Barriers and facilitators to physical activity among older Chinese adults in the UK: a qualitative descriptive study.

Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance []. ED is a common male health problem that can occur in all age groups and significantly affects the quality of life of both patients and their partners. More than 150 million men worldwide have ED []. Prevalence increases with age; 2–9% between the ages of 40–49, 20–40% between the ages of 60–69, and around 50% over the age of 70 []. Erectile dysfunction is caused by the interaction of vascular, neurological, and hormonal mechanisms. Tobacco use, obesity, sedentary lifestyle, and chronic alcohol consumption are major risk factors. In addition, comorbid conditions such as diabetes, hypertension, dyslipidemia, and depression increase the risk of developing ED [, ]. Currently, endothelial dysfunction is considered a common end pathway in the pathogenesis of ED. ED can be an early sign of widespread endothelial dysfunction and a predictor of other types of cardiovascular disease []. In recent years, there has been increasing evidence that inflammation plays a central role in the development of ED. The presence and severity of ED have been shown to be associated with inflammatory markers. The neutrophil-lymphocyte ratio (NLR) is considered an easily accessible and prognostic biomarker of systemic inflammation []. In addition, parameters such as the monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) have also been reported to be associated with ED []. More recently, other candidate biomarkers and risk factors related to endothelial and metabolic dysfunction, such as serum adropin, have also been investigated in patients with ED []. Likewise, comorbid conditions linked to systemic inflammation and endothelial dysfunction, such as obstructive sleep apnoea, have also been associated with ED []. Chronic low-grade inflammation forms an intermediate step in endothelial dysfunction in conditions such as obesity, metabolic syndrome, and diabetes, and contributes to the pathogenesis of ED [].