin-induced type I diabetes. Prefrontal cortex edema was evaluated by T2-weighted magnetic resonance. Voiding function was determined by a transcystometry. Endoplasmic reticulum (ER) stress, apoptosis, autophagy and pyroptosis were determined by western blot and immunohistochemistry. Key Results: Diabetes increased the levels of ER stress associated proteins including pIRE-1, cleaved caspase-12, pJNK, ATF4, ATF6 and CHOP, apoptosis associated caspase 3 and PARP proteins expression, autophagy associated proteins Beclin-1 and LC3-II proteins expression and pyroptosis associated caspase 1 and IL-1β proteins expression in the prefrontal cortex and bladders. IR led to a significantly prefrontal cortex edema and voiding dysfunction and further enhanced ER stress, apoptosis, autophagy and pyroptosis in brain and bladder of the diabetic rats. Diabetes thickened the lamina propria layers and increased bladder Masson’s trichrome stain. Intraperitoneal Ex-4 treatment significantly attenuated prefrontal cortex edema, ER stress, apoptosis, autophagy and pyroptosis in brains and bladders and improved bladder dysfunction. Conclusion and Implications: Glucagon-like peptide-1 receptor agonist Ex-4 ameliorates stroke-induced brain injury and bladder dysfunction in diabetic rats through inhibiting ER stress, apoptosis, autophagy and pyroptosis signaling.