According to data from the CDC, the prevalence of obesity in children and adolescents was 19.7% between the years 2017-20. The numbers are on a gradual rise, which goes to show that this is an alarming condition that’s not stopping anytime soon.
Based on these complications, a recent presenter at ENDO 2022 facilitated saying that adolescent boys who are obese or overweight and have risks of insulin resistance were found to have a “lower testicular volume” compared to a healthy weight adolescent boy.
The presenter, Rossalla Cannarella, MD, a Ph.D. candidate at the department of clinical and experimental medicine at the University of Catania in Italy, said that male infertility adheres to multiple etiological factors. However, to this day, no conclusive reasoning depicts the exact cause behind male infertility.
Further reiterating her presentation, Cannarella reported that one of the most common contributors to idiopathic male infertility is linked cases of childhood overweight or obesity.
She suggested that excess body fat deposition leads to risks of hyperinsulinemia or insulin resistance in the body, both of which are associated with reduced testicular volume in adolescent boys and one that gets worse with age.
In their research, Cannarella and her colleagues looked into multiple factors, including:
- Insulin resistance
- Type-2 diabetes
These factors were recorded in a cohort of adolescent teen boys who were 16 years and younger than that.
For the assessment, the subjects were made to undergo an oral glucose tolerance test, following which the testicular volume, fasting glycemia, age, BMI, insulin levels, and HbA1C levels were collected around 120 minutes after the test.
The results from the above findings were then compared with the levels recorded in boys under the age of 9 and, in boys between the years of 9-14 years, and in boys between the ages of 14 and 16. None of the placebo group underwent the oral glucose tolerance test.
For better variance in the study, the cohort included a total of 264 participants, out of which 61 boys had normal weight, 53 of the boys were overweight, and 150 of them were reportedly obese.
Also, 45 of the participants in the study had a standard insulin level of 20 IU/ml or higher. Around 97 participants were diagnosed with insulin resistance of 2.5 or more. Among them, 22 of the boys were diagnosed with prediabetes, and 3 were diagnosed with Type-2 diabetes.
Results from the study reported that the participants from the peripubertal age group with a normal body weight had a standard testicular volume. This was in comparison with the overweight and obese participants who showcased reduced testicular volume.
Besides body weight, even insulin levels played a crucial role in determining testicular volume. The participants in the pre and post-puberty group with normal insulin levels had a higher testicular volume than those with hyperinsulinemia or insulin resistance.
Surprisingly, the three participants with type-2 diabetes didn’t impact the testicular volume of the participants in any of the assigned age groups.
Reaching a final conclusion, Cannarella highlighted the importance of measuring testicular volume from an early age by the pediatricians to detect the early risk of infertility in the future. She further emphasized the need for routine semen analysis and andrological counseling for adolescent boys who are either overweight or obese. According to her, taking these steps could be a stepping stone toward preventing the risks of male infertility down the road.
Advocating for such medical interventions in the overweight and obese boys from the adolescent period could not just reduce the risks of obesity-related health complications and comorbidities, but it could also prepare the patient for the risk of infertility in the future.
However, Cannarella also emphasized that further longitudinal studies are needed to reach a more conclusive understanding of the association between body weight, insulin impacts, and fertility in men.