SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicGenomic Insights into Reproductive Regulation: Advances in Male and Female Fertility MechanismsView all 7 articles
Inflammatory Process-mediated Effects of Diabetes Mellitus on Male Fertility: A Systematic Review and Meta-analysis
Provisionally accepted
- 1Shandong first medical univeristy, Jinan, China
- 2Qingdao Agricultural University, Qingdao, Shandong Province, China
- 3Chinese Academy of Agricultural Sciences (CAAS), Beijing, Beijing Municipality, China
- 4Murdoch University, Perth, Western Australia, Australia
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Abstract: Background: Diabetes mellitus (DM) has emerged as a fast-growing global health problem, imposing substantial socioeconomic burdens and multidimensional health consequences, including detrimental impacts on male fertility. Although accumulating evidence suggests associations between DM and male reproductive dysfunction, comprehensive mechanistic synthesis through inflammatory pathways remains inadequately elucidated. Method: We conducted a systematic literature search on Web of Science, Embase and PubMed databases (1972-2022), aiming to investigate DM-related male infertility through meta-analysis. Following PRISMA guidelines, 8 out of 168 studies on type 1 diabetes (T1D) and 9 out of 185 studies on type 2 diabetes (T2D) were included to screen the relationship between diabetes and male infertility. In addition, 10 out of 840 inflammation-related studies (1961-2022) underwent rigorous selection for mechanistic exploration. Meta-analysis was conducted to evaluate the summary relative risk (RR) and 95% confidence intervals (CIs) of combined studies. Results: Meta-analysis demonstrated a significant impairment of male fertility in diabetic populations. The subgroup analyses revealed that T2D exhibits a higher probability of causing male infertility compared to T1D. Despite low between-study heterogeneity, inflammation biomarker (e.g., TNF-α) was implicated in diabetes-induced male infertility. Transcriptomic analyses further identified enriched inflammatory pathways and altered fertility-related gene expression. Conclusion: Current evidence in the context of diabetes indicates its detrimental impact on male fertility through inflammatory pathways.
Keywords: type 1 diabetes, type 2 diabetes, Inflammation, male infertility, Meta-analysis
Received: 31 Mar 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Hao, Yang, Feng, Zhao and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: YongLin Ren, y.ren@murdoch.edu.au
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