The relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels

Erectile dysfunction (ED) is defined as the incapability to develop and/or maintain penile erection, is one of the most common sexual disorders in men. ED is related with advancing age and metabolic syndromes and several cardiovascular risk factors like diabetes mellitus, hypertension and hyperlipidemia.

Vascular ED is the most common among the organic forms of ED, and it is mostly caused by primary atherosclerosis and/or endothelial dysfunction. ED is considered as a first sign of cardiovascular diseases that can identify individuals at an augmented risk of atherosclerotic cardiac disease. Platelets, a component of human blood, play an important role in the pathophysiology of atherothrombosis. Mean platelet volume (MPV) is commonly used to predict the functional alterations and activation of platelets. MPV levels might go up in various cardiovascular diseases, peripheral artery disease, and cerebrovascular diseases. Furthermore, MPV is related to various heart conditions like smoking, obesity, hyperlipidemia, hypertension, coronary artery disease, metabolic syndrome, statin and anti-hypertensive use, atrial fibrillation and systemic inflammation, thyroid diseases, diabetes mellitus and alcohol use. Despite the recognized role of vitamin D in bone and calcium metabolism, its deficit has become more prevalent in recent years. Low 25-hydroxyvitamin D levels are also associated with an increased risk of cardiovascular diseases. It is believed that suboptimal vitamin D levels affect the risk of atherosclerotic cardiovascular disease as well as lead to the development of conditions like hypertension, diabetes, inflammation and endothelial dysfunction, which are predominant vascular risk factors. Also, low vitamin D levels may contribute to the development of ED like heart diseases by causing endothelial dysfunction, inflammation, reduced glucose homeostasis and atherosclerosis. Recently, it has been revealed that MPV and 25-hydroxyvitamin D levels are negatively connected.

The study

This study was done to assess the relationship between mean platelet volume (MPV) and vitamin D levels as per ED severity.

A retrospective review of ED patients who applied to the andrology outpatient clinic was done.

The International Erectile Function Index-Erectile Function (IIEF-EF) questionnaire was used to measure the level of erectile function.

 As per this scoring system, patients were divided into two groups.

• IIEF score: between 17 and 25 = mild ED (Group 1)
• IIEF score between 16 and 0 = moderate-severe ED (Group 2)

Blood samples were taken from antecubital vein and MPV and 25-hydroxyvitamin D levels were evaluated.

In total, 90 patients were included in the study. These were randomized to Group 1 (n = 41) and Group 2 (n = 49). MPV levels were significantly greater in Group 2 (p = 0.001). IIEF-EF scores and 25-hydroxyvitamin D levels were positively correlated and a negative correlation was noted between IIEF-EF scores and MPV and between 25-hydroxyvitamin D levels and MPV levels.

The verdict

Significant positive correlation between ED severity and 25-hydroxyvitamin D levels and a significant negative correlation between ED severity and MPV levels was noted.

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