Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios

Abstract

The most important cause of erectile dysfunction (ED) among aging men is organic disease due to vascular disturbance that is often caused by atherosclerosis. Recently, studies have shown that atherosclerosis can manifest as an active inflammatory process rather than as passive vascular injury caused by lipid infiltration. Our study aimed to examine the association of ED with the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR), both of which are markers of inflammation. Between December 2014 and May 2015, 101 male patients aged 40-70 years who were seen at our institute due to ED were included in this study. Thirty-one sexually active men with similar clinical and demographic characteristics without ED were included in our study as a control group. The control and patient groups were compared with respect to their NLR and PLR values as well as other hormonal, biochemical, hematological parameters. The median ages of the patient and control groups were 49 (40-69) and 48 (43-65) years old, respectively. Comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and coronary artery disease were not significantly different between the groups (p > 0.05). The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were significantly higher in the patient group than in the control group (p < 0.05). Furthermore, the detected CRP levels were also significantly higher in the patient group than in the control group (p < 0.001). In the correlation analysis, the NLR, PLR, and CRP levels were negatively correlated with the IIEF-5 scores. A multivariate analysis was performed to determine the independent predictors of ED. PLR was identified as an independent predictor for ED. The neutrophil-to-lymphocyte and especially platelet-to-lymphocyte ratios are correlated with a diagnosis of ED, and these ratios could serve as practical parameters that will not elicit additional costs.

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

“…Of the remaining 20 articles, 6 were excluded with different reasons, which included unable to obtain the related data distribution in cases and controls, data not qualified (controls having ED). Finally, the remaining 14 studies (Akbas et al, ; Aldemir et al, ; Aldemir et al, ; Bayraktar & Albayrak, ; Ciftci et al, ; Ciftci et al, ; El Taieb, Hegazy, Maklad, & Khairy, ; Guo et al, ; Guo et al, ; La Vignera et al, ; Otunctemur et al, ; Sambel et al, ; Senturk et al, ; Wang et al, ) were enrolled in our systematic review and meta‐analysis, all of which were identified as case–control studies. No further articles were identified for inclusion through the repeated cited reference screening.…”

“…Thirteen studies reporting the PLT levels in ED (1580 subjects) and non‐ED cases (977 subjects) were included in the meta‐analysis (Akbas et al, ; Aldemir et al, ; Aldemir et al, ; Bayraktar & Albayrak, ; Ciftci et al, ; Ciftci et al, ; El Taieb et al, ; Guo et al, ; Guo et al, ; Otunctemur et al, ; Sambel et al, ; Senturk et al, ; Wang et al, ). The pooled SMD indicated that individuals with ED had about 0.215 k/μl higher of PLT levels than those without ED (SMD [95% CI] = 0.215 [0.133–0.297], p = 0.000), with severe heterogeneity existed ( I 2 = 90.1%).…”

The effect of using tadalafil 5 mg/day on neutrophil–lymphocyte and platelet–lymphocyte ratios in mild‐medium and severe erectile dysfunction patients; and comparison of clinical response

“…Sambel M et al conducted another study and examined the NLR and PLR values in 101 ED patients between 40 and 70 years of age and added 31 non‐ED patients who had similar clinical and demographical characteristics and who were sexually active to the study as the control group and found that the values that were already high in both groups were higher at a statistically significant level in the patient group ( p < 0.005), and the CRP value was higher in the patient group ( p < 0.001) and that these values were negatively correlated with IIEF‐5. They also showed that PLR was an independent predictor and that the NLR and particularly PLR was correlated with ED and could be used as practical parameters (Sambel et al, ). Unlike these studies, we found that the mean NLR values of mild‐moderate ED group and severe ED group were 1.83 ± 0.45 and 1.93 ± 0.85 respectively.…”

“…In recent years, publications indicating that active inflammatory processes cause ED are increasing. In these studies where neutrophil–lymphocyte (NLR) and platelet–lymphocyte ratios (PLR) were used as signs of inflammation, a significant relationship was found between diseases with these proportions (Furuncuoğlu et al, ; İdil Soylu et al, ; Meng et al, ; Sambel et al, ; Tulgar et al, ; Varım et al, ; Xu et al, ).…”

Complete blood count and penile colour doppler ultrasonography findings in erectile dysfunction: Is there a relationship?

“…There are also some studies investigating the relationship between NLR, PLR and ED. Sambel et al (. compared the ED group ( n = 101) with the control group ( n = 31) in their study.…”