López-Lemus Uriel A, Garza-Guajardo Raquel, Barboza-Quintana Oralia, Rodríguez-Hernandez Alejandrina, García-Rivera Alejandro, Madrigal-Pérez Violeta M, Guzmán-Esquivel José, García-Labastida Laura E, Soriano-Hernández Alejandro D, Martínez-Fierro Margarita L, Rodríguez-Sánchez Iram P, Sánchez-Duarte Elizabeth, Cabrera-Licona Ariana, Ceja-Espiritu Gabriel, Delgado-Enciso Iván
1 School of Medicine, University of Colima, Colima, Mexico.
2 Department of Pathological Anatomy and Cytopathology, University Hospital "Dr José Eleuterio González," Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico.
Am J Mens Health. 2018 May;12(3):639-648. doi: 10.1177/1557988318763631. Epub 2018 Mar 26.
Metabolic syndrome (MS) has been associated with testicular damage. Nonalcoholic fatty liver disease (NAFLD) is a multisystemic disease that affects different organs, but its effect on the testes is unknown. A study analyzing germ cell involvement on BALB/c mice was carried out. A parallel comparative study was conducted that investigated alterations in the germinal epithelium of male humans that died from an unrelated acute event. The complete medical histories and histologic samples of the thoracic aorta, liver tissue, and testicular tissue from the deceased subjects were collected. The degree of germinal epithelial loss (DGEL) was evaluated and the clinical and histologic data were compared between individuals with and without NAFLD. The only metabolic or morphologic variable that caused a significant difference in the DGEL, in both the animal model and humans, was the presence of liver steatosis. The percentage of steatosis was also correlated with the percentage of the DGEL. In humans, steatosis (greater than 20%) increased the risk 12-fold for presenting with a severe DGEL (OR: 12.5; 95% CI [1.2, 128.9]; p = .03). There was no association with age above 50 years or MS components. Steatosis grade was also correlated with atherosclerosis grade. NAFLD was a strongly associated factor implicated in severe DGEL, as well as the testis was identified as a probable target organ for damage caused by the disease. This finding could result in the search for new approach strategies in the management of men with fertility problems. Further studies are required to confirm these results.
代谢综合征（MS）与睾丸损伤有关。非酒精性脂肪性肝病（NAFLD）是一种影响不同器官的多系统疾病，但其对睾丸的影响尚不清楚。开展了一项分析BALB/c小鼠生殖细胞受累情况的研究。进行了一项平行对照研究，调查死于无关急性事件的男性生发上皮的改变。收集了已故受试者的完整病史以及胸主动脉、肝组织和睾丸组织的组织学样本。评估生发上皮丢失程度（DGEL），并比较有无NAFLD个体的临床和组织学数据。在动物模型和人类中，唯一导致DGEL出现显著差异的代谢或形态学变量是肝脂肪变性的存在。脂肪变性百分比也与DGEL百分比相关。在人类中，脂肪变性（大于20%）使出现严重DGEL的风险增加12倍（比值比：12.5；95%置信区间[1.2, 128.9]；p = 0.03）。与50岁以上年龄或MS组分无关。脂肪变性分级也与动脉粥样硬化分级相关。NAFLD是与严重DGEL密切相关的因素，睾丸也被确定为该疾病所致损伤的可能靶器官。这一发现可能会促使人们寻找治疗有生育问题男性的新方法策略。需要进一步研究来证实这些结果。
