Abstract
PURPOSE: The aim of this study was to evaluate the relationship between Fatty Liver Index(FLI) and Erectile Dysfunction(ED) and its severity. MATERIALS AND METHODS: A group of 230 male patients with ED complaints underwent evaluation. Comprehensive routine blood serum tests were conducted to identify potential etiological factors contributing to ED. Additionally, waist circumference(WC) measurements were obtained to facilitate the calculation of the FLI. Participants were also asked to complete the validated Turkish adaptation of the 5-item International Index of Erectile Function (IIEF-5) questionnaire to assess the severity and impact of ED. RESULTS: Out of all participants, 55 were classified as non-ED, while 175 were diagnosed with ED, mostly in the mild to moderate category. According to FLI scores, 132 had hepatic steatosis(HS). Body mass index (BMI) and WC were significantly higher in the ED group. Fasting blood glucose, ALT, and triglycerides (TG) were elevated in those with ED, while AST and total testosterone levels were lower. A significant association was found between higher FLI scores and ED (p < 0.05). The FLI score was significantly higher (p < 0.05) in the severe ED group compared to the moderate, mild-moderate, and mild ED groups. CONCLUSION: Based on the results of our study, the FLI appears to be a simple method that shows a high correlation with the severity of ED. We believe that the use of the FLI in the diagnosis and follow-up of ED is noteworthy, and further prospective studies with larger sample sizes are needed to support this conclusion. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12894-025-01865-w.