From inflammation to sexual dysfunctions: a journey through diabetes, obesity, and metabolic syndrome

J Endocrinol Invest. 2018 Nov;41(11):1249-1258. doi: 10.1007/s40618-018-0872-6. Epub 2018 Mar 16.


Metabolic diseases are associated with chronic low-grade inflammation, which has been indicated as a potential mediator of endothelial dysfunction and cardiovascular disease. Visceral adiposity is thought to be the starting condition of the inflammatory state through the release of inflammatory cytokines, including TNF-alpha, CRP, and IL-6, which in turn promote endothelial dysfunction, endothelial expression of chemokines (IL-1) and adhesion molecules (ICAM-1, VCAM-1, and P-selectin), and the inhibition of anti-atherogenic factors (adiponectin). Obesity, metabolic diseases, and diabetes, all conditions characterized by abdominal fat, are well-recognized risk factors for sexual dysfunction in both sexes. Evidence from randomized-controlled trials supports the association between inflammatory milieau and erectile dysfunction in men suffering from metabolic diseases, whereas, in women, this has to be confirmed in further studies. A healthy lifestyle based on dietary pattern with high content of whole grain, fruit, nuts and seeds, and vegetables and low in sodium and saturated fatty acids plus regular physical activity may help to modulate the pro-inflammatory state associated with metabolic diseases and the related burden of sexual dysfunctions.

Keywords: Chronic low-grade inflammation; Erectile dysfunction; Female sexual dysfunction; Healthy lifestyle; Visceral adiposity.

Publication types

  • Review

MeSH terms

  • Adiposity / physiology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / pathology*
  • Humans
  • Inflammation / metabolism
  • Inflammation / pathology*
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / pathology*
  • Obesity / metabolism
  • Obesity / pathology*