Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy.
Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy.
J Endocrinol Invest. 2024 Jul;47(7):1787-1795. doi: 10.1007/s40618-023-02285-z. Epub 2024 Jan 16.
The aim of the present study is to evaluate the association of metabolic and glycemic variables with semen parameters in patients with type 1 diabetes (T1D) with and without erectile dysfunction (ED).
The study population included 88 adults with T1D using a continuous glucose monitoring, of whom 28 with ED (ED group) and 60 without it (NO ED group). All men completed the International Index of Erectile Function (IIEF-5) and underwent body composition analysis (BIA) and semen analysis.
ED group showed worse HbA1c levels [median (IQR), 8.4 (7.7, 9.9) vs 7.4 (7, 8.2) %, P < 0.001)], higher insulin dose [60 (51, 65) vs 45 (38, 56) UI/die, P = 0.004)] and a higher total body water and intracellular water as compared with ED group. Men in the ED group presented higher semen volume [2.8 (2.6, 4.2) vs 2.5 (2.2, 2.7) mL, P < 0.001] and sperm concentration [24 (19, 29) vs 20 (12, 23) mil/mL, P = 0.010], but reduced sperm progressive motility [28 (25, 35) vs 35 (25, 36) %, P = 0.011], higher rate of non-progressive motility [15 (10, 15) vs 10 (5, 10) %, P < 0.001] and higher rate of typical morphology [7(5, 8) vs 5 (4, 5) %, P = 0.001]. Based on multivariate logistic regression analysis performed to assess the association between clinical variables and ED, intracellular water (OR 3.829, 95% CI 1.205, 12.163, P = 0.023) resulted as the only independent predictor of ED.
Men with T1D and ED showed worse metabolic profile which is associated with poor semen quality, as compared with those without ED.
本研究旨在评估代谢和血糖变量与 1 型糖尿病(T1D)伴或不伴勃起功能障碍(ED)患者精液参数的相关性。
研究人群包括 88 名使用连续血糖监测仪的 T1D 成年患者,其中 28 名患有 ED(ED 组),60 名无 ED(非 ED 组)。所有男性均完成国际勃起功能指数(IIEF-5)问卷,并进行身体成分分析(BIA)和精液分析。
ED 组的糖化血红蛋白(HbA1c)水平[中位数(IQR),8.4(7.7,9.9)%比 7.4(7,8.2)%,P<0.001]、胰岛素剂量[60(51,65)UI/d 比 45(38,56)UI/d,P=0.004]和总水量、细胞内水更高。ED 组的精液量[2.8(2.6,4.2)ml 比 2.5(2.2,2.7)ml,P<0.001]和精子浓度[24(19,29)ml/ml 比 20(12,23)ml/ml,P=0.010]更高,但精子前向运动能力[28(25,35)%比 35(25,36)%,P=0.011]、非前向运动能力[15(10,15)%比 10(5,10)%,P<0.001]和典型形态学[7(5,8)%比 5(4,5)%,P=0.001]更高。为评估临床变量与 ED 之间的相关性,进行了多变量逻辑回归分析,结果显示细胞内水(OR 3.829,95%CI 1.205,12.163,P=0.023)是 ED 的唯一独立预测因子。
与无 ED 的患者相比,T1D 伴 ED 的患者代谢状况更差,这与精液质量较差有关。