Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis

IF 3.4 2区医学 Q1 ANDROLOGY Andrology Pub Date : 2025-03-19 DOI:10.1111/andr.70022

Gianmaria Salvio, Alessandro Ciarloni, Nicola Ambo, Monia Bordoni, Michele Perrone, Silvia Rossi, Giancarlo Balercia

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Abstract

Background

Hypogonadism and infertility are two conditions that are heavily affected by overweight and obesity in the male patient. Glucagon-like peptide 1 agonists (GLP-1RAs) are a recently introduced class of antidiabetic drugs with powerful weight-loss effect; this may induce an indirect positive effect on the testicular function. Nevertheless, recent evidence also suggests a potential direct influence of these molecules on the gonadal function.

Objectives

Our study aims at evaluating the effects of GLP-1RAs on hormone secretion in male patients and comparing their impact on the testicular function with other antidiabetic agents or weight-lowering drugs.

Materials and methods

A literature search was conducted using PubMed, EMBASE, and Scopus database to assess the effects of GLP-1RAs on hormone levels, sperm parameters, and erectile function in overweight and obese men. Before–after analysis and comparison between therapy with GLP-1RAs and other treatment regimens were performed.

Results

Seven studies (n = 680) were included in the quantitative analysis. Treatment with GLP-1RAs produced a significant increase in total serum testosterone (TT), with a standardized mean difference of 1.39 ng/mL (95% confidence interval: 0.70, 2.09; p < 0.0001). Free serum testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) showed similar increase, while weight, body mass index (BMI), waist circumference (WC), and glycated hemoglobin (HbA1c) decreased. Meta-regression showed a significant negative correlation between standardized mean difference in TT levels before–after treatment and percentage change in weight and BMI. When compared with other treatment options, GLP-1RAs showed a comparable effect on serum androgens, but greater BMI reduction and increase in serum gonadotropins and indexes of the erectile function.

Conclusion

Our systematic review and meta-analysis suggest a possible role for GLP-1RAs in the therapy of functional hypogonadism related to overweight and obesity, while also promoting weight loss. The limitations of the current literature do not allow to demonstrate a direct action of GLP-1RAs on the testicular function.

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胰高血糖素样肽1受体激动剂对睾丸功能障碍的影响：系统回顾和荟萃分析。

背景：在男性患者中，性腺功能减退和不育症是受超重和肥胖严重影响的两种疾病。胰高血糖素样肽1激动剂（GLP-1RAs）是最近推出的一类具有强大减肥效果的降糖药物；这可能对睾丸功能产生间接的积极影响。然而，最近的证据也表明这些分子对性腺功能有潜在的直接影响。目的：探讨GLP-1RAs对男性患者激素分泌的影响，并与其他降糖药、减肥药比较其对睾丸功能的影响。材料与方法：通过PubMed、EMBASE和Scopus数据库进行文献检索，评估GLP-1RAs对超重和肥胖男性激素水平、精子参数和勃起功能的影响。对GLP-1RAs治疗方案与其他治疗方案进行前后分析和比较。结果：7项研究（n = 680）纳入定量分析。GLP-1RAs治疗可显著增加血清总睾酮（TT），标准化平均差异为1.39 ng/mL(95%可信区间：0.70,2.09；结论：我们的系统综述和荟萃分析表明，GLP-1RAs可能在治疗与超重和肥胖相关的功能性性腺功能减退中发挥作用，同时也促进体重减轻。目前文献的局限性不允许证明GLP-1RAs对睾丸功能的直接作用。

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来源期刊

Andrology ANDROLOGY-

CiteScore

9.10

自引率

6.70%

发文量

200

期刊介绍： Andrology is the study of the male reproductive system and other male gender related health issues. Andrology deals with basic and clinical aspects of the male reproductive system (gonads, endocrine and accessory organs) in all species, including the diagnosis and treatment of medical problems associated with sexual development, infertility, sexual dysfunction, sex hormone action and other urological problems. In medicine, Andrology as a specialty is a recent development, as it had previously been considered a subspecialty of urology or endocrinology