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This review summarized several common mechanisms of penile vascular endothelial dysfunction in MetS-associated ED, deeply discussed the roles of common pathological manifestations of MetS such as glucose metabolism disorder, hypertension, dyslipidemia and obesity on penile vascular endothelium, and explored treatments targeting these mechanisms in order to provide potential therapeutic targets and strategies in patients with MetS-associated ED

Elevated SAH may therefore signal impaired clearance, oxidative stress, kidney or liver burden, mitochondrial dysfunction or inadequate zinc-dependent adenosine metabolism