左甲状腺素在治疗动脉性勃起功能障碍中是否有作用？平均血小板体积的临床意义。

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

作者信息

Cannarella Rossella, Calogero Aldo E, Aversa Antonio, Condorelli Rosita A, La Vignera Sandro

机构信息

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Department of Experimental and Clinical Medicine, "Magna Graecia" University, 88100 Catanzaro, Italy.

出版信息

J Clin Med. 2020 Mar 10;9(3):742. doi: 10.3390/jcm9030742.

DOI:10.3390/jcm9030742

PMID:32164208

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7141360/

Abstract

BACKGROUND

Arterial erectile dysfunction (ED) is an early sign of vascular damage. Rare evidence has been published so far as to whether subclinical hypothyroidism (SCH) affects arterial erectile function. Therefore, the objective of this study was to fill this gap.

METHODS

Patients with arterial ED and SCH were consecutive enrolled and randomly divided into Group A ( = 20) and Group B ( = 20). Group A was treated with levo-thyroxine (LT4) at the dose of 1 µg/kg/day for six months, whereas patients of the group B did not receive any treatment. Thyroid stimulating hormone (TSH), free-thyroxine (FT4), peak systolic velocity (PSV), International Index of Erectile Function 5-item version (IIEF-5) score, mean platelet volume (MPV), and total cholesterol were evaluated at enrollment (T0) and after six months (T1). Patients without hypertension, diabetes mellitus, dyslipidemia, not on drugs, and with normal total testosterone (TT) values were included in this study.

RESULTS

Group A and B did not differ for age (61.2 ± 4.8 vs. 60.3 ± 5.6 years), body-mass index (28.7 ± 2.5 vs. 28.3 ± 2.6 Kg/m), and serum TT levels (481.2 ± 54.0 vs. 492.1 ± 59.7 ng/dL). At T0, serum TSH levels (6.5 ± 1.2 vs. 6.0 ± 1.0 µIU/mL), FT4 (8.8 ± 0.6 vs. 8.8 ± 0.6 pmol/L), PSV (26.5 ± 1.4 vs. 25.8 ± 2.1 cm/s), IIEF-5 score (8.2 ± 1.7 vs. 9.0±1.7), and total cholesterol (167.8 ± 21.7 vs. 171.6 ± 21.3 mg/dL) did not significantly differ in patients of Group A vs. those of Group B. MPV was significantly higher in Group A than in Group B (12.3 ± 0.3 vs. 11.8±0.7 fL). At T1, Group A showed significantly lower TSH (2.26 ± 0.5 µIU/mL), MPV (9.5 ± 0.3 fL), and total cholesterol (137.8 ± 29.2 mg/dL) and significantly higher FT4 (9.3 ± 0.4 pmol/L), PSV (40.0 ± 2.6 cm/s), and IIEF-5 score (20.2 ± 3.6) compared to pre-treatment values. None of these endpoints showed significant change at T1 compared to T0 in patients of group B.

CONCLUSIONS

Lt4 therapy is associated with an improvement of the erectile function at the vascular level, a decrease in MPV and total cholesterol. LT4 therapy should be considered in patients with arterial ED and SCH.

摘要

背景

动脉性勃起功能障碍（ED）是血管损伤的早期迹象。关于亚临床甲状腺功能减退症（SCH）是否影响动脉性勃起功能，目前发表的证据很少。因此，本研究的目的是填补这一空白。

方法

连续纳入动脉性ED和SCH患者，并随机分为A组（n = 20）和B组（n = 20）。A组患者接受剂量为1 μg/kg/天的左甲状腺素（LT4）治疗6个月，而B组患者未接受任何治疗。在入组时（T0）和6个月后（T1）评估促甲状腺激素（TSH）、游离甲状腺素（FT4）、收缩期峰值流速（PSV）、国际勃起功能指数5项版本（IIEF-5）评分、平均血小板体积（MPV）和总胆固醇。本研究纳入了无高血压、糖尿病、血脂异常、未服用药物且总睾酮（TT）值正常的患者。

结果

A组和B组在年龄（61.2±4.8岁 vs. 60.3±5.6岁）、体重指数（28.7±2.5 vs. 28.3±2.6 Kg/m²）和血清TT水平（481.2±54.0 vs. 492.1±59.7 ng/dL）方面无差异。在T0时，A组患者与B组患者相比，血清TSH水平（6.5±1.2 vs. 6.0±1.0 μIU/mL）、FT4（8.8±0.6 vs. 8.8±0.6 pmol/L）、PSV（26.5±1.4 vs. 25.8±2.1 cm/s）、IIEF-5评分（8.2±1.7 vs. 9.0±1.7）和总胆固醇（167.8±21.7 vs. 171.6±21.3 mg/dL）无显著差异。A组的MPV显著高于B组（12.3±0.3 vs. 11.8±0.7 fL）。在T1时，与治疗前值相比，A组的TSH（2.26±0.5 μIU/mL）、MPV（9.5±0.3 fL）和总胆固醇（137.8±29.2 mg/dL）显著降低，FT4（9.3±0.4 pmol/L）、PSV（40.0±2.6 cm/s）和IIEF-5评分（20.2±3.6）显著升高。与T0相比，B组患者在T1时这些终点指标均无显著变化。