目的：通过荟萃分析量化评估肥胖与勃起功能障碍（ED）风险的关联。方法：遵循PRISMA指南，系统检索中英文数据库（截至2025年3月），纳入观察性研究（队列、横断面、病例对照研究），提取调整后效应值（OR及95%CI）。采用美国卫生保健研究与质量局(AHRQ)量表评估研究质量，随机效应模型合并效应值，并通过亚组分析（地域、肥胖定义）和敏感性分析验证结果稳健性。结果：共纳入10项研究（n=230 744），9项为横断面研究。荟萃分析显示，肥胖显著增加ED风险（随机效应OR=1.80，95% CI: 1.29~2.51），异质性较高（I²=99.9%）。亚组分析表明，美国人群关联强度（OR=2.10，95% CI: 1.23~3.60）高于中国人群（OR=1.16，95% CI: 1.05~1.28）；以BMI≥25 kg/m³为肥胖标准时，效应值最高（OR=3.05，95% CI: 2.06~4.51）。敏感性分析证实结果稳健（排除任一研究后OR波动范围1.60~1.94）。结论：肥胖是ED的重要危险因素，其效应强度受地域及肥胖定义影响。建议欧美人群以BMI≥30 kg/m²作为干预阈值，亚洲人群需关注BMI≥25 kg/m³的代谢风险。

Objective To quantify the association between obesity and erectile dysfunction (ED) risk through a meta-analysis. Methods Following PRISMA guidelines, systematic searches of Chinese and English databases (up to March 2025) were conducted to include observational studies (cohort, cross-sectional, case-control). Adjusted effect sizes (OR and 95% CI) were extracted. Study quality was assessed using the Agency for Healthcare Research and Quality(AHRQ) scale, and a random-effects model was applied to pool effect sizes. Subgroup analyses (geographic region, obesity definitions) and sensitivity analyses were performed to validate robustness. Results Ten studies (n=230 744), including nine cross-sectional studies, were included. The meta-analysis revealed that obesity significantly increased ED risk (random-effects OR=1.80, 95% CI: 1.29-2.51), with high heterogeneity (I²=99.9%). Subgroup analyses indicated stronger associations in USA populations (OR=2.10, 95% CI: 1.23-3.60) than in Chinese populations (OR=1.16, 95% CI: 1.05-1.28). The highest effect size was observed when using BMI≥25 kg/m³ as the obesity threshold (OR=3.05, 95% CI: 2.06-4.51). Sensitivity analyses confirmed robust results (OR: 1.60-1.94 after excluding any single study). Conclusions Obesity is a critical risk factor for ED, with effect strength influenced by geographic region and obesity definitions. Interventions targeting BMI≥30 kg/m² in Western populations and metabolic risks at BMI≥25 kg/m³ in Asian populations are recommended.