Is There a Role for Levo-Thyroxine for the Treatment of Arterial Erectile Dysfunction? The Clinical Relevance of the Mean Platelet Volume

Cannarella, Rossella; Calogero, Aldo E.; Aversa, Antônio; Condorelli, Rosita A.; Vignera, Sandro La

doi:10.3390/jcm9030742

Cited by 6 publications

(3 citation statements)

References 26 publications

(28 reference statements)

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“…In particular, in several cross-sectional studies, MPV, a marker of platelet activation, has a statistically significant higher value in patients with SCH compared to euthyroid ones [18][19][20], suggesting a possible prothrombotic effect of elevated thyrotropin (TSH) [18]. Indeed, the association between SCH and coronary artery disease [33][34][35], as well as endothelial dysfunction [36,37], is established, with an increased risk of cardiovascular events and mortality in those with higher TSH levels, particularly in those with a TSH concentration of 10 mIU/L or greater.…”

Section: Discussionmentioning

confidence: 99%

Thyroid hormones and platelet activation in COVID-19 patients

Colonnello

Criniti

Lorusso

et al. 2022

J Endocrinol Invest

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Purpose To retrospectively describe the association between thyroid hormones (TH) and platelet activation, as represented by mean platelet volume (MPV), in a cohort of patients hospitalized for COVID-19 with no known thyroid disease, and to correlate these data with the severity of COVID-19 and the occurrence of death/ARDS (Acute Respiratory Distress Syndrome). Methods 103 patients with real-time polymerase chain reaction (RT-PCR) testing-confirmed COVID-19 and hospitalized were enrolled. Serum samples were collected from patients upon admission before starting any treatment. Chi-squared test was used to determine the association between euthyroid sick syndrome (ESS) and COVID-19 severity. Multivariate logistic regression was performed to evaluate the best independent predictors of COVID-19 deaths/ARDS. Results 39/103 (37.9%) of patients were found to have ESS, and this condition was an independent predictor for the severity of COVID-19 (p = 0.003). Lower TSH and lower FT3/FT4 ratio correlated with higher MPV (p = 0,001 and p = 0.010), with an opposite trend with respect to what has been documented in non-COVID patients. Increasing MPV and lower FT3 significantly increased the risk, in COVID-19 patients, of an adverse outcome of death/ARDS. Conclusion Increased platelet activation, as represented by increased MPV, has already been reported to correlate with COVID-19 severity, possibly as a consequence of cytokine release. We demonstrated, in a cohort of 103 patients with COVID-19, that MPV is inversely correlated to TH levels, in particular in the case of ESS, where downregulation of TH axis may occur in case of systemic cytokine inflammation and more severe outcomes (death/ARDS). That ESS itself may directly cause platelet activation, as demonstrated by higher MPV in these patients, is an interesting hypothesis which deserves further investigation.

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Section: Discussionmentioning

confidence: 99%

Thyroid hormones and platelet activation in COVID-19 patients

Colonnello

Criniti

Lorusso

et al. 2022

J Endocrinol Invest

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“…This suggests that subclinical hypothyroidism can contribute to ED and CVD directly through the reduction of NO and indirectly through the increase in MPV. Accordingly, in a recent study, we have shown how treatment with levothyroxine reduces MPV levels and improves erectile function in patients with subclinical hypothyroidism compared to patients who are not undergoing treatment [53].…”

Section: Limitsmentioning

confidence: 97%

Mean Platelet Volume as a Marker of Vasculogenic Erectile Dysfunction and Future Cardiovascular Risk

Crafa

Condorelli

Mongioì

et al. 2020

JCM

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Cardiovascular diseases are the main cause of mortality in the Western population, so the attempt to find a marker capable of predicting their early onset is not surprising. It is known that arteriogenic erectile dysfunction (ED) precedes the onset of a major coronary event by several years. However, a marker that is able to early identify those patients who should undergo further diagnostic investigations is, to date, missing. Recent research on this topic has focused on the role of the mean platelet volume (MPV), a marker of platelet activity that is high in most vascular diseases, such as coronary artery disease (CAD), stroke, peripheral artery disease (PAD), and ED. The basic pathophysiological mechanism of all these clinical conditions is atherosclerosis. Platelets play a central role in amplifying this process both indirectly by stimulating endothelial cells to produce inflammatory cytokines and chemokines, and directly through the expression of membrane receptors and the release of molecules that contribute to the formation of atherosclerotic plaque. The objective of this review is to critically analyze the evidence on the role of MPV in predicting the diagnosis and severity of vasculogenic ED and the possibility of using this simple marker as a first step to start a diagnostic process aimed at assessing the cardiovascular risk in these patients.

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“…Dunque, l'ipotiroidismo subclinico potrebbe inficiare la funzione erettile direttamente riducendo i livelli di NO e indirettamente tramite l'aumento dei livelli di VPM. In effetti il trattamento sostitutivo con levo-tiroxina in pazienti con ipotiroidismo subclinico è stato recentemente associato a un miglioramento della funzione erettile e a una riduzione dei livelli di VPM rispetto a pazienti che non vengono sottoposti a tale trattamento [18].…”

Section: Prospettive Terapeuticheunclassified

Ruolo del volume piastrinico medio nella disfunzione erettile a patogenesi arteriosa

et al. 2021

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SommarioIl volume piastrinico medio (VPM) è un parametro che sta acquisendo sempre maggiore importanza nella stratificazione del rischio vascolare sistemico dal momento che è in grado di predire il grado di attività piastrinica. Piastrine più attive sono infatti più trombogeniche e contribuiscono al processo di aterosclerosi che, a sua volta, è la principale causa della disfunzione vascolare. La disfunzione erettile (DE) è una condizione che impatta notevolmente sulla qualità della vita di un uomo e, tra le varie cause, la DE su base vascolare arteriosa è quella che ha la prevalenza maggiore. Per questo motivo, alcuni studi hanno cercato di valutare la relazione tra i valori di VPM nei pazienti con DE, suggerendo che questo parametro può essere considerato uno strumento per la diagnosi precoce della DE oltre che un possibile nuovo bersaglio terapeutico, facilmente valutabile.

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Is There a Role for Levo-Thyroxine for the Treatment of Arterial Erectile Dysfunction? The Clinical Relevance of the Mean Platelet Volume

Cited by 6 publications

References 26 publications

Thyroid hormones and platelet activation in COVID-19 patients

Thyroid hormones and platelet activation in COVID-19 patients

Mean Platelet Volume as a Marker of Vasculogenic Erectile Dysfunction and Future Cardiovascular Risk

Ruolo del volume piastrinico medio nella disfunzione erettile a patogenesi arteriosa

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