Peng Jingxuan, An Jinshun, Chen Yuxing, Zhou Jun, Xiang Boyu
Department of Urology, Xiangya Hospital, Central South University, Changsha 410000, China.
Department of Urology, First Affiliated Hospital of Jishou University, Jishou 416000,China.
Sex Med. 2025 Jan 10;12(6):qfae093. doi: 10.1093/sexmed/qfae093. eCollection 2024 Dec.
While previous studies have explored the associations and causalities among platelet count (PC), mean platelet volume (MPV), and erectile dysfunction (ED), further investigations are needed to clarify these relationships using advanced methodologies and analyzing specific populations.
To investigate the associations and causalities among PC, MPV, and ED using observational study and Mendelian randomization (MR) analysis.
A total of 114 patients with ED and 158 healthy control participants underwent a fasting blood draw to test for PC and MPV along with a comprehensive laboratory examination. The International Erectile Function Index was used to diagnose ED. Genetic variants of ED were obtained from individuals of European ancestry including 6175 ED cases and 217 630 controls. PC and MPV values were obtained from the UK Biobank and Investigating the effect of varying the whole blood inter-donation interval (INTERVAL) studies, encompassing a cohort of 173 480 individuals of European descent. Inverse-variant weighted (IVW), weighted median (WM), and MR-Egger methods were employed in MR analysis to explore the causal effects between variables to assess the impact of PC and MPV on ED. Various sensitivity analyses were employed to ensure the reliability of the results.
Both observational study results and MR results revealed that elevated PC levels were associated with a heightened risk of ED, whereas reductions in MPV were linked to a decreased risk.
Logistic regression analysis indicated that an increased PC was associated with a greater risk of ED, with an odds ratio (OR) of 1.14 (95% CI: 1.08, 1.22; .005), whereas decreased MPV was linked to an increased risk for ED, with an OR of 0.65 (95% CI: 0.48, 0.88; .003). Our MR analysis also revealed that genetically predicted PC was associated with a 1.09-fold increased risk of ED (95% CI: 1.01, 1.18; = .016). Conversely, genetically predicted MPV was linked to a 0.93-fold increased risk of ED (95% CI: 0.88, 0.99; = .014). The absence of heterogeneity ( > .05) and pleiotropy ( > .05) was confirmed through Cochran's tests and MR-Egger regression. Exclusion of individual single-nucleotide polymorphisms (SNPs) did not alter the robustness of the results.
In clinical work, it is an important guide for the prevention, diagnosis, and treatment of ED.
Our study employed a combination of observational studies and MR studies to strengthen our evidence. The observational study's sample size was relatively small, and MR was limited to individuals of European ancestry.
A high PC and a low MPV are associated with an increased risk of ED, highlighting the importance of addressing platelet parameters in ED management.
尽管先前的研究已经探讨了血小板计数（PC）、平均血小板体积（MPV）和勃起功能障碍（ED）之间的关联及因果关系，但仍需要进一步研究，以采用先进方法并分析特定人群来阐明这些关系。
采用观察性研究和孟德尔随机化（MR）分析，研究PC、MPV和ED之间的关联及因果关系。
114例ED患者和158名健康对照者接受空腹采血，以检测PC和MPV，并进行全面的实验室检查。采用国际勃起功能指数诊断ED。ED的基因变异来自欧洲血统个体，包括6175例ED病例和217630名对照。PC和MPV值来自英国生物银行和研究全血献血间隔时间变化的影响（INTERVAL）研究，该研究涵盖了173480名欧洲血统个体。MR分析采用逆方差加权（IVW）、加权中位数（WM）和MR-Egger方法，以探讨变量之间的因果效应，评估PC和MPV对ED的影响。采用多种敏感性分析以确保结果的可靠性。
观察性研究结果和MR结果均显示，PC水平升高与ED风险增加相关，而MPV降低与风险降低相关。
逻辑回归分析表明，PC升高与ED风险增加相关，优势比（OR）为1.14（95%CI：1.08，1.22；P = 0.005），而MPV降低与ED风险增加相关，OR为0.65（95%CI：0.48，0.88；P = 0.003）。我们的MR分析还显示，基因预测的PC与ED风险增加1.09倍相关（95%CI：1.01，1.18；P = 0.016）。相反，基因预测的MPV与ED风险增加0.93倍相关（95%CI：0.88，0.99；P = 0.014）。通过Cochran检验和MR-Egger回归证实不存在异质性（P > 0.05）和多效性（P > 0.05）。排除单个单核苷酸多态性（SNP）不会改变结果的稳健性。
在临床工作中，这对ED的预防、诊断和治疗具有重要指导意义。
我们的研究采用观察性研究和MR研究相结合的方法来加强证据。观察性研究的样本量相对较小，且MR仅限于欧洲血统个体。
高PC和低MPV与ED风险增加相关，凸显了在ED管理中关注血小板参数的重要性。
