Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Mean platelet volume as a predictive marker of erectile dysfunction: a meta-analysis

International Journal of Impotence Research volume 34, pages 746–752 (2022)Cite this article

Subjects

Abstract

Erectile dysfunction (ED) is a global health problem that commonly occurs due to multiple factors, particularly by a vascular abnormality with the activation of platelet (PLT). Mean platelet volume (MPV), a PLT activity marker, has been hypothesized to be associated with ED. The present meta-analysis aims to evaluate the MPV and its contribution to ED diagnosis. A systematic searching to summarize the association of MPV as a predictive marker for ED was conducted on two databases, including MEDLINE (PubMed) and CINAHL (EBSCOhost). We included all English studies that measured MPV levels in ED and non-ED subjects. A total of 168 publications were initially retrieved and screened systematically. 12 studies with 1643 subjects were included for both qualitative and quantitative analysis. The MPV mean difference between ED patients and healthy subjects; vasculogenic and non-vasculogenic ED showed significant differences. Our findings show PLT is associated with the development of ED. Higher MPV level was found in the ED subjects compared to the healthy controls. Nevertheless, the evidence is still limited due to the small number of studies and further investigations are required to support the utilization of MPV for ED diagnosis.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Preferred reporting items for systematic review and meta-analysis (PRISMA) flow chart.
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. JAMA. 1993;270:83–90.

    Article  Google Scholar 

  2. Wagner G, Fugl-Meyer KS, Fugl-Meyer AR. Impact of erectile dysfunction on quality of life: patient and partner perspectives. Int J Impot Res. 2000;12:S144–6. https://doi.org/10.1038/sj.ijir.3900594.

    Article  Google Scholar 

  3. Gandaglia G, Briganti A, Jackson G, Kloner RA, Montorsi F, Montorsi P, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014;65:968–78. https://doi.org/10.1016/j.eururo.2013.08.023.

    Article  Google Scholar 

  4. Rondina MT, Weyrich AS, Zimmerman GA. Platelets as cellular effectors of inflammation in vascular diseases. Circ Res. 2013;112:1506–19. https://doi.org/10.1161/CIRCRESAHA.113.300512.

    Article  CAS  Google Scholar 

  5. Sopova K, Tatsidou P, Stellos K. Platelets and platelet interaction with progenitor cells in vascular homeostasis and inflammation. Curr Vasc Pharm. 2012;10:555–62. https://doi.org/10.2174/157016112801784486.

    Article  CAS  Google Scholar 

  6. Ibrahim A, Ali M, Kiernan TJ, Stack AG. Erectile dysfunction and ischaemic heart disease. Eur Cardiol. 2018;13:98–103. https://doi.org/10.15420/ecr.2017.21.3.

    Article  Google Scholar 

  7. Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Vasiliadou C, Alexopoulos N, et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J. 2006;27:2640–8. https://doi.org/10.1093/eurheartj/ehl341.

    Article  CAS  Google Scholar 

  8. Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2014;175:107–11. https://doi.org/10.1016/j.ejogrb.2013.12.036.

    Article  Google Scholar 

  9. Otunctemur A, Bozkurt M, Beşiroğlu H, Polat EC, Ozcan L, Ozbek E. Erectile dysfunction is positively correlated with mean platelet volume and platelet count, but not with eosinophil count in peripheral blood. Urol J. 2015;12:2347–52.

    Google Scholar 

  10. Bayraktar Z, Albayrak S. Blood platelet activity in men with vasculogenic erectile dysfunction. Arch Ital di Urol e Androl. 2017;89:51–4. https://doi.org/10.4081/aiua.2017.1.51.

    Article  CAS  Google Scholar 

  11. Sonmez MG, Goger YE, Sonmez LO, Aydin A, Balasar M, Kara C. Can eosinophil count, platelet count, and mean platelet volume be a positive predictive factor in penile arteriogenic erectile dysfunction etiopathogenesis? Am J Men’s Health. 2017;11:678–83.

    Article  Google Scholar 

  12. La Vignera S, Condorelli RA, Burgio G, Vicari E, Favilla V, Russo GI, et al. Functional characterization of platelets in patients with arterial erectile dysfunction. Andrology. 2014;2:709–15.

    Article  Google Scholar 

  13. Ciftci H, Gumuş K, Yagmur I, Sahabettin S, Çelik H, Yeni E, et al. Assessment of Mean Platelet Volume in men with vasculogenic and nonvasculogenic erectile dysfunction. Int J Impot Res. 2015;27:38–40. https://doi.org/10.1038/ijir.2014.17.

    Article  CAS  Google Scholar 

  14. Aldemir M, Akdemir F, Okulu E, Ener K, Ozayar A, Gudeloglu A. Evaluation of blood platelet count and function in patients with erectile dysfunction. Andrologia. 2016;48:189–92. https://doi.org/10.1111/and.12430.

    Article  CAS  Google Scholar 

  15. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;2019:9213074. https://doi.org/10.1155/2019/9213074.

    Article  CAS  Google Scholar 

  16. Pogorzelska K, Krętowska A, Krawczuk-Rybak M, Sawicka-Żukowska M. Characteristics of platelet indices and their prognostic significance in selected medical condition—a systematic review. Adv Med Sci. 2020;65:310–5.

    Article  Google Scholar 

  17. Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res. 1983;32:443–60. https://doi.org/10.1016/0049-3848(83)90255-4.

    Article  CAS  Google Scholar 

  18. Abdel-rahman TM. Mean platelet volume and prognosis of unstable angina. World J Cardiovasc Dis. 2015;5:32–41.

    Article  Google Scholar 

  19. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010;8:148–56. https://doi.org/10.1111/j.1538-7836.2009.03584.x.

    Article  CAS  Google Scholar 

  20. Yang G, Muzepper M. Platelet indices and erectile dysfunction: a systematic review and meta-analysis. Andrologia. 2019;51:e13248. https://doi.org/10.1111/and.13248.

    Article  Google Scholar 

  21. Moher D, Liberati A, Tetzlaff J, Altman DG,PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097.

    Article  Google Scholar 

  22. Rhoden EL, Teloken C, Sogari PR, Souto CAV. The use of simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res. 2002;14:245–50.

    Article  CAS  Google Scholar 

  23. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30. https://doi.org/10.1016/s0090-4295(97)00238-0.

    Article  CAS  Google Scholar 

  24. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions version 6.2 (updated February 2021). Cochrane. 2021. www.training.cochrane.org/handbook.

  25. Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. 2017;6:79–90. https://doi.org/10.21037/tau.2016.09.06.

    Article  Google Scholar 

  26. Ludwig W, Phillips M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014;92:1–6.

    Article  Google Scholar 

  27. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120:151–7. https://doi.org/10.1016/j.amjmed.2006.06.010.

    Article  Google Scholar 

  28. Meena BL, Kochar DK, Agarwal TD, Choudhary R, Kochar A. Association between erectile dysfunction and cardiovascular risk in individuals with type-2 diabetes without overt cardiovascular disease. Int J Diabetes Dev Ctries. 2009;29:150–4. https://doi.org/10.4103/0973-3930.57345.

    Article  Google Scholar 

  29. Ponholzer A, Temml C, Rauchenwald M, Madersbacher S. Vascular risk factors and erectile dysfunction in a cohort of healthy men. Int J Impot Res. 2006;18:489–93. https://doi.org/10.1038/sj.ijir.3901468.

    Article  CAS  Google Scholar 

  30. Vrentzos GE, Paraskevas KI, Mikhailidis DP. Dyslipidemia as a risk factor for erectile dysfunction. Curr Med Chem. 2007;14:1765–70. https://doi.org/10.2174/092986707781058931.

    Article  CAS  Google Scholar 

  31. Roumeguère T, Wespes E, Carpentier Y, Hoffmann P, Schulman CC. Erectile dysfunction is associated with a high prevalence of hyperlipidemia and coronary heart disease risk. Eur Urol. 2003;44:355–9. https://doi.org/10.1016/s0302-2838(03)00306-3.

    Article  Google Scholar 

  32. Vlachopoulos C, Rokkas K, Ioakeimidis N, Aggeli C, Michaelides A, Roussakis G, et al. Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol. 2005;48:996–1002. https://doi.org/10.1016/j.eururo.2005.08.002.

    Article  Google Scholar 

  33. Inman BA, Sauver JL, Jacobson DJ, McGree ME, Nehra A, Lieber MM, et al. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc. 2009;84:108–13. https://doi.org/10.4065/84.2.108.

    Article  Google Scholar 

  34. Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2011;58:1378–85. https://doi.org/10.1016/j.jacc.2011.06.024.

    Article  Google Scholar 

  35. Pizzulli L, Yang A, Martin JF, Lüderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J. 1998;19:80–4. https://doi.org/10.1053/euhj.1997.0747.

    Article  CAS  Google Scholar 

  36. Wang XS, Guo LQ, Xiao ZY, Guan Y, Zhang JY, Li M, et al. Mean platelet volume might be an effective indicator of arterial erectile dysfunction. Asian J Androl. 2018;21:62–6. https://doi.org/10.4103/aja.aja_74_18.

    Article  Google Scholar 

  37. El Taieb MA, Hegazy EM, Maklad SM, Khairy R. Platelet Indices as a marker for early prediction of erectile dysfunction in diabetic patients. Andrologia. 2019;51:e13163 https://doi.org/10.1111/and.13163.

    Article  CAS  Google Scholar 

  38. Senturk AB, Yaytokgil M, Yilmaz AH, Ekici M, Aydin C, Demir E, et al. Can platelets be the early biomarkers of erectile dysfunction? J Pak Med Assoc. 2018;68:515–518.

    Google Scholar 

  39. Resorlu M, Adam G, Doluoglu OG, Bozkurt S, Sancak BE, Alpaslan A, et al. Mean platelet volume and platelet distribution as a diagnostic marker for penile vascular disease in patients with erectile dysfunction. Rev Int Androl. 2016;14:41–5. https://doi.org/10.1016/j.androl.2015.11.001.

    Article  Google Scholar 

  40. Guo LQ, Liu YQ, Sun WD, Yuan MZ, Xiao ZY, Song HB, et al. significance of platelet distribution width as a severity marker of erectile dysfunction. Andrologia. 2017;49:1–7. https://doi.org/10.1111/and.12628.

    Article  Google Scholar 

  41. Tangal S, Ozayar A, Ener K, Gokçe MI, Haliloglu AH. Does mean platelet volume (MPV) have a role in evaluation of erectile dysfunction and its severity? Rev Int Androl. 2020;18:1–6. https://doi.org/10.1016/j.androl.2018.07.007.

    Article  Google Scholar 

  42. Culha MG, Atalay HA, Canat HL, Alkan I, Ozbir S, Can O, et al. The relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels. Aging Male. 2020;23:173–8. https://doi.org/10.1080/13685538.2018.1459544.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank and appreciate all of the supports from the Department of Urology, Dr. Cipto Mangunkusumo Hospital for allowing this manuscript to be appropriately written and published.

Funding

This research received funding from Universitas Indonesia under PUTI 2020 grant program, project number NKB-1867/UN2.RST/HKP.05.00/2020.

Author information

Authors and Affiliations

  1. Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

    Nur Rasyid, Maruto Harjanggi, Widi Atmoko & Ponco Birowo

Authors
  1. Nur Rasyid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maruto Harjanggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Widi Atmoko
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ponco Birowo
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NR, PB, and MH provided the presented idea. NR and MH wrote the manuscript. MH performed the data analysis. PB and WA did critical reading and editing the manuscript. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Nur Rasyid.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rasyid, N., Harjanggi, M., Atmoko, W. et al. Mean platelet volume as a predictive marker of erectile dysfunction: a meta-analysis. Int J Impot Res 34, 746–752 (2022). https://doi.org/10.1038/s41443-021-00523-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-021-00523-7

This article is cited by

Search

Advanced search

Quick links