Cobalt, antimony exposure ups erectile dysfunction risk

High levels of exposure to the heavy metals cobalt and antimony appears to increase the risk of developing erectile dysfunction (ED), according to a new study.

Data from 1,328 men were retrieved from the 2001–2002 and 2003–2004 cycles of the National Health and Nutrition Examination Survey. Urinary levels of 12 heavy metals, including cobalt, antimony, and lead, were assessed in the present analysis, and their impact on ED risk was quantified using multivariable logistic regression. For exposure to combinations of metals, weighted quantile sum (WQS) regression was employed.

Of the participants, 397 had prior histories of ED, while the remaining 931 did not. Those with the condition were significantly older (mean, 62.4 vs 41.3; p<0.001) and were more likely to be obese (body mass index [BMI] ≥30 kg/m², 32.0 percent vs 24.4 percent; p=0.005 for BMI overall). Comorbidities likewise significantly differed between groups, such that men with ED were more likely to have had cardiovascular diseases, diabetes, or hypertension (p<0.001 for all). [Asian J Androl 2022;doi:10.4103/aja202237]

Levels of 10 heavy metals were detectable in >80 percent of blood and urine participant samples. The only exceptions were beryllium and platinum, which were below the limit of detection in more than 99 percent of samples. Both metals were excluded from further analyses.

Unadjusted models showed that aside from cobalt and antimony, urinary levels of barium, cadmium, cesium, molybdenum, and lead also significantly and negatively affected ED risk. After full adjustments for potential confounders, however, only cobalt (odds ratio [OR], 1.36, 95 percent confidence interval [CI], 1.10–1.73; p=0.02) and antimony (OR, 1.41, 95 percent CI, 1.12–1.77; p=0.018) remained significantly associated with ED.

These findings remained true even when heavy metal concentrations were expressed as continuous variables. Men belonging to the topmost tertile of cobalt were nearly 50-percent more likely to have ED than those in the bottom tertile (OR, 1.49, 95 percent CI, 1.02–2.41; p_trend=0.012). For antimony, such risk was raised by 53 percent (third vs first tertile: OR, 1.53, 95 percent CI, 1.08–2.40; p_trend=0.041).

Additionally, WQS regression revealed that a mixture of urinary heavy metals was significantly associated with an elevated likelihood of ED (OR, 1.31, 95 percent CI, 1.04–1.72; p<0.05). Cobalt accounted for more than half (53.1 percent) of this effect, followed by uranium (34.3 percent), antimony (9.0 percent), and lead (3.6 percent).

“To date, this is the first epidemiological study to determine the relationship between heavy metals exposure and ED,” the researchers said.

“Our results demonstrated the possible roles of cobalt and antimony exposure in the pathogenesis of ED. The evaluation of heavy metal exposure should be included in the risk assessment of ED. Further studies are needed to elucidate the underlying mechanism,” they added.