Wagner Isabel Viola, Klöting Nora, Savchuk Iuliia, Eifler Lisa, Kulle Alexandra, Kralisch-Jäcklein Susan, Dötsch Jörg, Hiort Olaf, Svechnikov Konstantin, Söder Olle
Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Pediatrics, Medical Faculty, University of Cologne, Cologne, Germany.
Endocrinology. 2021 Apr 1;162(4). doi: 10.1210/endocr/bqab017.
Type 1 diabetes mellitus (T1DM) is associated with impaired spermatogenesis and lower testosterone levels and epididymal weight. However, the underlying processes in the testis are unknown and remain to be elucidated. Therefore, the present study focused on the effects of T1DM on testicular function in a spontaneously diabetic rat model. BB/OKL rats after diabetes manifestation were divided into 3 groups: those without insulin treatment and insulin treatment for a duration of 2 and of 6 weeks. Anthropometrical data, circulating levels of gonadotrophins, testosterone, and inhibin B were measured. Intratesticular testosterone, oxidative stress, inflammation, and apoptosis were analyzed. Key enzymes of steroidogenesis were evaluated in the testis. Untreated diabetic rats had significantly lower serum follicle-stimulating hormone and luteinizing hormone levels. Serum and intratesticular testosterone levels significantly decreased in untreated diabetic rats compared to healthy controls. Key markers of Leydig cell function were significantly downregulated at the RNA level: insulin-like factor 3 (Insl3) by 53% (P = .006), Star by 51% (P = .004), Cyp11A1 by 80% (P = .003), 3Beta-Hsd2 by 61% (P = .005), and Pbr by 52% (P = .002). In the insulin-treated group, only Cyp11A1 and 3Beta-Hsd2 transcripts were significantly lower. Interestingly, the long-term insulin-treated group showed significant upregulation of most steroidogenic enzymes without affecting testosterone levels. Tumor necrosis factor α and apoptosis were significantly increased in the long-term insulin-treated rats. In conclusion T1DM, with a severe lack of insulin, has an adverse action on Leydig cell function. This is partially reversible with well-compensated blood glucose control. Long-term T1DM adversely affects Leydig cell function because of the process of inflammation and apoptosis.
1型糖尿病(T1DM)与精子发生受损、睾酮水平降低及附睾重量减轻有关。然而,睾丸中的潜在机制尚不清楚,仍有待阐明。因此,本研究聚焦于T1DM对自发性糖尿病大鼠模型睾丸功能的影响。糖尿病症状出现后的BB/OKL大鼠被分为3组:未接受胰岛素治疗组、接受2周胰岛素治疗组和接受6周胰岛素治疗组。测量人体测量数据、促性腺激素、睾酮和抑制素B的循环水平。分析睾丸内睾酮、氧化应激、炎症和细胞凋亡情况。评估睾丸中类固醇生成的关键酶。未治疗的糖尿病大鼠血清促卵泡激素和促黄体生成素水平显著降低。与健康对照组相比,未治疗的糖尿病大鼠血清和睾丸内睾酮水平显著下降。睾丸间质细胞功能的关键标志物在RNA水平显著下调:胰岛素样因子3(Insl3)下调53%(P = 0.006),类固醇生成急性调节蛋白(Star)下调51%(P = 0.004),细胞色素P450侧链裂解酶(Cyp11A1)下调80%(P = 0.003),3β-羟基类固醇脱氢酶2(3Beta-Hsd2)下调61%(P = 0.005),外周型苯二氮䓬受体(Pbr)下调52%(P = 0.002)。在胰岛素治疗组中,只有Cyp11A1和3Beta-Hsd2转录本显著降低。有趣的是,长期胰岛素治疗组大多数类固醇生成酶显著上调,但不影响睾酮水平。长期胰岛素治疗的大鼠肿瘤坏死因子α和细胞凋亡显著增加。总之,严重缺乏胰岛素的T1DM对睾丸间质细胞功能有不良作用。通过良好的血糖控制,这种作用部分可逆。长期T1DM由于炎症和细胞凋亡过程对睾丸间质细胞功能产生不利影响。