Phillips Karen P, Tanphaichitr Nongnuj
a Assistant Professor, Interdisciplinary School of Health Sciences, Faculty of Health Sciences, Principal Scientist, Institute of Population Health, University of Ottawa, 43 Templeton Street, Room 215, Ottawa, ON K1N 6N5, Canada.
b Senior Scientist, Ottawa Hospital Research Institute, and Professor in Obstetrics and Gynecology, and Biochemistry/Microbiology/Immunology, University of Ottawa, 725 Parkdale Avenue, Ottawa, ON K1Y 4E9, Canada.
Expert Rev Endocrinol Metab. 2010 Mar;5(2):229-251. doi: 10.1586/eem.09.65.
Male infertility, characterized by hypogonadism, decreased semen quality or ejaculatory dysfunction, accounts for approximately 20% of infertility cases. Obesity and metabolic dysfunction have been identified, among other causal factors, to contribute to male infertility. In the context of the Western world's 'obesity epidemic', this article discusses three main biological mechanisms linking obesity to impaired male reproductive function: hypogonadism, testicular heat stress/hypoxia-induced apoptosis and endocrine disruption by 'obesogens'. Among these, obesity-induced hypogonadism is undoubtedly the most clinically significant and is easily assessed. Rapidly expanding areas of research in this area include leptin modulation of kisspeptins and hypothalamic-pituitary-testicular hormone pathways, and roles of other adipocytokines in male infertility, as well as the impact of exposure to obesogens on the quality of semen.
男性不育症以性腺功能减退、精液质量下降或射精功能障碍为特征，约占不育病例的20%。除其他致病因素外，肥胖和代谢功能障碍已被确定为导致男性不育的因素。在西方世界“肥胖流行”的背景下，本文讨论了将肥胖与男性生殖功能受损联系起来的三种主要生物学机制：性腺功能减退、睾丸热应激/缺氧诱导的细胞凋亡以及“肥胖因子”引起的内分泌干扰。其中，肥胖引起的性腺功能减退无疑是临床上最重要的，并且易于评估。该领域迅速扩展的研究领域包括瘦素对 kisspeptins 和下丘脑 - 垂体 - 睾丸激素途径的调节、其他脂肪细胞因子在男性不育中的作用，以及接触肥胖因子对精液质量的影响。
