1型糖尿病对下丘脑-垂体-睾丸轴的影响

Effects of Type 1 Diabetes on the Hypothalamic-Pituitary-Testes Axis

1型糖尿病是由于胰腺β细胞功能损伤而导致胰岛素绝对缺乏的自身免疫性疾病,胰岛素缺乏引起各系统的代谢紊乱,可导致下丘脑-垂体-睾丸轴的功能缺陷。胰岛素在生殖系统中起重要作用,由于胰岛素缺乏,影响了精子生成,导致生育力的下降。1型糖尿病患者由于缺乏瘦素及其受体,导致性成熟障碍和不育,而1型糖尿病患者的低睾酮水平亦可引起性功能障碍、性欲减退和勃起功能障碍。同时,1型糖尿病还可对精子质量产生影响,可能还有其他因素共同参与该疾病进程。综述1型糖尿病与上述因素对男性生殖系统的影响。

Type 1 diabetes is an autoimmune disease characterized by a lack of insulin production in the beta cells of pancreas, which causes a variety of systemic disorders of the whole-body metabolism. It has been demonstrated that patients with type 1 diabetes have functional defects in the hypothalamic-pituitary-testes axis due to the lack of insulin. Insulin plays an important role in the reproductive system. The lack of insulin could result in the impaired spermatogenesis and clinical subfertility. Those patients with type 1 diabetes showed the insufficient sexual maturation and infertility related to the lack of leptin and its receptor. The lowered level of testosterone in those patients may also cause sexual dysfunction, loss of libido and erectile dysfunction. Besides the lowered levels of hormones, the sperm quality in those patients can be affected by type 1 diabetes and other factors. The effects of type 1 diabetes on male reproduction, especially hypothalamic-pituitary-testes axis, were hereby reviewed.