title: Metabolic syndrome in white European men presenting for primary couple's infertility: investigation of the clinical and reproductive burden.
abstract: Despite complex interactions between obesity, dyslipidemia, hyperinsulinaemia, and the reproductive axis, the impact of metabolic syndrome on human male reproductive function has not been analysed comprehensively. Complete demographic, clinical, and laboratory data from 1337 consecutive primary infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (categorised 0 vs. 1 vs. 2 or higher). NCEP-ATPIII criteria were used to define metabolic syndrome. Semen analysis values were assessed based on the 2010 World Health Organisation (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and metabolic syndrome. Metabolic syndrome was found in 128 (9.6%) of 1337 men. Patients with metabolic syndrome were older (p < 0.001) and had a greater Charlson Comorbidity Index of 1 or higher (chi-square: 15.6; p < 0.001) compared with those without metabolic syndrome. Metabolic syndrome patients had lower levels of total testosterone (p < 0.001), sex hormone-binding globulin (p = 0.004), inhibin B (p = 0.03), and anti-Müllerian hormone (p = 0.009), and they were hypogonadal at a higher rate (chi-square: 32.0; p < 0.001) than patients without metabolic syndrome. Conversely, the two groups did not differ significantly in further hormonal levels, semen parameters, and rate of either obstructive or non-obstructive azoospermia. At multivariate logistic regression analysis, testicular volume (OR: 0.90; p = 0.002) achieved independent predictor status for WHO pathological semen concentration; conversely, age, Charlson Comorbidity Index scores, metabolic syndrome, and inhibin B values did not. No parameters predicted normal sperm morphology and total progressive motility. Metabolic syndrome accounts for roughly 9% of men presenting for primary couple's infertility. Although metabolic syndrome patients have a lower general male health status, semen analysis values seem independent of the presence of metabolic syndrome.
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.|Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ventimiglia
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.|Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Capogrosso
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Colicchia
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Boeri
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Serino
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.|Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Castagna
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Clementi
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.|Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: La Croce
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Regina
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Department of Urology, University of Naples Federico II, Naples, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Mirone
authors.affiliation: Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Damiano
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.|Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Montorsi
authors.affiliation: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.|Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Salonia
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood; D053713:Azoospermia / Q000097:blood / Q000150:complications; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000150:complications*; D007248:Infertility, Male / Q000097:blood / Q000150:complications*; D007265:Inhibins / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D055101:Semen Analysis; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013081:Sperm Motility; D013739:Testosterone / Q000097:blood*; D044465:White People
chemical_list: D012738:Sex Hormone-Binding Globulin; C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D054304:Anti-Mullerian Hormone
keywords: hypogonadism; infertility; metabolic syndrome; semen analysis