The Burden of Metabolic Diseases on Male Reproductive Health

Type 2 Diabetes effects Male Fertility

During the recent decades, we have witnessed fertility rates dwindling worldwide, while metabolic diseases followed an opposite tendency, with their prevalence dramatically increasing . Those trends are particularly marked in both developed and under-development countries, where type 2 diabetes mellitus (T2DM) and obesity are key players in the ever-increasingly number of new metabolic disorder cases, fostered by overeating and sedentarism.

The previous premises, acting during the same time period, arose the possibility of metabolic disorders and infertility were somehow connected. In addition, a normal reproductive function requires a significant quantity of energy, so it is highly influenced by energy homeostasis . Furthermore, the prevalence of reproductive dysfunction is significantly higher in people suffering from metabolic diseases, particularly males. From all the infertility cases documented worldwide, about a third account for male-only factor. In fact, even a pre-diabetic state is enough to harm sperm parameters . However, the mechanisms underlying this link are still controversial.

Unsurprisingly, gut hormones are major players linking metabolic disorders and reproductive function. Insulin is produced and released by pancreatic β-cells in response to high serum glucose concentration, and promotes global glucose uptake and metabolism. Testicular cells are not an exception. Insulin also promotes the expression of glucose transporter family members (GLUT), the glycolytic metabolism and lactate production by Sertoli cells. In addition, type 1 diabetes mellitus (T1DM) patients present lower expression of enzymes linked to glycolysis and GLUTs in testis, and lower lactate concentration in the adluminal compartment . There is also in vitro evidence that those effects are present in Sertoli cells and directly connected to insulin deprivation.

To read full article visit International Journal of Diabetology & Vascular Disease Research

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