Abstract
OBJECTIVE: The inflammatory burden index (IBI) has been recently proposed as a comprehensive marker of systemic inflammation. This study investigated the association between IBI and erectile dysfunction (ED). METHODS: We analyzed data from 2,117 male participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Participants were categorized into ED and non-ED groups. Multivariate logistic regression assessed the association between IBI and ED occurrence. Smooth curve fitting examined potential non-linear relationships between IBI and ED. RESULTS: Among 2,117 male participants, 644 (30.42%) were diagnosed with ED. After full adjustment, IBI demonstrated a significant positive association with ED (OR = 2.26, 95% CI: 1.54-3.31, p = < 0.0001). Participants in the highest IBI quartile (Q4) had a substantially elevated ED risk compared to the lowest quartile (Q1) (OR = 2.89, 95% CI: 1.61-5.21, p = 0.0004). Smooth curve fitting confirmed a positive correlation between IBI and ED. Subgroup analyses demonstrated consistent associations across different strata. IBI showed superior predictive performance for ED (AUC = 0.6475, 95% CI: 0.6223-0.6727) compared to other inflammatory markers including CRP (AUC = 0.6279), SIRI (AUC = 0.6121), NLR (AUC = 0.6027), and SII (AUC = 0.5580). CONCLUSION: Our NHANES database analysis demonstrated a significant positive association between IBI and ED. IBI exhibited superior predictive capability for ED compared to established inflammatory markers. These findings suggest IBI's potential utility in clinical settings for identifying individuals at elevated ED risk. However, clinical implementation should be considered exploratory pending validation in diverse prospective populations.