Objective  To evaluate the association between complete blood count (CBC)-derived inflammatory indices and the risk and severity of erectile dysfunction (ED) among men in the Fangchenggang region of Guangxi, China, and to further explore the joint effects of these indices with age.

Methods  A total of 1, 057 participants were enrolled from the Fangchenggang Area Male Health and Examination Survey (FAMHES) conducted in 2011 and 2013. Multivariable logistic regression models were used to assess the association between log-transformed inflammatory indices including neutrophil-to-lymphocyte ratio (NLR), monocyte-tolymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) and ED risk. Restricted cubic spline (RCS) models were applied to evaluate dose-response relationships, and inflammatory indicators combined with stratified analyses by age were performed to examine joint effects.

Results  The prevalence of ED was 53.7%. After full adjustment for potential confounders, all inflammatory indices except SII were positively associated with ED risk (OR=1.27-1.56, P < 0.05). Specifically, MLR, SIRI, and AISI were mainly associated with mild ED, while NLR was primarily associated with moderate-to-severe ED. MLR, SIRI, and AISI showed linear dose-response relationships with ED risk. There were joint effects between the levels of these four inflammatory indices (except SII) and age.

Conclusion  CBC-derived inflammatory indices are associated with the risk and severity of ED, and there is a joint effect with age.