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Undiagnosed prediabetes is highly prevalent in primary infertile men – results from a cross‐sectional study
Author(s) -
Boeri Luca,
Capogrosso Paolo,
Ventimiglia Eugenio,
Pederzoli Filippo,
Frego Nicola,
Cazzaniga Walter,
Chierigo Francesco,
Alfano Massimo,
Piemonti Lorenzo,
Viganò Paola,
Pontillo Marina,
Montanari Emanuele,
Montorsi Francesco,
Salonia Andrea
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14558
Subject(s) - medicine , prediabetes , logistic regression , diabetes mellitus , male infertility , infertility , body mass index , comorbidity , cross sectional study , testosterone (patch) , semen analysis , sex hormone binding globulin , gynecology , hormone , endocrinology , type 2 diabetes , androgen , pregnancy , biology , pathology , genetics
Objective To study the prevalence and the risk associated with prediabetes (Pre DM ) in primary infertile men. Patients and methods Data from 744 infertile men were analysed. Health‐significant comorbidities were scored with the Charlson Comorbidity Index ( CCI ). Serum hormones were measured in every man. Semen analysis was based on 2010 World Health Organization (WHO) reference criteria. Pre DM was defined according to the clinical criteria detailed by the American Diabetes Association ( Diabetes Care 2014; 37 (Suppl. 1): S81). Descriptive statistics and logistic regression analyses tested the association between Pre DM status, hormonal milieu and seminal parameters. The predictive accuracy of all variables was evaluated using the area under the curve, and the clinical net benefit estimated by decision curve analysis ( DCA ). Results Of the 744 men, Pre DM was found in 114 (15.4%). Men with PreDM (+Pre DM) were older, had higher CCI scores, lower total testosterone and sex hormone‐binding globulin but higher follicle‐stimulating hormone ( FSH ) and 17β‐oestradiol values compared to those without PreDM (−Pre DM) (all P ≤ 0.04). Higher sperm DNA fragmentation index ( DFI ; P = 0.014) and idiopathic non‐obstructive azoospermia ( iNOA ; P < 0.001) were found more frequently in +Pre DM men. At multivariable logistic regression analysis, older age, FSH and iNOA (all P ≤ 0.04) were significantly associated with +Pre DM status. DCA demonstrated a clinical net benefit in discriminating men at higher risk of a +Pre DM status. Conclusions About 15% of primary infertile men had criteria suggestive of undiagnosed Pre DM . A Pre DM status was associated with a greater risk of hypogonadism, higher DFI values and iNOA status. Age, FSH values and iNOA status could be considered as useful parameters to recognise men with Pre DM and implement early preventive interventions in those men at risk of the consequences from poor glycaemic control.