肥胖相关的内毒素血症对男性性腺功能影响的研究进展

Research progress on the effect of obesity related endotoxemia on male gonadal function

肥胖是影响人口健康的重大公共卫生问题,其可造成包括性腺功能低下等的男性生殖健康疾病。通过收集近期的一些研究资料,我们发现造成男性性腺功能受损的发生机制除了雌激素代谢异常、瘦素抵抗及炎症细胞因子对下丘脑-垂体轴的直接抑制作用,还包括肠道因素对性腺功能及生育力造成的损害。究其成因,主要是肠黏膜通透性增加而出现肠内细菌易位侵入循环系统,诱发代谢性内毒素血症,并引起氧化应激,损害睾丸Leydig细胞与生殖细胞功能。益生菌可减少肠道细菌易位,从而减轻或消除代谢性内毒素血症对睾丸组织的损害,提升性腺功能。但益生菌的疗效尚未被广泛认可,针对肥胖男性这一群体,开展更为具体的临床用药研究将是未来研究的新方向。

Obesity is a major public health problem affecting population health,which can cause male reproductive health diseases,including hypogonadism.By collecting some recent research data,we find that in addition to the abnormal metabolism of estrogen,leptin resistance and the direct inhibition of inflammatory cytokines on the hypothalamic-pituitary axis,the pathogenesis of impaired male gonadal function also includes the damage of intestinal factors on gonadal function and fertility.The main cause is the increase of intestinal mucosal permeability,which resulted in intestinal bacterial translocation invading the circulatory system,inducing metabolic endotoxemia and oxidative stress,which damaged the function of Leydig cells and germ cells of testis.Probiotics can reduce the translocation of intestinal bacteria,thereby reducing or eliminating the damage of metabolic endotoxemia to testicular tissue and improving gonadal function.However,the efficacy of probiotics has not been widely recognized,and it will be a new direction for future research to carry out more specific clinical drug studies for obese men.