A systematic review on the impact of type 2 diabetes on Leydig and Sertoli cells: Molecular mechanisms and functional consequences.
Type 2 diabetes (T2D) disrupts male reproductive function by impairing Leydig and Sertoli cell activity, leading to hormonal imbalances and defective spermatogenesis. This systematic review explores the molecular mechanisms underlying T2D-induced dysfunction in these testicular cells, emphasizing alterations in steroidogenesis, cell signaling, and metabolic regulation.
A systematic review of peer-reviewed studies was conducted using databases such as PubMed. to identify relevant studies published between January 1, 2010, and December 30, 2024. Studies investigating the effects of type 2 diabetes mellitus on Leydig and Sertoli cells. Key molecular markers, androgen receptors, insulin-like growth factor-binding proteins (Igfbp5), and cell junction proteins (Cx43, TJP1, GJA1), were analyzed. Additionally, pathways such as PI3K/Akt, MEK5-ERK5-MEF2C, and inflammatory markers (PERK, IKKβ) were reviewed to understand their roles in diabetic testicular dysfunction. The risk of bias was assessed using the SYRCLE tool.
T2D reduces Leydig cell function by downregulating insulin receptors (IR-β, IR-α) and disrupting steroidogenic pathways, leading to lower testosterone levels. Increased miR-504 and miR-935 expression suppresses the MEK5-ERK5-MEF2C survival pathway, promoting apoptosis in Leydig cells. Sertoli cell dysfunction is characterized by decreased VEGF expression, impaired BTB integrity, and metabolic shifts favoring glycogen accumulation instead of lactate production. Insulin resistance further exacerbates these effects, leading to defective spermatogenesis.
Diabetes-induced dysfunction in Leydig and Sertoli cells is a key contributor to male infertility. Targeting VEGF restoration, insulin signaling pathways, and miRNA regulation may offer potential therapeutic strategies. Further studies are needed to develop interventions that preserve testicular function in diabetic individuals.
A systematic review of peer-reviewed studies was conducted using databases such as PubMed. to identify relevant studies published between January 1, 2010, and December 30, 2024. Studies investigating the effects of type 2 diabetes mellitus on Leydig and Sertoli cells. Key molecular markers, androgen receptors, insulin-like growth factor-binding proteins (Igfbp5), and cell junction proteins (Cx43, TJP1, GJA1), were analyzed. Additionally, pathways such as PI3K/Akt, MEK5-ERK5-MEF2C, and inflammatory markers (PERK, IKKβ) were reviewed to understand their roles in diabetic testicular dysfunction. The risk of bias was assessed using the SYRCLE tool.
T2D reduces Leydig cell function by downregulating insulin receptors (IR-β, IR-α) and disrupting steroidogenic pathways, leading to lower testosterone levels. Increased miR-504 and miR-935 expression suppresses the MEK5-ERK5-MEF2C survival pathway, promoting apoptosis in Leydig cells. Sertoli cell dysfunction is characterized by decreased VEGF expression, impaired BTB integrity, and metabolic shifts favoring glycogen accumulation instead of lactate production. Insulin resistance further exacerbates these effects, leading to defective spermatogenesis.
Diabetes-induced dysfunction in Leydig and Sertoli cells is a key contributor to male infertility. Targeting VEGF restoration, insulin signaling pathways, and miRNA regulation may offer potential therapeutic strategies. Further studies are needed to develop interventions that preserve testicular function in diabetic individuals.