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Monserrat-Mesquida M, Quetglas-Llabrés MM, Bouzas C, García S, Mateos D, Ugarriza L, Gómez C, Tur JA, Sureda A. Effects of Regular Exercise on the Biochemical, Oxidative, and Inflammatory Profiles and Quality of Life in Older Spaniards with Metabolic Syndrome. Antioxidants (Basel) 2024; 13:450. [PMID: 38671898 PMCID: PMC11047339 DOI: 10.3390/antiox13040450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Metabolic syndrome increases the risk of developing diabetes and cardiovascular disease. The regular practice of physical activity is a crucial factor for healthy aging and for controlling and preventing chronic diseases. To assess the effects of regular physical activity on the biochemical and inflammatory profiles, as well as the quality of life of older adults diagnosed with metabolic syndrome. Participants (aged 55-70 years; living in the Balearic Islands, Spain) were divided into two groups (n = 50 each) according to the degree of physical activity measured by metabolic equivalents of task (METs). Anthropometric parameters, blood pressure, biochemical and hematological parameters, and inflammatory biomarkers were measured. Beck Depression Inventory and adherence to the Mediterranean diet questionnaires, as well as the Dietary Inflammatory Index, chair test, health-related quality of life (HRQoL), and Rapid Assessment of Physical Activity, were also determined. The characterization of the patients was similar in both groups, showing a homogeneous sample. The group with the highest METs experienced a decrease in depression and an increase in the intensity of physical activity. Adherence to the Mediterranean diet and HRQoL physical dimensions increased in participants with the highest METs, also showing a decrease in glycemia and glycosylated hemoglobin values. Inflammatory biomarkers, including tumor necrosis factor alpha, interleukin-6, interleukin-1β, and osteoprotegerin, decreased in patients practicing more physical activity. High levels of physical activity are related to a healthier lifestyle, characterized by high adherence to the Mediterranean diet, decreased depressive behavior, oxidative stress, and inflammatory status in older people with metabolic syndrome.
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Affiliation(s)
- Margalida Monserrat-Mesquida
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Maria Magdalena Quetglas-Llabrés
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Silvia García
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - David Mateos
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Lucía Ugarriza
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- C.S. Camp Redó, IBSalut, 07010 Palma de Mallorca, Spain
| | - Cristina Gómez
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Clinical Analysis Service, University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Antoni Sureda
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.M.-M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
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Corona G, Rastrelli G, Sparano C, Vignozzi L, Sforza A, Maggi M. Advances in the treatment of functional male hypogonadism. Expert Rev Endocrinol Metab 2024; 19:163-177. [PMID: 38117229 DOI: 10.1080/17446651.2023.2296022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Functional hypogonadism is frequently found in obese men, particularly those with metabolic complications. Several possible therapeutic approaches could be considered. AREAS COVERED An extensive search on Medline, Embase, and Cochrane databases was performed to retrieve the available studies assessing the change of testosterone (T) and sexual function upon dieting or physical activity programs, as well as glucagon-like peptide 1 analogues. The role of lifestyle interventions associated with T replacement therapy (TRT) was also evaluated. The expert opinion provided here has been corroborated by meta-analyzing the results of the retrieved studies. EXPERT OPINION Current evidence supports the beneficial role of lifestyle modifications in increasing T and improving sexual function as a function of weight loss. While dieting programs are associated with greater effects in younger populations, physical exercise has major effects in older ones. Among the dieting programs, a very low-calorie ketogenic diet shows the best results; aerobic or endurance physical exercise perform similarly. The advantages of functional hypogonadism in lifestyle modifications are empowered by the association with TRT. Therefore, TRT may be a valuable complementary strategy to increase muscle mass and facilitate physical exercise while improving sexual symptoms, thus favoring the motivation and compliance for lifestyle interventions.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence, Italy
| | - Clotilde Sparano
- Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Endocrinology Unit, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence, Italy
| | - Alessandra Sforza
- Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Mario Maggi
- Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Endocrinology Unit, Florence, Italy
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Santi D, Lotti F, Sparano C, Rastrelli G, Isidori AM, Pivonello R, Barbonetti A, Salonia A, Minhas S, Krausz C, Vignozzi L, Maggi M, Corona G. Does an increase in adipose tissue 'weight' affect male fertility? A systematic review and meta-analysis based on semen analysis performed using the WHO 2010 criteria. Andrology 2024; 12:123-136. [PMID: 37226894 DOI: 10.1111/andr.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Obesity negatively impact on the metabolism of sex hormones, leading to reduced testosterone serum levels. However, how the obesity could negatively impact on the overall gonadal function, particularly on male fertility, remained unclear so far. OBJECTIVE To systematically review evidences regarding the influence of body weight excess on the sperm production. METHODS A meta-analysis was conducted, searching all prospective and retrospective observational studies reporting male subjects older than 18 years old, with body weight excess from overweight to severe obesity were considered. Only studies using the V edition of the World Health Organization (WHO) manual for semen analysis interpretation were considered. No specific interventions were considered. Search was focused on studies comparing overweight/obese to normal weight subjects. RESULTS Twenty-eight studies were considered. Total sperm count and sperm progressive motility were significantly lower in overweight compared to normal weight subjects. Meta-regression analyses demonstrated that patients' age impacted on sperm parameters. Similarly, obese men showed lower sperm concentration, total sperm number, progressive and total motilities, and normal morphology lower than normal weight subjects. Reduced sperm concentration in obese men was influenced by age, smoking habit, varicocele, and total testosterone serum levels at meta-regression analyses. CONCLUSIONS The male potential fertility is reduced in subjects with increased body weight, compared to normal weight men. The higher was the increased body weight, the worst was the sperm quantity/quality. This result comprehensively included obesity among non-communicable risk factor for male infertility, shedding new lights on the negative impact of increased body weight on overall gonadal function.
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Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Unit of Endocrinology, Department of Medical Specialties, AziendaOspedaliero-Universitaria of Modena, Modena, Italy
| | - Francesco Lotti
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Clotilde Sparano
- Endocrinology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Centre for Rare Diseases (Endo-ERN accredited), Policlinico Umberto I Hospital, Rome, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- UNESCO, Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Arcangelo Barbonetti
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Suks Minhas
- Department of Urology, Imperial College NHS Healthcare, London, UK
| | - Csilla Krausz
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Center for Prevention, Diagnosis and Treatment of Infertility, Careggi Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Corona DG, Vena W, Pizzocaro A, Rastrelli G, Sparano C, Sforza A, Vignozzi L, Maggi M. Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study. J Endocrinol Invest 2023; 46:2195-2211. [PMID: 37515706 DOI: 10.1007/s40618-023-02136-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/09/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED. METHODS All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively. RESULTS Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal. CONCLUSIONS The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.
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Affiliation(s)
- D G Corona
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy.
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - C Sparano
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - A Sforza
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Graziani A, Grande G, Ferlin A. The complex relation between obstructive sleep apnoea syndrome, hypogonadism and testosterone replacement therapy. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1219239. [PMID: 37881222 PMCID: PMC10597633 DOI: 10.3389/frph.2023.1219239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/22/2023] [Indexed: 10/27/2023] Open
Abstract
Obstructive sleep apnoea syndrome (OSAS) is an under-recognized medical disease. The main risk factors for OSAS are male sex, older age, obesity, and metabolic syndrome, that are also associated with male hypogonadism (MH). Therefore, obesity has been classically identified as the most evident link between OSAS and MH. However, OSAS is per se linked to the development of MH by a combined effect of hypoxia, increased night-time awakenings, reduced sleep efficiency and fragmented sleep. Similarly, MH might represent a risk factor for OSAS, mainly related to sleep disturbances that are frequently associated with low testosterone. Data on testosterone replacement therapy (TRT) in patients with OSAS are limited. Nevertheless, TRT is generally contraindicated by guidelines in the presence of untreated or severe OSAS. TRT might in fact worse OSAS symptoms in different ways. Furthermore, OSAS has been proposed to be a risk factor for secondary polycythaemia and TRT might exacerbate polycythaemia. Therefore, TRT in hypogonadal men affected by untreated OSAS or severe OSAS should be considered with caution and in a personalised way. Nevertheless, the type and dosage of TRT should be considered, as short-term high-dose TRT might worsen OSAS, whereas long-term lower doses could eventually determine a clinical improvement of symptoms of OSAS. Here we reviewed the data on the association between OSAS, MH and TRT, including the opportunity of assessment of patients who develop signs and symptoms of OSAS during TRT by polysomnography.
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Andrade G, Iori I, Hsieh MK, Milani G, Zandoná PCE, Teixeira TA, Drevet JR, Costa EM, Hallak J. Serum lipid profile levels and semen quality: new insights and clinical perspectives for male infertility and men's health. Int Urol Nephrol 2023; 55:2397-2404. [PMID: 37442905 DOI: 10.1007/s11255-023-03688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023]
Abstract
PURPOSE Several clinical scenarios regulate the final ejaculated semen, which is pivotal to reproductive success. Sperm motility and plasma membrane fusogenic activity primarily rely on the peculiar sperm lipid composition, influenced by the patient's metabolism, genetics, nutritional, environmental status, and concomitant clinical entities such as varicocele. This study aimed to determine the relationship between serum lipid profile and testicular function (semen quality and testosterone levels). METHODS This retrospective study uses medical charts of 278 infertile men who attended andrological care between 2000 and 2019. Seminal analysis data, lipid profile, and total serum testosterone were collected. A multiple linear regression analysis was performed to evaluate the influence of the lipid parameters on the seminal variables. Statistical analyses were carried out with p ≤ 0.05 considered statistically significant. RESULTS Seminal creatine kinase activity (p = 0.024) is negatively related to HDL (p = 0.032) and triglycerides (p = 0.037), while total testosterone (p < 0.0001) and seminal volume (p = 0.046) appeared both to be negatively related to triglycerides (p = 0.030 and p = 0.033, respectively). CONCLUSION Medical advice commonly advocated to prevent endothelial dysfunction and cardiovascular disease and improve HDL-cholesterol and triglyceride levels in dyslipidemic patients should also be given to infertile men. Physicians should give patients a thorough assessment, including the blood lipid profile, hormonal status, and routine seminal examinations. We propose a more comprehensive men´s health check-up for the infertile male population, not limited to a simple evaluation of basic sperm parameters.
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Affiliation(s)
- Gustavo Andrade
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Ivan Iori
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Mariana K Hsieh
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Faculdade Israelita de Ciências da Saúde Albert Einstein School of Medicine, Sao Paulo, Brazil
| | - Giovanna Milani
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Pedro C E Zandoná
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil
| | - Thiago A Teixeira
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil
- Division of Urology, Federal University of Amapa, University Hospital, Macapa, Brazil
| | - Joël R Drevet
- Faculty of Medicine, GReD Institute, CNRS-INSERM-Université Clermont Auvergne, CRBC Building, Clermont-Ferrand, France
| | - Elaine Maria Costa
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil
- Division of Endocrinology, University of Sao Paulo, Sao Paulo, Brazil
| | - Jorge Hallak
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil.
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil.
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil.
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Graziani A, Grande G, Martin M, Ferraioli G, Colonnello E, Iafrate M, Dal Moro F, Ferlin A. Chronic Prostatitis/Chronic Pain Pelvic Syndrome and Male Infertility. Life (Basel) 2023; 13:1700. [PMID: 37629557 PMCID: PMC10455764 DOI: 10.3390/life13081700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/29/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is defined as urologic pain or discomfort in the pelvic region, associated with urinary symptoms and/or sexual dysfunction, lasting for at least 3 of the previous 6 months. The rate of symptoms related to prostatitis has a mean prevalence of 8-8.2%. CP/CPPS is most frequent in men younger than 50 years, among whom it is the most common urologic diagnosis. In the last decades, many studies have been published on CP/CPPS and its association with male infertility. The pathophysiologic relation between CP/CPPS and male infertility involves several aspects, which are not well studied yet. A reduction in semen parameters has been demonstrated in patients with CP/CPPS, and several mechanisms have been proposed to represent putative pathophysiological links between CP/CPPS and infertility, including male accessory gland inflammation, metabolic syndrome, inflammatory bowel disease, HPV co-infection and autoimmunity. In light of this evidence, a multidisciplinary approach is advocated for patients with known CP/CPPS, and particular attention is needed for male patients of infertile couples in order to evaluate male accessory glands correctly. In addition, it is advisable that future studies dealing with the treatment of CP/CPPS take into consideration all the different pathophysiological aspects implicated.
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Affiliation(s)
- Andrea Graziani
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
| | - Giuseppe Grande
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
| | - Michel Martin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
| | - Giordana Ferraioli
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy
| | - Elena Colonnello
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Chair of Endocrinology and Medical Sexology (ENDOSEX), University of Tor Vergata, 00133 Rome, Italy
| | - Massimo Iafrate
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy
| | - Fabrizio Dal Moro
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy
| | - Alberto Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
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Corona G, Cucinotta D, Di Lorenzo G, Ferlin A, Giagulli VA, Gnessi L, Isidori AM, Maiorino MI, Miserendino P, Murrone A, Pivonello R, Rochira V, Sangiorgi GM, Stagno G, Foresta C, Lenzi A, Maggi M, Jannini EA. The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction. J Endocrinol Invest 2023; 46:1241-1274. [PMID: 36698034 PMCID: PMC9876440 DOI: 10.1007/s40618-023-02015-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE Erectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized. METHODS The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. RESULTS Several evidence-based statements were released providing the necessary up-to-date guidance in the context of ED with organic and psychosexual comorbidities. Many of them were related to incorrect lifestyle habits suggesting how to associate pharmacotherapies and counseling, in a couple-centered approach. Having the oral therapy with phosphodiesterase type 5 inhibitors as the gold standard along with several other medical and surgical therapies, new therapeutic or controversial options were also discussed. CONCLUSIONS These are the first guidelines based on a multidisciplinary approach that involves the most important Societies related to the field of sexual medicine. This fruitful discussion allowed for a general agreement on several recommendations and suggestions to be reached, which can support all stakeholders in improving couple sexual satisfaction and overall general health.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
| | - D Cucinotta
- Chair of Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Di Lorenzo
- Section of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - V A Giagulli
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "Aldo Moro", Bari, Italy
- Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - L Gnessi
- Section of Food Science, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Section of Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M I Maiorino
- Division of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - P Miserendino
- Diabetology and Endocrinology Unit, ASP #, Caltanissetta, Italy
| | - A Murrone
- Cardiology Unit, Città di Castello and Gubbio-GualdoTadino Hospitals, Azienda Usl Umbria 1, Gubbio, Italy
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- Staff of UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - V Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G M Sangiorgi
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - G Stagno
- Diabetology Unit, ASP Reggio Calabria, Reggio Calabria, Italy
| | - C Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - A Lenzi
- Section of Food Science, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - E A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, E Tower South Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy.
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Crafa A, Calogero AE, Cannarella R, Condorelli RA, Aversa A, La Vignera S. Productivity Index in Clinical Andrology: Research Directions on High-Impact Topics and in Particular on Male Infertility. J Clin Med 2023; 12:jcm12093152. [PMID: 37176596 PMCID: PMC10179551 DOI: 10.3390/jcm12093152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
PURPOSE Andrological diseases have an important social and economic impact as they cause a serious impairment of the quality of life of the affected patient. Epidemiologically, the impact of these disorders is progressively increasing, as demonstrated by the ever-growing prevalence of male infertility. This evidence justifies the rapid development of research in andrology that the scientific community has undertaken in recent decades. This study aims to evaluate the productivity index of the main andrological topics studied and reported in the literature. METHODS The total number of published articles was extracted from the Scopus database by entering the following keywords and mesh terms: "Male Infertility", "Erectile Dysfunction", "Premature Ejaculation", "Male Hypogonadism", "Testicular Tumors", "Prostate Cancer", "Prostatic hyperplasia", "Prostate hyperplasia", "Prostatitis", "Prostate inflammation", and "Male Accessory Gland Infections". Furthermore, a list of the top 50 researchers sorted by productivity was created for each topic. For male infertility, a further search was performed by combining the search term "male infertility" with the above-mentioned terms. Thus, a list of the top 30 authors in order of productivity was also extracted. The graphs were created using Excel. RESULTS AND CONCLUSIONS As could be expected, we observed that prostate cancer and male infertility were the two most investigated topics, followed by benign prostatic hyperplasia and erectile dysfunction, whose prevalence is set to increase given the progressive aging of the population. Less investigated is the inflammation of the accessory sexual glands. In conclusion, this study provides a ranking of the main andrological topics investigated in the literature, also presenting the top list of the most productive authors for each one.
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Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Aldo Eugenio Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
- Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | | | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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10
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Lenert ME, Burton MD. Sensory neuron LKB1 mediates ovarian and reproductive function. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.28.534533. [PMID: 37034663 PMCID: PMC10081243 DOI: 10.1101/2023.03.28.534533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Treatments for reproductive disorders in women primarily consist of hormone replacement therapy, which can have negative health impacts. Bidirectional communication between sensory neurons and innervated organs is an emerging area of interest in tissue physiology with potential relevance for reproductive disorders. Indeed, the metabolic activity of sensory neurons can have profound effects on reproductive phenotypes. To investigate this phenomenon, we utilized a murine model with conditional deletion in sensory neurons of liver kinase B1 (LKB1), a serine/threonine kinase that regulates cellular metabolism. Female mice with this LKB1 deletion (Nav1.8cre;LKB1fl/fl) had significantly more pups per litter compared to wild-type females. Interestingly, the LKB1 genotype of male breeders had no effect on fertility outcomes, thus indicating a female-specific role of sensory neuron metabolism in fertility. LKB1 deletion in sensory neurons resulted in reduced ovarian innervation from dorsal root ganglia neurons and increased follicular turnover compared to littermate controls. In summary, LKB1 expression in peripheral sensory neurons plays an important role in modulating fertility of female mice via ovarian sensory innervation.
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Affiliation(s)
- Melissa E Lenert
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, School of Behavioral and Brain Sciences, Center for Advanced Pain Studies (CAPS), The University of Texas at Dallas, Richardson, TX 75080
| | - Michael D Burton
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, School of Behavioral and Brain Sciences, Center for Advanced Pain Studies (CAPS), The University of Texas at Dallas, Richardson, TX 75080
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11
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Liang J, Chen X, Huang J, Nie W, Yang Q, Huang Q, Deng K. Implications of serum uric acid for female infertility: results from the national health and nutrition examination survey, 2013-2020. BMC Womens Health 2023; 23:103. [PMID: 36906587 PMCID: PMC10007853 DOI: 10.1186/s12905-023-02234-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/19/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND There is limited concrete evidence connecting serum uric acid levels to female infertility. Therefore, this study aimed to find out if serum uric acid levels are independently related to female infertility. METHODS From the National Health and Nutrition Examination Survey (NHANES) 2013-2020, a total sample of 5872 chosen female participants between the ages of 18 and 49 were identified for this cross-sectional study. The serum uric acid levels (mg/dL) of each participant were tested, and the reproductive health questionnaire was used to evaluate each subject's reproductive status. Both in the analyses of the full sample and each subgroup, logistic regression models were used to evaluate the relationship between the two variables. A stratified multivariate logistic regression model was used to perform the subgroup analysis based on serum uric acid levels. RESULTS Infertility was found in 649 (11.1%) of the 5,872 female adults in this study, with greater mean serum uric acid levels (4.7 mg/dL vs. 4.5 mg/dL). Serum uric acid levels were associated with infertility in both the initial and adjusted models. According to multivariate logistic regression, the odds of female infertility were found to be significantly higher with rising serum uric acid levels (Q4 [≥ 5.2 mg/dL] vs. Q1 [≤ 3.6 mg/dL]), adjusted odds ratio [aOR] = 1.59, p = 0.002]. The data suggests that there is a dose-response relationship between the two. CONCLUSIONS The results from this nationally representative sample from the United States confirmed the idea that there is a link between increased serum uric acid levels and female infertility. Future research is necessary to evaluate the relationship between serum uric acid levels and female infertility and explicate the underlying mechanisms of this relationship.
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Affiliation(s)
- Jiemei Liang
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China
| | - Xiting Chen
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China
| | - Jinfa Huang
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China
| | - Weizhe Nie
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China
| | - Qian Yang
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China
| | - Qitao Huang
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China
| | - Kaixian Deng
- Department of Gynaecology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), No. 1, Jiazi Road, Lunjiao Town, Shunde District, Foshan, 528300, Guangdong, China.
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12
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Lotti F, Maggi M. Effects of diabetes mellitus on sperm quality and fertility outcomes: Clinical evidence. Andrology 2023; 11:399-416. [PMID: 36416060 DOI: 10.1111/andr.13342] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diabetes mellitus is a global epidemic characterized by high morbidity and mortality. Diabetes mellitus can lead to acute and chronic systemic complications. Among them, a negative effect of diabetes mellitus on sperm quality and male/couple fertility has been suggested. However, available studies in diabetes mellitus men evaluated relatively small cohorts with discordant results. OBJECTIVES To evaluate the clinical evidences of the effects of diabetes mellitus on sperm quality and fertility outcomes. METHODS An extensive Medline search was performed identifying studies in the English language. RESULTS The prevalence of diabetes mellitus in infertile men ranges from 0.7% to 1.4%, while the prevalence of infertility in diabetes mellitus men, evaluated in a few studies, ranges from 35% to 51%. Male diabetes mellitus seems to play a negative effect on couple fecundity, while being childless or subfertile men might increase the risk of diabetes mellitus. Available cross-sectional studies investigating semen parameters and male sexual hormones in men with diabetes mellitus are heterogeneous, assessed relatively small cohorts, show often discordant results and frequently are not directly comparable to derive robust conclusions. Two meta-analyses support a negative effect of diabetes mellitus on sperm normal morphology and no effect on sperm total count, with contradictory results regarding other semen parameters. Considering only studies on type 1 diabetes mellitus men, meta-analyses support a negative effect of diabetes mellitus on sperm motility and no effect on sperm total count, with contradictory results regarding other semen parameters. The rate of children observed among type 1 diabetes mellitus men was lower than controls, especially in subjects with a longer diabetes mellitus duration. Couples with a diabetes mellitus male partner undergoing assisted reproduction techniques showed lower pregnancy rates than controls. No study evaluated the impact of diabetes mellitus treatment on semen quality and male fertility. CONCLUSIONS Overall, available data show that diabetes mellitus might impair male reproductive health and couple fertility. However, further larger and full of details studies are needed.
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Affiliation(s)
- Francesco Lotti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Andrology, Female Endocrinology, and Gender Incongruence Unit, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Endocrinology Unit, Univesity of Florence, Florence, Italy
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13
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Amer OE, Sabico S, Khattak MNK, Al-Daghri NM. Circulating Nitric Oxide and Metabolic Syndrome in Arab Children and Adolescents: A Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020210. [PMID: 36832339 PMCID: PMC9954847 DOI: 10.3390/children10020210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/12/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) represents a cluster of known cardiometabolic risk factors, which elevates the risk of type 2 diabetes mellitus (T2DM), atherosclerotic cardiovascular disease (CVD) and chronic kidney disease (CKD) in adults and, only recently, even in children and adolescents. Circulating nitric oxide (NOx) has been observed to influence MetS risk factors in adults, but this has been scarcely investigated in children. The aim of the present study was to determine whether circulating NOx levels correlate with known components of MetS in Arab children and adolescents. METHODS Anthropometrics, serum NOx, lipid profile and fasting glucose levels were measured in 740 Saudi Arabs aged 10-17 years (68.8% girls). The presence of MetS was screened using the criteria of de Ferranti et al. Results: Overall, serum NOx levels were significantly higher in MetS participants compared to non-MetS (25.7 µmol/L (10.1-46.7) versus 11.9 µmol/L (5.5-22.9), p < 0.001) even after adjustments for age, BMI and sex. With the exception of elevated blood pressure, higher circulating NOx significantly increased the odds for MetS and its components. Lastly, receiver operating characteristics (ROC) showed that NOx, as a diagnostic marker for MetS, had good sensitivity and was higher in boys than girls (all MetS participants: area under the curve (AUC) = 0.68, p < 0.001), (girls with MetS: AUC = 0.62, p = 0.002), (boys with MetS: AUC = 0.83, p < 0.001)). CONCLUSIONS MetS and most of its components were significantly associated with circulating NOx levels in Arab adolescents and may be a promising diagnostic biomarker for MetS.
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14
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Majzoub A, Elbardisi H, Madani S, Leisegang K, Mahdi M, Agarwal A, Henkel R, Khalafalla K, ElSaid S, Arafa M. Impact of body composition analysis on male sexual function: A metabolic age study. Front Endocrinol (Lausanne) 2023; 13:1050441. [PMID: 36686453 PMCID: PMC9846759 DOI: 10.3389/fendo.2022.1050441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction Metabolic Age (MetAge) and body composition analysis may reflect an individual's metabolic status, which is believed to influence male sexual and gonadal functions. Although erectile dysfunction (ED) and hypogonadism are increasingly prevalent with age, they are also detected among younger men. This study aims to assess the impact of MetAge and body composition on male sexual and gonadal status overall, and particularly in men younger than 40 years of age. Methods This was a cross-sectional study of 90 male healthcare workers, between the ages of 18-55, randomly selected based on their corporation numbers. In addition to Bioelectric Impedance Analysis, subjects were requested to fill the International Index of Erectile Function questionnaire (IIEF-5) and to provide an early morning serum testosterone (T) sample. Results The mean participants' age was 39.4 ± 9.4 years, MetAge was 45.54 ± 10.35 years, serum T level was 13.68 ± 4.49 nmol/L and BMI was 28.8 ± 4.7 kg/m2. Significant negative correlations were obtained between serum T, MetAge, body weight and fat composition. Significant negative correlations between the IIEF-5 score, MetAge, and fat composition, were only reported in subjects <40 years of age. Significantly lower T levels (p=0.002), significantly older MetAge (p=0.034), and higher BMI (p=0.044) and degree of obesity (p=0.042) were observed in participants <40 years with erectile dysfunction (ED) compared to their counterparts without ED. Discussion MetAge and body composition parameters significantly impact the androgenic state. ED in men <40 years is associated with lower T levels, older MetAge and higher BMI and degree of obesity.
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Affiliation(s)
- Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Clinical Urology, Weill Cornell Medicine -Qatar, Doha, Qatar
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Clinical Urology, Weill Cornell Medicine -Qatar, Doha, Qatar
| | - Sarah Madani
- Department of Biology and Physiology or Organisms, University of Science and Technology Houari Boumediene, Algiers, Algeria
| | - Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Mohamed Mahdi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- Case Western Reserve University, Moreland Hills, OH, United States
| | - Ralf Henkel
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
- Department of Metabolism, Digestion and Reproduction at Imperial College London, London, United Kingdom
- LogixX Pharma, Theale, United Kingdom
| | | | - Sami ElSaid
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Clinical Urology, Weill Cornell Medicine -Qatar, Doha, Qatar
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Clinical Urology, Weill Cornell Medicine -Qatar, Doha, Qatar
- Andrology Department, Cairo University, Cairo, Egypt
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15
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Leisegang K. Oxidative Stress in Men with Obesity, Metabolic Syndrome and Type 2 Diabetes Mellitus: Mechanisms and Management of Reproductive Dysfunction. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1358:237-256. [PMID: 35641873 DOI: 10.1007/978-3-030-89340-8_11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Reactive oxygen species (ROS) are critical physiological mediators of cellular function, including male fertility. When ROS exceed antioxidant regulation, oxidative stress occurs which is detrimental to cellular function. Oxidative stress has been found to be a central mediator of obesity, metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM), as well as with male infertility. Human studies have correlated testicular oxidative stress in obese males, and animal studies have further provided insight into potential mechanisms of action. Management of oxidative stress is not well defined. Appropriate nutrition and exercise can be recommended for all diabetic patients, and weight loss for obese patients with MetS and T2DM. Consideration of dietary supplements including micronutrients, antioxidants or medicinal herbs are recommended. Metformin may also offer benefits on testicular oxidative stress and fertility parameters. Significantly more research on causation, mechanisms, clinical assessments and appropriate management of infertility on obesity, MetS and T2DM is still required.
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Affiliation(s)
- Kristian Leisegang
- School of Natural Medicine, University of the Western Cape, Bellville, Cape Town, South Africa.
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16
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Salvio G, Ciarloni A, Cutini M, delli Muti N, Finocchi F, Perrone M, Rossi S, Balercia G. Metabolic Syndrome and Male Fertility: Beyond Heart Consequences of a Complex Cardiometabolic Endocrinopathy. Int J Mol Sci 2022; 23:ijms23105497. [PMID: 35628307 PMCID: PMC9143238 DOI: 10.3390/ijms23105497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/02/2022] [Accepted: 05/13/2022] [Indexed: 12/06/2022] Open
Abstract
Metabolic syndrome (MetS) is a highly prevalent condition among adult males, affecting up to 41% of men in Europe. It is characterized by the association of obesity, hypertension, and atherogenic dyslipidemia, which lead to premature morbidity and mortality due to cardiovascular disease (CVD). Male infertility is another common condition which accounts for about 50% of cases of couple infertility worldwide. Interestingly, male infertility and MetS shares several risk factors (e.g., smoking, ageing, physical inactivity, and excessive alcohol consumption), leading to reactive oxygen species (ROS) production and increased oxidative stress (OS), and resulting in endothelial dysfunction and altered semen quality. Thus, the present narrative review aims to discuss the pathophysiological mechanisms which link male infertility and MetS and to investigate the latest available evidence on the reproductive consequences of MetS.
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17
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Triglycerides/Glucose Index is Associated with Sperm Parameters and Sperm DNA Fragmentation in Primary Infertile Men: A Cross-Sectional Study. Metabolites 2022; 12:metabo12020143. [PMID: 35208217 PMCID: PMC8875300 DOI: 10.3390/metabo12020143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/04/2022] Open
Abstract
Study question: we aimed to investigate the relationship between the tyg index and both semen and hormonal characteristics in a cohort of primary infertile men. Summary answer: almost one in two primary infertile men presented with a triglycerides/glucose index (tyg) suggestive of insulin resistance (ir). overall, patients with tyg suggestive of ir showed worse clinical, hormonal, and semen parameters. What is already known: male factor infertility (MFI) is often associated with metabolic disorders such as diabetes mellitus and metabolic syndrome, where insulin resistance (IR) plays a relevant pathological role. Recently, TyG has been suggested as a user-friendly IR marker. Study Design: serum hormones and the sperm DNA fragmentation index (SDF) were measured in every patient. The semen analysis was based on 2010 WHO reference criteria. Glucose and insulin levels were measured for every man after a 12-h overnight fast, and the homeostatic model assessment index (HOMA-IR) was then calculated and categorized using a 2.6 threshold. Similarly, fasting glucose and triglycerides levels were measured and the TyG index was calculated and categorized using an 8.1 threshold. Descriptive statistics and logistic regression models tested the association between the TyG and semen and hormonal characteristics. Participants: complete demographic, clinical, and laboratory data from 726 consecutive white European primary infertile men were considered for this analysis. Main results and the role of chance: the median (IQR) age was 39 (35–43) years. A TyG and HOMA suggestive for IR was found in 339 (46.6%) and 154 (21.2%) men, respectively. During the Spearman’s test, the TyG index was highly correlated with HOMA-IR (rho = 0.46, p < 0.001). Compared to men with a normal TyG, men with TyG > 8.1 were older, had greater BMI and CCI scores, and lower total testosterone and sperm concentration, but higher DFI, and presented a greater proportion of NOA (all p < 0.01). The multivariable logistic regression analysis showed that men with TyG > 8.1 were at higher risk of SDF > 30 (OR 1.92 (CI: 1.2–2.9)) and NOA (OR 1.78 (CI: 1.1–2.8)). Wider implications of the findings: the Tyng index may act as a reliable marker of IR in the clinical work-up of primary infertile men in real-life settings.
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18
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Jayasena CN, Anderson RA, Llahana S, Barth JH, MacKenzie F, Wilkes S, Smith N, Sooriakumaran P, Minhas S, Wu FCW, Tomlinson J, Quinton R. Society for Endocrinology guidelines for testosterone replacement therapy in male hypogonadism. Clin Endocrinol (Oxf) 2022; 96:200-219. [PMID: 34811785 DOI: 10.1111/cen.14633] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 12/15/2022]
Abstract
Male hypogonadism (MH) is a common endocrine disorder. However, uncertainties and variations in its diagnosis and management exist. There are several current guidelines on testosterone replacement therapy that have been driven predominantly by single disciplines. The Society for Endocrinology commissioned this new guideline to provide all care providers with a multidisciplinary approach to treating patients with MH. This guideline has been compiled using expertise from endocrine (medical and nursing), primary care, clinical biochemistry, urology and reproductive medicine practices. These guidelines also provide a patient perspective to help clinicians best manage MH.
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Affiliation(s)
- Channa N Jayasena
- Section of Investigative Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | | | - Sofia Llahana
- School of Health Sciences, City, University of London, London & Department of Endocrinology & Diabetes, University College London Hospitals (UCLH) NHS Foundation Trust, London, UK
| | - Julian H Barth
- Specialist Laboratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Finlay MacKenzie
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Scott Wilkes
- School of Medicine, University of Sunderland, Sunderland, UK
| | | | - Prasanna Sooriakumaran
- Department of Uro-oncology, UCLH NHS Foundation Trust, London & Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Sukhbinder Minhas
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Frederick C W Wu
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jeremy Tomlinson
- Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK
| | - Richard Quinton
- Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals NHS Foundation Trust & Translational & Clinical Research Institute, University of Newcastle-upon-Tyne, UK
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Corona G, Rastrelli G, Vignozzi L, Barbonetti A, Sforza A, Mannucci E, Maggi M. The Role of testosterone treatment in patients with metabolic disorders. Expert Rev Clin Pharmacol 2021; 14:1091-1103. [PMID: 34085587 DOI: 10.1080/17512433.2021.1938548] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The specific role of testosterone [T] replacement therapy [TRT] on glycometabolic profile and body composition, particularly in patients with metabolic syndrome [MetS] and/or type 2 diabetes mellitus [T2DM], is still the object of an intense debate. AREAS COVERED To discuss available evidence on the association between T and metabolic diseases and on the possible effect of T administration on metabolic disorder-associated hypogonadism. Both preclinical and clinical data have been considered. In addition, a meta-analysis of the available placebo and non-placebo-controlled randomized clinical trials [RCTs] investigating the effects of TRT in T2DM or MetS in several outcomes has been also performed. EXPERT OPINION Data derived from preclinical and clinical studies suggest that T administration, by reducing fat mass, can improve body composition and ameliorate some aspects of glucose metabolism. The effects of TRT on sexual function in patients with established metabolic derangements are inconsistent, whereas better results were observed in preclinical conditions or in patients with newly diagnosed T2DM.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Arcangelo Barbonetti
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandra Sforza
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Edoardo Mannucci
- Department of Diabetology, Azienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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