title: Reproductive function in male patients with type 1 diabetes mellitus.
abstract: This study was undertaken to evaluate conventional and some of the main bio-functional spermatozoa parameters, serum gonadal hormones and didymo-epididymal ultrasound features in patients with type 1 diabetes mellitus (DM1). DM1 affects an increasing number of men of reproductive age. Diabetes may affect male reproduction by acting on the hypothalamic-pituitary-testicular axis, causing sexual dysfunction or disrupting male accessory gland function. However, data on spermatozoa parameters and other aspects of the reproductive function in these patients are scanty. Thirty-two patients with DM1 [27.0 (25.0-30.0 years)] and 20 age-matched fertile healthy men [28.0 (27.25-30.75 years)] were enrolled. Patients with diabetic neuropathy, other endocrine disorders or conditions known to alter spermatozoa parameters were excluded. Each subject underwent semen analysis, blood withdrawal for fasting and post-prandial glycaemia, hormonal analysis and didymo-epididymal ultrasound evaluation before and after ejaculation. Patients with DM1 had a lower percentage of spermatozoa with progressive motility [10.0 (7.0-12.75) vs. 45.0 (42.0-47.75) %; p < 0.01] and a higher percentage of spermatozoa with abnormal mitochondrial function than controls [47.0 (43.0-55.0) vs. 2.0 (1.0-5.0) %; p < 0.01]. Patients also had greater post-ejaculatory diameters of cephalic [11.5 (10.2-13.6) vs. 6.0 (4.0-7.0) mm; p < 0.01] and caudal epididymis [5.5 (4.00-7.55) vs. 3.0 (2.0-4.0) mm; p < 0.01] compared to controls, suggesting a lack of the physiological post-ejaculation epididymal shrinkage. Correlation analysis suggested that progressive motility was associated with fasting glucose (r = -0.68; p < 0.01). The other parameters did not show any significant difference. Patients with DM1 had a lower percentage of spermatozoa with progressive motility, impaired mitochondrial function and epididymal post-ejaculatory dysfunction. These findings may explain why patients with DM1 experience fertility disturbance. Larger multi-centric studies are necessary to confirm these results.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: La Vignera
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: R A
authors.initials: RA
authors.lastname: Condorelli
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Mauro
authors.affiliation: Unit of Pediatrics, Teaching Hospital "Policlinico - Vittorio Emanuele", University of Catania, Catania, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Lo Presti
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Mongioì
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Russo
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: A E
authors.initials: AE
authors.lastname: Calogero
mesh_terms: D000328:Adult; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D004249:DNA Damage; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008928:Mitochondria / Q000378:metabolism / Q000473:pathology; D012098:Reproduction; D012307:Risk Factors; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000378:metabolism / Q000473:pathology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: male infertility; mitochondrial function; type 1 diabetes mellitus