(055) HEAVY METAL EXPOSURE AND ERECTILE DYSFUNCTION: INSIGHTS FROM THE ALL OF US RESEARCH PROGRAM

Abstract Introduction Erectile dysfunction (ED) has long been associated with cardiovascular disease, a sedentary lifestyle, smoking, obesity, and diabetes. However, the role of environmental factors in ED is still not fully understood. Current literature is unclear on the relationship between heavy metal exposure and ED, despite growing evidence that such exposure can lead to oxidative stress, thereby increasing the risk of various diseases. The All of Us (AoU) Research Program is a prospective clinico-genomic database that focuses on individuals from underrepresented populations. Objective We aimed to use the AoU database to examine how high levels of heavy metals in the blood relate to erectile dysfunction. Methods AoU release version 7 was analyzed. Men with an EHR-coded diagnosis of ED were included in the analysis. Serum and blood levels of lead, selenium, magnesium, zinc, and copper were analyzed. Patients with elevated heavy metal levels in the blood were defined as those with lead levels above 25 μg/dL, selenium levels above 160 μg/L or 0.1 ppm, magnesium levels above 2.2 mg/dL, zinc levels above 120 μg/dL, and copper levels above 140 μg/dL or ceruloplasmin levels above 40 mg/dL. P-values were calculated using univariate logistic regression and chi-squared tests with Bonferroni correction. Results The total cohort of men was 153 582, with 15 523 of them having ED (10.1%). Of these men, 19.2% were Black, 62.9% were White, and 17.9% were of another race. Among men with ED, 66.1% were over 65 years old, 26.8% were 45-64 years old, and 4.4% were 18-44 years old. Patients with elevated lead (OR: 4.58, p < 0.001), zinc (OR: 2.07, p = 0.005), or magnesium (OR: 1.39, p < 0.001) levels were more likely to have ED. However, elevated copper (OR: 0.67, p = 0.005) and selenium (OR: 0.955, p = 0.874) levels were not associated with a higher rate of ED. Overall, men with ED who had elevated heavy metal levels were more likely to have a higher BMI (p = 0.010), be unemployed (p < 0.001), have low income (p < 0.001), rent their homes (p < 0.001), and be older (p < 0.001). There was no significant difference in education status (p = 0.172) or race (p = 0.117). Conclusions Using a large prospective database that focuses on underserved populations, our study found that heavy metal levels higher than established cutoffs were associated with higher rates of ED. Lead appeared to have the largest effect on ED rates, while zinc surprisingly had a higher odds ratio of being elevated in patients with ED. These results add to the relatively scant literature on heavy metals' influence on ED. Lastly, our findings suggest that it is important to include heavy metals in the risk assessment for ED. Disclosure No.