Abstract：
BACKGROUND: The potential impact of diabetes mellitus type 1 (DM1) on male fertility is currently poorly defined. Hyperglycaemia and insulin deficiency may affect spermatogenesis. Some evidence suggests that men with DM1 have a significant reduction in progressive sperm motility, sperm morphology and semen volume, without significant changes in sperm concentration and count, but definite data are lacking.
OBJECTIVE: To evaluate the impact of DM1 on clinical parameters related to male fertility and semen analysis.
METHODS: We compared a court of 42 male DM1 patients with 43 nondiabetic subjects overlapping in age and remaining clinical data in an observational case-control study. All subjects underwent a comprehensive andrological reproductive evaluation, including medical history, physical examination, and semen analysis. We collected biochemical data in all patients with DM1, while diabetic patients with any alteration in semen parameters underwent sperm culture and scrotal ultrasound. In addition, all men completed the IIEF-5 questionnaire (International Index of Erectile Function-5) and the AMS (Aging Male Symptom score) questionnaire.
RESULTS: Patients with DM1 had a higher prevalence of infertility, erectile dysfunction and worse semen parameters compared with controls. In particular, semen volume, total sperm count, and total and progressive sperm motility were significantly lower (p < 0.001, p = 0.003, p = 0.048, and p = 0.022 respectively). In addition, the rate of semen anti-sperm antibody positivity, the AMS score and FSH levels were higher.
CONCLUSIONS: Several mechanisms may contribute to these semen alterations in DM1 patients, such as oxidative damage to spermatogenesis, seminal infections and pelvic neurological changes. These data suggest that patients with DM1 should be counselled from an andrological-reproductive point of view.
OBJECTIVE: To evaluate the impact of DM1 on clinical parameters related to male fertility and semen analysis.
METHODS: We compared a court of 42 male DM1 patients with 43 nondiabetic subjects overlapping in age and remaining clinical data in an observational case-control study. All subjects underwent a comprehensive andrological reproductive evaluation, including medical history, physical examination, and semen analysis. We collected biochemical data in all patients with DM1, while diabetic patients with any alteration in semen parameters underwent sperm culture and scrotal ultrasound. In addition, all men completed the IIEF-5 questionnaire (International Index of Erectile Function-5) and the AMS (Aging Male Symptom score) questionnaire.
RESULTS: Patients with DM1 had a higher prevalence of infertility, erectile dysfunction and worse semen parameters compared with controls. In particular, semen volume, total sperm count, and total and progressive sperm motility were significantly lower (p < 0.001, p = 0.003, p = 0.048, and p = 0.022 respectively). In addition, the rate of semen anti-sperm antibody positivity, the AMS score and FSH levels were higher.
CONCLUSIONS: Several mechanisms may contribute to these semen alterations in DM1 patients, such as oxidative damage to spermatogenesis, seminal infections and pelvic neurological changes. These data suggest that patients with DM1 should be counselled from an andrological-reproductive point of view.
摘要：
背景：目前尚不清楚1型糖尿病（DM1）对男性生育能力的潜在影响。高血糖和胰岛素缺乏可能影响精子发生。一些证据表明，患有DM1的男性精子运动性进行性显著降低，精子形态和精液体积，精子浓度和数量没有显著变化，但是缺乏明确的数据。
目的：评估DM1对男性生育力和精液分析相关临床参数的影响。
方法：我们在一项观察性病例对照研究中比较了42名男性DM1患者与43名非糖尿病患者年龄重叠和剩余临床数据。所有受试者都接受了全面的男性生殖评估，包括病史,体检,精液分析。我们收集了所有DM1患者的生化数据，而精液参数有任何改变的糖尿病患者接受了精子培养和阴囊超声检查。此外,所有男性均完成IIEF-5问卷(国际勃起功能指数-5)和AMS(老年男性症状评分)问卷.
结果：DM1患者的不孕症患病率较高，与对照组相比，勃起功能障碍和较差的精液参数。特别是,精液体积,精子总数,总精子活动力和进行性精子活动力均显着降低（分别为p<0.001，p=0.003，p=0.048和p=0.022）。此外,精液抗精子抗体阳性率，AMS评分和FSH水平较高.
结论：一些机制可能有助于DM1患者的这些精液改变，例如对精子发生的氧化损伤，精液感染和盆腔神经改变。这些数据表明，应从男性生殖的角度对DM1患者进行咨询。
目的：评估DM1对男性生育力和精液分析相关临床参数的影响。
方法：我们在一项观察性病例对照研究中比较了42名男性DM1患者与43名非糖尿病患者年龄重叠和剩余临床数据。所有受试者都接受了全面的男性生殖评估，包括病史,体检,精液分析。我们收集了所有DM1患者的生化数据，而精液参数有任何改变的糖尿病患者接受了精子培养和阴囊超声检查。此外,所有男性均完成IIEF-5问卷(国际勃起功能指数-5)和AMS(老年男性症状评分)问卷.
结果：DM1患者的不孕症患病率较高，与对照组相比，勃起功能障碍和较差的精液参数。特别是,精液体积,精子总数,总精子活动力和进行性精子活动力均显着降低（分别为p<0.001，p=0.003，p=0.048和p=0.022）。此外,精液抗精子抗体阳性率，AMS评分和FSH水平较高.
结论：一些机制可能有助于DM1患者的这些精液改变，例如对精子发生的氧化损伤，精液感染和盆腔神经改变。这些数据表明，应从男性生殖的角度对DM1患者进行咨询。
