| Abstract | This study aimed at comparing the effects of atorvastatin and vitamin E on erectile dysfunction in patients initially irresponsive to
sildenafil, with investigation into the underlying possible mechanisms. Sixty patients were randomly divided into three groups: the
atorvastatin group received 80mg daily, the vitamin E group received 400 IU daily and the control group received placebo capsules.
Patients were examined both before and after 6 weeks of treatment for biochemical tests; Superoxide dismutase (SOD), glutathione
peroxidase (GPO), C-reactive protein (CRP), interleukin-6 (IL-6), nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) and for
erectile function tests; International index of erectile function (IIEF-5) scores and Rigiscan. Both atorvastatin and vitamin E showed a
statistically significant GPO increase (Po0.05) and a statistically significant IL-6 decrease (Po0.05). Only atorvastatin showed a
statistically significant increase in NO (15.19%, Po0.05), eNOS (20.58%, Po0.01), IIEF-5 score (53.1%, Po0.001) and Rigiscan rigidity
parameters (Po0.01), in addition to a statistically significant decrease in CRP (57.9%, Po0.01). However, SOD showed a statistically
significant increase only after vitamin E intake (23.1%, Po0.05). Both atorvatstain and vitamin E had antioxidant and antiinflammatory
activities. Although activating eNOS by atorvastatin was the real difference, and expected to be the main mechanism
for NO increase and for improving erectile dysfunction. Atorvastatin, but not vitamin E, is a promising drug for sildenafil
nonresponders. |