The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis

The effects of diabetes mellitus include long-term damages, dysfunctions, and failures of various organs. An important complication of diabetes is the disturbance in the male reproductive system. Glucose metabolism is an important event in spermatogenesis. Moreover, glucose metabolism is also important for maintaining basic cell activity, as well as specific functions, such as motility and fertilization ability in mature sperm. Diabetic disease and experimentally induced diabetes both demonstrated that either type 1 diabetes or type 2 diabetes could have detrimental effects on male fertility, especially on sperm quality, such as sperm motility, sperm DNA integrity, and ingredients of seminal plasma. Epigenetic modifications are essential during spermatogenesis. The epigenetic regulation represents chromatin modifications including DNA methylation, histone modifications, remodeling of nucleosomes and the higher-order chromatin reorganization and noncoding RNAs. If spermatogenesis is affected during the critical developmental window, embryonic gonadal development, and germline differentiation, environmentally-induced epigenetic modifications may become permanent in the germ line epigenome and have a potential impact on subsequent generations through epigenetic transgenerational inheritance. Diabetes may influence the epigenetic modification during sperm spermatogenesis and that these epigenetic dysregulation may be inherited through the male germ line and passed onto more than one generation, which in turn may increase the risk of diabetes in offspring.

关于美国、欧洲和中国的多囊卵巢综合征临床指南或共识的比较分析（英文）

通过比较欧洲人类生殖和胚胎学会和美国生殖医学协会联合发表的鹿特丹共识、中国的多囊卵巢综合征诊治标准专家共识和美国内分泌学会的临床实践指南,分析了不同指南对育龄期、青春期和围绝经期多囊卵巢综合症诊断标准的差异,概括了多囊卵巢综合征临床治疗的主要方面,同时提出了一些诊治方面的新进展及今后需要进一步关注的问题。在多囊卵巢综合征的诊断上,对育龄期女性的标准三大指南略有不同,而对青春期和围绝经期女性的标准尚待完善。多囊卵巢综合征的治疗主要围绕肥胖、月经失调、高雄激素血症、胰岛素抵抗、不孕、青春期、心理干预等来进行,各大指南各有侧重。由于不同种族的多囊卵巢综合征的临床表现差异较大,需要尽早建立具有种族特异性的指南来改善诊疗过度或不足的情况。