Abstract
BACKGROUND: Individual antioxidants may not fully capture the comprehensive antioxidant intake from an individual's diet. This study utilizes the Complex Dietary Antioxidant Index (CDAI) to evaluate the combined effects of various dietary antioxidants in the diet. The goal is to investigate the relationship between CDAI and the incidence of erectile dysfunction (ED), offering insights for dietary guidelines and intervention strategies aimed at mitigating the burden of ED. METHODS: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) database in the years 2001-2004. We employed a weighted multivariate logistic regression model to validate the relationship between CDAI and ED. Subgroup analyses were conducted to explore the correlation between CDAI and ED across different subgroups. Additionally, we used propensity score matching (PSM) to adjust for several key confounding variables, enhancing the robustness of the results. RESULTS: In the fully adjusted multivariate logistic regression model for confounding variables, CDAI is negatively correlated with the risk of ED (OR = 0.95, 95% CI: 0.92-0.99, P = 0.005). When CDAI is transformed into a categorical variable based on quartiles, Q3 (OR = 0.73, 95% CI: 0.53-0.99, P = 0.040) and Q4 (OR = 0.70, 95% CI: 0.51-0.96, P = 0.026) show a negative correlation with the risk of ED. Subgroup analysis reveals no significant interaction. After adjusting for major confounding variables through PSM, the association between CDAI and reduced risk of ED remains significant. CONCLUSION: In our study cohort, there is an association between CDAI and a reduced risk of ED, and further research is needed to validate and refine this conclusion.