摘要
糖尿病是一种全球流行病,具有高发病率和高死亡率的特点.糖尿病可导致急性和慢性全身并发症.糖尿病所致的男性生殖障碍成为了人类关注的热点.多项研究表明,糖尿病通过多种途径诱发男性生育力损伤,包括勃起及射精功能障碍、下丘脑-垂体-性腺轴的紊乱、附睾和睾丸内损害、精液质量损害、睾丸和精子糖代谢异常以及影响子代健康等.其涉及到的机制包括氧化应激、炎症、自噬、凋亡、表观遗传调控及线粒体损伤等.针对男性生育力损伤的干预措施有糖尿病治疗药物、抗氧化剂、中药及针灸、间充质干细胞疗法、运动及体育锻炼和肠道菌群干预等.本文通过总结目前关于糖尿病与男性生育力之间关系的研究进展,探讨其导致男性不育的内在机制,探寻其潜在的干预措施,为提高男性生殖健康提供参考.
Abstract
Diabetes mellitus is a global epidemic characterized by high incidence and mortality rates.It can lead to both acute and chronic systemic complications.Diabetes-induced male reproductive disorders have become a focal point of concern.Numerous studies have shown that hyperglycemia can impair male fertility through various pathways,including erectile and ejaculatory dysfunction,disruption of the hypothalamic-pituitary-gonadal axis,damage to the epididymis and testis,impaired semen quality,abnormalities in testicular and sperm glucose metabolism,and adverse effects on offspring health.The mechanisms involved include oxidative stress,inflammation,autophagy,apoptosis,epigenetic regulation,and mitochondrial damage.Interventions for male fertility impairment include diabetes treatment drugs,antioxidants,Traditional Chinese Medicine and acupuncture,mesenchymal stem cell therapy,exercise and physical training,as well as gut microbiota interventions.This article aims to review the current research on the relationship between diabetes and male fertility,explore the underlying mechanisms leading to male infertility,and identify potential interventions to improve male reproductive health,which holds significant clinical value.
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