Department of Vascular Surgery, Drum Tower Hospital Affiliated to School of Medicine, Nanjing University, Nanjing, China.
Andrologia. 2019 Jun;51(5):e13248. doi: 10.1111/and.13248. Epub 2019 Feb 10.
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.
血小板水平升高被认为与心血管疾病有关，而心血管疾病与勃起功能障碍（ED）密切相关。本系统评价和荟萃分析旨在评估 ED 患者与对照组之间的血小板指标，包括血小板计数（PLT）、平均血小板体积（MPV）和血小板分布宽度（PDW），试图阐明血小板指标在 ED 发病机制中的可能作用。我们最初通过对 Cochrane 图书馆、PubMed、EMBASE 和 MEDLINE 数据库进行文献检索，筛选出可能与血小板指标和 ED 相关的候选研究，并根据预先确定的纳入和排除标准纳入研究。两名独立的研究者从合格研究中提取有关文章数据和结局指标的相关信息，并使用 Stata 12.0 软件进行荟萃分析。通过合格研究中获得的不同 ED 病因进行亚组分析。应用标准均数差（SMD）和相应的 95%置信区间（95%CI）来估计结局指标。我们的荟萃分析共纳入了 14 篇文章，共纳入了 1595 例病例和 987 例对照。汇总估计倾向于 ED 患者的 MPV 水平升高，SMD 为 0.651 fl，95%CI 为 0.567-0.735，p=0.000。亚组分析显示，血管性 ED 患者的 MPV 水平也高于对照组（SMD[95%CI]=1.026[0.823-1.228]，p=0.000）。然而，基于 PLT 和 PDW 水平的汇总分析产生了不一致的结果，并且没有强有力的证据表明血小板水平与 ED 之间存在相关性。总之，我们的研究中血管性 ED 患者的 MPV 水平较高。然而，需要谨慎进一步解释这些结果，并需要更多高质量的研究。
