{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:12:00Z","timestamp":1789038720598,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: This study aimed to investigate the association between metabolic and atherogenic indices and erectile dysfunction (ED) severity, and to compare their diagnostic performance in predicting severe ED. Methods: This retrospective study included 221 men with ED between January 2025 and January 2026. ED severity was assessed using the International Index of Erectile Function-5 (IIEF-5). The triglyceride\u2013glucose (TyG) index, atherogenic index of plasma (AIP), Castelli Risk Index-1 and -2, and atherogenic coefficient (AC) were calculated from routine laboratory parameters. Correlation, logistic regression, and ROC analyses were performed. Results: Patients with severe ED (n = 57) had significantly higher triglyceride, fasting glucose, TyG, and AIP levels and lower high-density lipoprotein cholesterol (HDL) levels than those with mild-to-moderate ED (all p &lt; 0.05). TyG (\u03c1 = 0.369, p &lt; 0.001) and AIP (\u03c1 = 0.359, p &lt; 0.001) were positively correlated with severe ED. In the multivariable model, the TyG index remained associated with severe ED after adjustment for AIP, age, BMI, total testosterone, and the TyG-by-testosterone interaction (OR: 4.354, 95% CI: 1.668\u201311.364; p = 0.003). Total testosterone was not independently associated with severe ED (p = 0.510), and the TyG-by-testosterone interaction was not significant (p = 0.281). ROC analysis showed that TyG had the best predictive performance (AUC: 0.743). Conclusions: The TyG index showed discrimination for IIEF-5-defined severe ED and may have value as a complementary metabolic risk-stratification parameter.<\/jats:p>","DOI":"10.3390\/jcm15187016","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:27:21Z","timestamp":1789036041000},"page":"7016","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic and Atherogenic Thresholds in the Severity of Erectile Dysfunction: The Dominant Role of the Triglyceride-Glucose Index"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8788-8302","authenticated-orcid":false,"given":"Omer","family":"Erdogan","sequence":"first","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"given":"Omur","family":"Memik","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"given":"Mustafa","family":"Gunes","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Oguz Ozden","family":"Cebeci","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Murat","family":"Ustuner","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-9274","authenticated-orcid":false,"given":"Ahmed Omer","family":"Halat","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Ali Kemal","family":"Uslubas","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Taha","family":"Erseckin","sequence":"additional","affiliation":[{"name":"Department of Urology, Kocaeli City Hospital, University of Health Sciences, 41000 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jsxm.2015.12.019","article-title":"Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015","volume":"13","author":"McCabe","year":"2016","journal-title":"J. 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