Xiansheng Zhang

Oct 4, 2024 | nature.com | Yuyang Zhang |Xiansheng Zhang |Yu Chang |Tingrui Pan |Ruojiang Wang |Xu Wu | +3 more

Erectile dysfunction (ED) is a prevalent type of sexual dysfunction, and continuous monitoring of penile tumescence and rigidity during spontaneous nocturnal erections is crucial for its diagnosis and classification. However, the current clinical standard device, limited by its active mechanical load, is bulky and nonwearable and strongly interferes with erections, which compromises both monitoring reliability and patient compliance. Here, we report a wearable adaptive rigidity monitoring (WARM) system that employs a measurement principle without active loads, allowing for the assessment of penile tumescence and rigidity through a specifically designed elastic dual-ring sensor. The dual-ring sensor, comprising two strain-sensing rings with distinct elastic moduli, provides high resolution (0.1%), robust mechanical and electrical stability (sustaining over 1000 cycles), and strong interference resistance. An integrated flexible printed circuit (FPC) collects and processes sensing signals, which are then transmitted to the host computer via Bluetooth for ED assessment. Additionally, we validated the WARM system against the clinical standard device using both a penile model and healthy volunteers, achieving high consistency. Furthermore, the system facilitates the continuous evaluation of penile erections during nocturnal tumescence tests with concurrent sleep monitoring, demonstrating its ability to minimize interference with nocturnal erections. In conclusion, the WARM system offers a fully integrated, wearable solution for continuous, precise, and patient-friendly measurement of penile tumescence and rigidity, potentially providing more reliable and accessible outcomes than existing technologies.

Aug 29, 2024 | nature.com | Yuyang Zhang |Hui Gao |Xiansheng Zhang |Xu Wu |Guodong Liu

Systemic immune inflammation index (SII) is a global parameter that comprehensively reflects body inflammation, this study aims to assess the correlation between this index and erectile dysfunction (ED). This cross-sectional study incorporated 164 ED patients and 95 healthy adult males. The collection of general demographic information and pertinent hematological data from the participants enabled the computation of corresponding SII values. Statistical analysis, encompassing descriptive statistics as well as normality and logistic regression analyses, was carried out employing SPSS version 26. The findings of the univariate analysis revealed a noteworthy distinction in triglyceride levels (TG) (P = 0.017) and SII (P < 0.001) between ED patients and the healthy population. Subsequent multivariate logistic regression analysis unveiled a significant association between SII (odd ratio (OR):1.012, 95% confidence interval (CI):1.008–1.015; P < 0.001) and the occurrence of ED. Since the impact value is not clearly visible, SII/100 is utilized to magnify the effect value one hundredfold. The regression analysis results indicate that the OR value of SII/100 is 3.171, and the 95% CI is 2.339–4.298 (P < 0.001). The Receiver Operating Characteristic (ROC) curve analysis ascertained an AUC of 0.863 (P < 0.001) for SII, with a determined cut-off value of 391.53(109/L), exhibiting a sensitivity of 81.7% and specificity of 83.2%. Moreover, when comparing patients with varying degrees of ED severity, both univariate (P < 0.001) and subsequent multivariate logistic regression analyses (OR: 1.007, 95% CI: 1.004–1.010; P < 0.001) underscored the significance of the SII value. At this point, SII/100 OR: 1.971, 95% CI: 1.508–2.576 (P < 0.001). The ROC curve analysis in this context demonstrated an AUC of 0.799 (P < 0.001), with a determined cut-off value of 746.63(109/L), featuring a sensitivity of 60.6% and specificity of 91.6%. These discerned outcomes affirm a correlation between SII and ED, establishing its potential not only in predicting the onset of ED but also in differentiating among various levels of ED severity.

Aug 29, 2024 | nature.com | Wei Zhang |Yuyang Zhang |Xiansheng Zhang |Xu Wu |Hui Jiang |Guodong Liu

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) and involves risk factors such as atherosclerosis and endothelial dysfunction. Since the atherogenic index of plasma (AIP) may be potentially valuable in predicting cardiovascular risk, we conducted a comprehensive analysis of the relationship between AIP and ED using large-scale data, as well as exploring its potential implications for clinical and future research. We screened the National Health and Nutrition Examination Survey (NHANES) database using R software, selected datasets from two study cycles for cross-sectional analysis, enrolled covariates and performed statistical analyses using multivariate logistic regression. Furthermore, sensitivity analyses were performed and the relationship between the AIP index and ED was further assessed using generalized additive model regression and smoothed curve fitting. After an initial filter of 21,161 participants, 1503 participants were included, and the AIP level in the ED group was 0.21 ± 0.02 compared with 0.08 ± 0.01 in the group without ED, which was analyzed to show a statistically significant difference between them (P < 0.0001), and the difference was further confirmed in the sensitivity analyses. We suggest that early assessment, intervention, and individualized treatment of ED in people with high AIP levels is warranted, as it not only improves sexual function but also reduces the risk of CVD. However, it was a limitation of this study that the study population was all from the US, and more research is needed in the future to elucidate the causal relationship between AIP and ED and the association in a wider population.

Dec 20, 2023 | nature.com | Yuyang Zhang |Xu Wu |Guodong Liu |Xingliang Feng |Wei Zhang |Hui Jiang | +1 more

The aim of this study was to assess the association between a new metabolic index, the cardiometabolic index (CMI) and erectile dysfunction (ED). The data for this study relied on the National Health and Nutrition Examination Survey (NHANES), a cross-sectional database, between 2001 and 2004. The CMI was calculated as the following formula: Triglyceride (TG) (mmol/L)/ High density lipid-cholesterol (HDL-C) (mmol/L) ×waist-height ratio (WHtR). The multivariate logistic regression analyses were conducted to assess the association between CMI and ED, supplemented by subgroup analysis and dose-response curves. Finally, a total of 1367 adult male participants were identified, and the mean CMI was 0.83 ± 0.02. Multivariate logistic regression analysis showed that in model 2 controlling for all potential confounders, CMI was significantly associated with ED (OR = 1.49, 95% CI: 1.09, 2.04) (p = 0.017). Subsequently, we convert the CMI from a continuous variable to a categorical variable (Tertiles). The results showed that male participants in CMI Tertile 3 group had a higher risk of ED than those in Tertile 1 group in model 2 (OR = 2.07, 95% CI: 1.12, 3.83, P = 0.024). The subgroup analysis of model 2 demonstrated that CMI was significantly associate with ED in participants aged ≥50 y (OR = 2.31, 95% CI: 1.35, 3.95, P = 0.005), body mass index (BMI) > 30 kg/m2 (OR = 1.78, 95% CI: 1.10, 2.90, P = 0.023), with hypertension (OR = 1.89, 95% CI: 1.63, 3.45, P = 0.020), with diabetes mellitus (OR = 1.67, 95% CI: 1.13, 2.47, P = 0.015), with cardiovascular disease (CVD) (OR = 1.54, 95% CI: 1.12, 2.10, P = 0.011) and smoking (OR = 2.07, 95% CI: 1.26, 3.39, P = 0.007). This study demonstrates a strong association between CMI and ED and an increased risk of ED with higher CMI levels. More prospective studies with large samples and good designs are needed to validate our results in the future.