https://doi.org/10.4081/aiua.2026.14907
Metabolic parameters, insulin resistance surrogates, and Peyronie’s disease: a cross-sectional analysis of disease presence and curvature severity
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 8 May 2026
Methods: This retrospective, cross-sectional study included 317 adult men, comprising 123 patients diagnosed with PD and 192 control subjects without clinical evidence of PD. Demographic data, body mass index (BMI), comorbidities, and fasting laboratory parameters (glucose, total cholesterol, LDL, HDL, and triglycerides) were collected. TG/HDL ratio and TyG index were calculated using established formulas. Between-group comparisons were performed using Mann-Whitney U and chi-square or Fisher’s exact tests, with false discovery rate correction for multiple comparisons. Multivariable binary logistic regression analysis was conducted to identify independent predictors of PD presence. Within the PD cohort, associations between penile curvature degree and metabolic parameters were evaluated using Spearman’s correlation analysis.
Results: Patients with PD had a significantly lower median BMI compared to controls (25.0 vs. 27.3 kg/m², p < 0.001). LDL-cholesterol and total cholesterol levels were lower in the PD group on univariable analysis; however, these differences did not remain significant after correction for multiple testing. No significant differences were observed between groups for fasting glucose, triglycerides, HDL, TG/HDL ratio, or TyG index. In multivariable analysis, BMI emerged as the only independent predictor of PD presence (OR 0.83 per kg/m² increase, 95% CI 0.76-0.90; p < 0.001). No metabolic parameter, including insulin resistance surrogates, was independently associated with PD. Among PD patients, penile curvature degree showed no significant correlation with BMI, lipid profile components, TG/HDL ratio, or TyG index.
Conclusions: In this cohort, BMI – but not lipid profile components or insulin resistance surrogate markers – was independently associated with the presence of Peyronie’s disease, while metabolic factors were not related to curvature severity. These findings suggest that systemic metabolic dysregulation may play a limited role in PD development and phenotypic expression, highlighting the importance of local tissue-specific mechanisms in disease pathogenesis.
Downloads
1. Babu A, Kayes O. Recent advances in managing Peyronie's disease. F1000Res. 2020 May 20;9:F1000 Faculty Rev-381. DOI: https://doi.org/10.12688/f1000research.20557.1
2. DiBenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X. A Population-Based Study of Peyronie's Disease: Prevalence and Treatment Patterns in the United States. Adv Urol. 2011;2011:282503. DOI: https://doi.org/10.1155/2011/282503
3. Moreland RB, Nehra A. Pathophysiology of Peyronie's disease. Int J Impot Res. 2002; 14:406-10. DOI: https://doi.org/10.1038/sj.ijir.3900875
4. Al-Thakafi S, Al-Hathal N. Peyronie's disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up. Transl Androl Urol. 2016; 5:280-9. DOI: https://doi.org/10.21037/tau.2016.04.05
5. Paulis G, Brancato T. Inflammatory mechanisms and oxidative stress in Peyronie's disease: therapeutic "rationale" and related emerging treatment strategies. Inflamm Allergy Drug Targets. 2012;11:48-57. DOI: https://doi.org/10.2174/187152812798889321
6. Arafa M, Eid H, El-Badry A, et al. The prevalence of Peyronie's disease in diabetic patients with erectile dysfunction. Int J Impot Res. 2007; 19:213-7. DOI: https://doi.org/10.1038/sj.ijir.3901518
7. Kendirci M, Trost L, Sikka SC, Hellstrom WJ. Diabetes mellitus is associated with severe Peyronie's disease. BJU Int. 2007; 99:383-6. DOI: https://doi.org/10.1111/j.1464-410X.2007.06611.x
8. Rhoden EL, Riedner CE, Fuchs SC, et al. A cross-sectional study for the analysis of clinical, sexual and laboratory conditions associated to Peyronie's disease. J Sex Med. 2010; 7(4 Pt1):1529-37. DOI: https://doi.org/10.1111/j.1743-6109.2009.01584.x
9. Usta MF, Bivalacqua TJ, Jabren GW, et al. Relationship between the severity of penile curvature and the presence of comorbidities in men with Peyronie's disease. J Urol. 2004; 171(2 Pt 1):775-9. DOI: https://doi.org/10.1097/01.ju.0000097498.34847.7c
10. Giannini C, Santoro N, Caprio S, et al. The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds. Diabetes Care. 2011; 34:1869-74. DOI: https://doi.org/10.2337/dc10-2234
11. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008; 6:299-304. DOI: https://doi.org/10.1089/met.2008.0034
12. de Giorgis T, Marcovecchio ML, Di Giovanni I, et al. Triglyceridesto- HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children. Eur J Endocrinol. 2013;170:173-80. DOI: https://doi.org/10.1530/EJE-13-0452
13. Gianazza S, Belladelli F, Leni R, et al. Peyronie's disease development and management in diabetic men. Andrology. 2023; 11:372-378. DOI: https://doi.org/10.1111/andr.13224
14. Crocetto F, Imbimbo C, Barone B, et al. Which inflammatory marker, between systemic immune-inflammation index and neutrophil to eosinophil ratio, is associated with Peyronie's disease and are there any implications for a better understanding of its mechanisms? Basic Clin Androl. 2023; 33:38. DOI: https://doi.org/10.1186/s12610-023-00213-y
15. Habous M, Malkawi I, Han E, et al. Peyronie's Disease is common in poorly controlled diabetics but is not associated with the Metabolic Syndrome. Urol Ann. 2019; 11:252-256. DOI: https://doi.org/10.4103/UA.UA_164_18
16. Romero-Corral A, Somers VK, Sierra-Johnson J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010; 31:737-46. DOI: https://doi.org/10.1093/eurheartj/ehp487
17. Crocetto F, Barone B, Manfredi C, et al. Are insulin resistance and non-alcoholic fatty liver disease associated with Peyronie's disease? A pilot study. J Physiol Pharmacol. 2022; 73(1).
18. Hatfield BS, King CR, Udager AM, et al. Peyronie disease: a clinicopathologic study of 71 cases with emphasis on histopathologic patterns and prevalent metaplastic ossification. Hum Pathol. 2020; 104:9-17. DOI: https://doi.org/10.1016/j.humpath.2020.07.013
19. Gacci M, Corona G, Vignozzi L, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int. 2015; 115:24-31. DOI: https://doi.org/10.1111/bju.12728
20. Amato MC, Giordano C, Galia M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010; 33:920-2. DOI: https://doi.org/10.2337/dc09-1825
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.