title: Spermatozoal cell death-inducing DNA fragmentation factor-α-like effector A (CIDEA) gene expression and DNA fragmentation in infertile men with metabolic syndrome and normal seminogram.
abstract: BACKGROUND
  This is the first study to investigate spermatozoal cell death-inducing DNA fragmentation factor-α-like effector A (CIDEA) gene expression and DNA fragmentations in the spermatozoa of men diagnosed with metabolic syndrome (MS) who have normal seminograms with unexplained infertility, and to correlate these parameters with seminal glucose concentration.
  
  
  METHODS
  This study included 120 participants: 75 male subjects with MS (38 fertile and 37 infertile), and a control group of 45 fertile males without MS. HOMA-IR, semen analysis, and biochemical measurement of seminal plasma insulin and glucose levels were carried out. Spermatozoal insulin gene and CIDEA gene expressions were performed by the RT-PCR method. The percentage of spermatozoal DNA fragmentation was also estimated.
  
  
  RESULTS
  The spermatozoal insulin and CIDEA gene expression, as well as the DNA fragmentation, were significantly higher in the infertile MS group than in the fertile MS group, and significantly higher in both the MS groups than in the control group. Seminal glucose concentration showed significant positive correlations with seminal insulin level, spermatozoa insulin, CIDEA gene expression, and DNA fragmentation. Moreover, there was a positive correlation between spermatozoa CIDEA gene expression and DNA fragmentation.
  
  
  CONCLUSIONS
  It can be concluded that MS may affect male fertility at the molecular level, through its possible inducing effect of spermatozoa CIDEA and insulin gene expression, DNA fragmentation, and increased seminal glucose.
authors.affiliation: Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia ; Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ayman Z
authors.initials: AZ
authors.lastname: Elsamanoudy
authors.affiliation: Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Hussein Abdelaziz
authors.initials: HA
authors.lastname: Abdalla
authors.affiliation: Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia ; Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hassanien
authors.affiliation: Department of Dermatology, Andrology and STDs, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Gaballah
keywords: CIDEA; DNA fragmentation; Insulin genes expression; Male infertility; Metabolic syndrome; Seminal glucose