The relationship between hyperuricemia (HUA) and erectile dysfunction (ED) remains inadequately understood. Given that HUA is often associated with various metabolic disorders, this study aims to explore the multivariate linear impacts of metabolic parameters on erectile function in ED patients with HUA. A cross-sectional analysis was conducted involving 514 ED patients with HUA in the Department of Andrology, Jiangsu Province Hospital of Chinese Medicine (Nanjing, China), aged 18 to 60 years. General demographic information, medical history, and laboratory results were collected to assess metabolic disturbances. Sexual function was evaluated using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Based on univariate analysis, variables associated with IIEF-5 scores were identified, and the correlations between them were evaluated. The effects of these variables on IIEF-5 scores were further explored by multiple linear regression models. Fasting plasma glucose (β = −0.628, P < 0.001), uric acid (β = −0.552, P < 0.001), triglycerides (β = −0.088, P = 0.047), low-density lipoprotein cholesterol (β = −0.164, P = 0.027), glycated hemoglobin (HbA1c; β = −0.562, P = 0.012), and smoking history (β = −0.074, P = 0.037) exhibited significant negative impacts on erectile function. The coefficient of determination (R2) for the model was 0.239, and the adjusted R2 was 0.230, indicating overall statistical significance (F-statistic = 26.52, P < 0.001). Metabolic parameters play a crucial role in the development of ED. Maintaining normal metabolic indices may aid in the prevention and improvement of erectile function in ED patients with HUA.

Keywords: erectile dysfunction; hyperuricemia; IIEF-5; metabolic parameters; multivariate linear regression