Early-onset diabetes appears to affect Peyronie disease severity

Early-onset diabetes mellitus appears to significantly affect the severity of Peyronie disease, according to research presented at the 2023 American Urological Association Annual Meeting in Chicago, Illinois.¹

“Revealing the mechanisms behind these findings will help us develop better management strategies in diabetic Peyronie disease patients,” the authors wrote in their abstract.

In their poster, the investigators explained that prior research pointed to a “possible common link between the fibroproliferative processes of PD and diabetes mellitus (DM) involving the pathways related to matrix metalloproteinases (MMPs) and TGF-β.²

For the current study, investigators retrospectively studied patients with Peyronie disease and diabetes mellitus between 2007 and 2022. Physical exam, photographs, and penile Doppler ultrasound were used to determine penile deformities.

“Patients were divided into subgroups according to the onset of [diabetes mellitus] as early (<45 years old), average (45-65 years old), and late (>65 years old),” the authors wrote.

Covariates examined included age, race, marital status, body mass index, comorbidities, and social history. Characteristics of Peyronie disease included age of diagnosis, Peyronie disease duration, trauma history, connective tissue disease, presence of penile deformity, plaque size and location, penile curvature, whether Peyronie disease impeded intercourse, penile pain, months to stabilize, surgery for Peyronie disease, Sexual Health Inventory for Men questionnaire, and penile doppler ultrasound. Characteristics of diabetes mellitus included type of diabetes, HbA1c levels at different time points, onset, duration, controlled or uncontrolled, duration of diabetes medication, treatment stages, diabetic complications, estimated glomerular filtration rate, and albuminuria.

A total of 185 patients were included in the study. The investigators found a strong correlation between early-onset diabetes mellitus and early development of Peyronie disease (rho = 0.52, P <.001). In addition, early-onset diabetes mellitus was also associated with formation of penile plaque (rho = -0.18, P = .03) as well as plaque size (rho = -0.35, P = .03). The investigators also reported a positive correlation between an increase in HbA1c level following initial diagnosis of Peyronie disease and formation of penile plaque (rho = 0.24, P = .03) and penile deformity (rho = 0.24, P = .049).

“In conclusion, early-onset diabetes mellitus and further increase in HbA1c levels after the Peyronie’s disease diagnosis significantly impact the severity of Peyronie’s disease,” study author Selman Unal, MD, of Johns Hopkins Medicine Brady Urological Institute, Baltimore, Maryland, said in his presentation.

“Revealing the mechanisms behind these findings will help us develop better management strategies in diabetic PD patients,” the authors added in their abstract.

References

1. Karakus S, Dai X, Unal S, et al. Early onset diabetes mellitus correlates with complications of Peyronie's disease. Presented at: American Urological Association Annual Meeting, April 28-May 1, Chicago, tract MP36-18

2. Gelbard MK, Rosenbloom J. Fibroproliferative disorders and diabetes: Understanding the pathophysiologic relationship between Peyronie’s disease, Dupuytren disease and diabetes. Endocrinol Diabetes Metab. 2020;4(2):e00195. doi:10.1002/edm2.195