Examining the relationship between erectile dysfunction and the ZJU index in US adults: results from NHANES 2001–2004

BACKGROUND: The ZJU index is a composite metric incorporating triglyceride (TG), fasting plasma glucose (FPG), the alanine aminotransferase (ALT) to aspartate aminotransferase ratio (AST) (ALT/AST), and body mass index (BMI). This study aimed to investigate the relationship between the ZJU index and the risk of erectile dysfunction (ED). METHODS: This analysis utilized data from 1,906 participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) dataset. We employed logistic regression modeling, smooth curve fitting, subgroup analysis, and threshold effect analysis to evaluate the association between the ZJU index and ED. The missing values in the covariates were filled by multiple interpolation. RESULTS: A significant positive association was observed between the ZJU index and ED risk (OR [95% CI] = 1.03 [1.01,1.05]). Analysis revealed a threshold at a ZJU index of 33.4, above which ED risk increased markedly, while the association was not significant below this value. Subgroup analysis indicated a stronger association in participants under 60 years of age. CONCLUSION: Higher ZJU index values are positively associated with an increased risk of erectile dysfunction, particularly among individuals under 60 years old. These findings suggest the potential utility of the ZJU index as a screening tool for ED risk assessment.