Platelet indices and erectile dysfunction: A systematic review and meta‐analysis

Abstract

Elevated platelet levels have been postulated to be associated with cardiovascular diseases, conditions closely linked to erectile dysfunction (ED). The current systematic review and meta‐analysis was performed to assess the platelet indices, which including platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with ED compared to controls in an attempt to clarify the possible role of platelet indices in the pathogenesis of ED. We initially screened the candidate studies observing the possible association between platelet indices and ED following literature search of database Cochrane Library, PubMed, EMBASE and MEDLINE and therefore included the studies based on the pre‐defined inclusion and exclusion criteria. Two independent investigators extracted the related information on article data and outcome measures from the qualified studies, and a meta‐analysis was therefore performed using Stata 12.0 software. Subgroup analyses were conducted by the different ED aetiology obtained from the eligible studies. The standard mean difference (SMD) and the corresponding 95% confidence intervals (95% CIs) were applied to estimate the outcome measures. A total of 14 articles were qualified in our meta‐analysis with a total of 1595 cases and 987 controls included. Pooled estimate was in favour of increased MPV levels in subjects with ED with a SMD of 0.651 fl, 95% CI 0.567–0.735, p = 0.000. Subgroup analysis showed that vasculogenic ED had a higher MPV levels than controls as well (SMD [95% CI] = 1.026 [0.823–1.228], p = 0.000). However, pooled analysis based on PLT and PDW levels has produced inconsistent results and not strong evidence on platelet level and ED correlation. In conclusion, vasculogenic ED patients had a higher MPV level in our study. However, the results need further interpretation with caution and more high‐quality studies are warranted.

Platelet indices and varicocele: A systematic review and meta‐analysis

“…The relationship between PDW level and the extent of coronary stenosis cannot be identified through a cohort study of a coronary artery patient. (Yang & Muzepper, 2019). The overall results of our meta-analysis showed that the PDW between patients with varicocele and healthy subjects shows no difference, too.…”

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

“…A meta-analysis of seven studies including 1319 patients confirmed that patients with ED have higher MPV values than controls and, particularly, patients with vasculogenic ED had significantly higher values compared to both healthy controls and patients with non-vascular ED [31]. A subsequent meta-analysis of 13 studies including 1595 patients with ED and 967 healthy men reached the same conclusion [32].…”

“…If by one hand the increase in MPV values in diseases increasing the cardiovascular risk indicates a common underlying pathophysiological mechanism [32], on the other, it is not possible to say whether MPV is a direct risk factor for CAD and ED or only an indirect marker [17]. Indeed, some authors dispute the usefulness of MPV for the early diagnosis of vascular diseases, starting from the assumption that the high MPV is a consequence of the vessel occlusion rather than the cause.…”

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

“…Accordingly, an increasingly higher percentage of platelets expressing the vitronectin receptor (integrin αvβ3) (VR), which is involved in the early phase of platelet aggregation, is associated with lower PSV values in the penile cavernous artery of patients with ED [17]. In addition, meta-analytic data indicate the occurrence of higher MPV values in patients with ED compared to controls [18].…”