Condorelli Rosita A, Calogero Aldo E, Cannarella Rossella, Giacone Filippo, Mongioi' Laura M, Cimino Laura, Aversa Antonio, La Vignera Sandro
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
J Clin Med. 2019 Apr 28;8(5):585. doi: 10.3390/jcm8050585.
. In recent years, research has focused on the impact that diabetes mellitus (DM) has on male reproductive function. The available evidence has mainly considered type 2 DM (DM2). However, we have previously shown that type 1 DM (DM1) also affects male reproductive health. Given the efficacy of carnitine in the treatment of male infertility, a topic that merits further investigation is its role in the treatment of infertile patients with DM1. To investigate the efficacy of carnitines for the treatment of asthenozoospermia in DM1 patients. This was a two-arm single-blind, randomized control trial. The patients enrolled in this study were assigned to the group receiving L-acetylcarnitine (LAC) (1.5 g daily for 4 months) or to the group receiving LAC (same dosage) plus L-carnitine (LC) (2 g daily for 4 months). Serum-glycated hemoglobin levels did not differ significantly after either of the two treatments given. Administration of LAC plus LC showed greater efficacy on progressive sperm motility than single therapy (increase 14% vs. 1% after treatment, respectively). The results of this study showed that the administration of LAC plus LC is more effective than the administration of LAC alone. The lower efficacy of LAC alone could be due to the lower overall administered dosage. Alternatively, a selective defect of carnitine transporters at an epididymal level could be hypothesized in patients with DM1. Further studies are needed to clarify this point.
近年来，研究聚焦于糖尿病（DM）对男性生殖功能的影响。现有证据主要针对2型糖尿病（DM2）。然而，我们之前已表明1型糖尿病（DM1）也会影响男性生殖健康。鉴于肉碱在治疗男性不育症方面的疗效，一个值得进一步研究的课题是其在治疗DM1不育患者中的作用。为研究肉碱对DM1患者弱精子症的治疗效果。这是一项双臂单盲随机对照试验。本研究纳入的患者被分配至接受L-乙酰肉碱（LAC）（每日1.5克，持续4个月）的组或接受LAC（相同剂量）加L-肉碱（LC）（每日2克，持续4个月）的组。两种治疗后血清糖化血红蛋白水平均无显著差异。LAC加LC治疗在改善精子前向运动能力方面比单一疗法更有效（治疗后分别增加14%和1%）。本研究结果表明，LAC加LC联合给药比单独使用LAC更有效。单独使用LAC疗效较低可能是由于总体给药剂量较低。或者，可以推测DM1患者在附睾水平存在肉碱转运体的选择性缺陷。需要进一步研究来阐明这一点。
