Alves M G, Martins A D, Rato L, Moreira P I, Socorro S, Oliveira P F
University of Beira Interior, Covilhã, Portugal.
Biochim Biophys Acta. 2013 May;1832(5):626-35. doi: 10.1016/j.bbadis.2013.01.011. Epub 2013 Jan 21.
Diabetes mellitus (DM) is one of the greatest public health threats in modern societies. Although during a few years it was suggested that DM had no significant effect in male reproductive function, this view has been challenged in recent years. The increasing incidence of DM worldwide will inevitably result in a higher prevalence of this pathology in men of reproductive age and subfertility or infertility associated with DM is expected to dramatically rise in upcoming years. From a clinical perspective, the evaluation of semen parameters, as well as spermatozoa deoxyribonucleic acid (DNA) integrity, are often studied due to their direct implications in natural and assisted conception. Nevertheless, recent studies based on the molecular mechanisms beyond glucose transport in testicular cells provide new insights in DM-induced alterations in male reproductive health. Testicular cells have their own glucose sensing machinery that react to hormonal fluctuations and have several mechanisms to counteract hyper- and hypoglycemic events. Moreover, the metabolic cooperation between testicular cells is crucial for normal spermatogenesis. Sertoli cells (SCs), which are the main components of blood-testis barrier, are not only responsible for the physical support of germ cells but also for lactate production that is then metabolized by the developing germ cells. Any alteration in this tied metabolic cooperation may have a dramatic consequence in male fertility potential. Therefore, we present an overview of the clinical significance of DM in the male reproductive health with emphasis on the molecular mechanisms beyond glucose fluctuation and transport in testicular cells.
糖尿病（DM）是现代社会中最大的公共卫生威胁之一。尽管在过去几年有人提出糖尿病对男性生殖功能没有显著影响，但近年来这一观点受到了挑战。全球糖尿病发病率的上升将不可避免地导致育龄男性中这种疾病的患病率更高，预计未来几年与糖尿病相关的亚生育力或不育症患病率将大幅上升。从临床角度来看，由于精液参数以及精子脱氧核糖核酸（DNA）完整性对自然受孕和辅助受孕有直接影响，因此常对其进行研究。然而，最近基于睾丸细胞葡萄糖转运分子机制的研究为糖尿病引起的男性生殖健康改变提供了新的见解。睾丸细胞有自己的葡萄糖感应机制，可对激素波动做出反应，并具有多种机制来应对高血糖和低血糖事件。此外，睾丸细胞之间的代谢协作对于正常精子发生至关重要。作为血睾屏障主要成分的支持细胞（SCs）不仅负责为生精细胞提供物理支持，还负责产生乳酸，然后发育中的生精细胞会对乳酸进行代谢。这种紧密的代谢协作中的任何改变都可能对男性生育潜力产生重大影响。因此，我们概述了糖尿病在男性生殖健康中的临床意义，重点关注睾丸细胞中葡萄糖波动和转运背后的分子机制。
