Higher baseline atherogenic index of plasma (AIP) was independently associated with nonresponse to once-daily tadalafil in men with erectile dysfunction, suggesting AIP may offer additional prognostic information, though further validation is needed.
The overall response rate to once-daily tadalafil 5 mg over 12 weeks was 73.1% among men aged ≥40 years with erectile dysfunction.
Nonresponders had significantly higher baseline AIP compared to responders.
Each 0.1-unit increase in baseline AIP was independently associated with a 20% higher odds of nonresponse to tadalafil.
Diabetes mellitus was independently associated with nonresponse to once-daily tadalafil.
Nonresponders had significantly higher BMI compared to responders.
ROC analysis demonstrated modest discriminatory ability of AIP for predicting nonresponse, with an optimal cutoff of 0.130.
This research suggests that a simple blood test calculation called the atherogenic index of plasma (AIP) — derived from routine cholesterol and triglyceride measurements — may help predict which men with erectile dysfunction are less likely to respond to a common daily dose of the medication tadalafil. In a study of 134 men who took tadalafil 5 mg daily for 12 weeks, about 73% showed a meaningful improvement in erectile function. Men who did not respond had higher AIP values at the start of treatment, and each small increase in AIP was associated with a 20% higher likelihood of not responding to the drug. The study also found that men with diabetes were more than three times as likely to not respond to tadalafil compared to men without diabetes, and nonresponders tended to have slightly higher body mass index. These findings point to the importance of overall metabolic health — including cholesterol balance, blood sugar control, and body weight — in determining how well erectile dysfunction medications work. This research suggests that AIP, which can be calculated from standard lipid panel results already commonly ordered by doctors, could provide useful additional information when planning treatment for erectile dysfunction. However, the authors note that AIP's ability to distinguish responders from nonresponders was modest, and they caution that it should be seen as one piece of a broader metabolic assessment rather than a definitive decision-making tool. Further studies in larger and more diverse populations are needed to validate these findings.
Gezmiş C, Çilesiz N, Uzut M, Satılmışoğlu M, Eroğlu A, Çetin B, et al.. (2026). The role of the atherogenic index of plasma in response to once-daily tadalafil in men with erectile dysfunction.. The aging male : the official journal of the International Society for the Study of the Aging Male. https://doi.org/10.1080/13685538.2026.2737481