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Quantification of testicular fat deposition in the evaluation of middle-aged overweight male infertility

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Abstract

Objectives

To measure the testicular volume and testicular fat deposition of middle-aged overweight men and to assess the utility of testicular fat deposition and testicular volume in determining and monitoring testicular infertility.

Materials and methods

Pelvic MRI with thin slice T2WI, T1WI and mDIXON Quant was performed on 30 middle-aged overweight patients in the treatment group and 30 middle-aged overweight men in the control group. Testicular volume and testicular fat deposition were measured separately based on thin slice T2WI and the fat fraction (FF) map of mDIXON Quant, and the testicular fat deposition observed with T1WI was used as a reference for qualitative diagnosis. Testicular volume and testicular fat deposition in middle-aged overweight individuals were compared using a t test with Bonferroni correction and receiver operating characteristic (ROC) curve.

Results

The testicular volumes (10.6–17.9 cm3) of individuals in the treatment group were smaller than those (12.6–19.0 cm3) of individuals in the control group (p < 0.05), and the average FF value (2.2–4.6%) of the testes in the treatment group was higher than that (1.5–3.1%) in the control group (p < 0.05). The ROC analysis showed that the area under the curve (AUC) of testicular fat deposition (0.899) was higher than that of testicular volume (0.777), and biopsy and sperm count were used as references to diagnose infertility. The diagnostic sensitivity (90.00%) of testicular fat deposition of the mDIXON Quant sequence was higher than that (50.00%) of the T1W sequence (p < 0.05). Testicular fat deposition was decreased after 6 months of active treatment with exercise weight loss and drug treatment, and no significant change in testicular volume was observed 6 months later.

Conclusion

The findings suggest that the proton density fat fraction (mDIXON Quant sequence in this study) approach is a novel tool for the quantitative and objective evaluation of testicular fat deposition. Testicular fat deposition measurement is more specific than testicular volume measurement in the diagnosis of male infertility, and the mDIXON Quant is more sensitive than T1WI in the diagnosis of testicular fat deposition. Furthermore, our findings may facilitate a more accurate diagnosis and monitoring of testicular infertility, therapeutic effect, and prognosis by measuring testicular fat deposition.

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References

  1. Best D, Avenell A, Bhattacharya S (2017) How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? A systematic review and meta-analysis of the evidence. Hum Reprod Update 23(6):681–705

    PubMed  Google Scholar 

  2. Jelstad S, Ditta Valsdottir T, Johansen EI, Jensen JR (2019) Eight sessions of endurance training decrease fasting glucose and improve glucose tolerance in middle-aged overweight males. Arch Physiol Biochem 26:1–8

    Google Scholar 

  3. Aggerholm AS, Thulstrup AM, Toft G, Ramlau-Hansen CH, Bonde JP (2008) Is overweight a risk factor for reduced semen quality and altered serum sex hormone profile? Fertil Steril 90(3):619–626

    CAS  PubMed  Google Scholar 

  4. Paasch U, Grunewald S, Kratzsch J, Glander HJ (2010) Obesity and age affect male fertility potential. Fertil Steril 94(7):2898–2901

    PubMed  Google Scholar 

  5. Condorelli R, Calogero AE, La Vignera S (2013) Relationship between testicular volume and conventional or nonconventional sperm parameters. Int J Endocrinol 2013:145792

    PubMed  PubMed Central  Google Scholar 

  6. Ehala-Aleksejev K, Punab M (2018) Relationships between total testicular volume, reproductive parameters and surrogate measures of adiposity in men presenting for couple's infertility. Andrologia 50(4):e12952

    Google Scholar 

  7. López-Torres AS, Chirinos M (2017) Modulation of human sperm capacitation by progesterone, estradiol, and luteinizing hormone. Reprod Sci 24(2):193–201

    PubMed  Google Scholar 

  8. Zeng Y, Hesketh T (2016) The effects of China’s universal two-child policy. Lancet 388(10054):1930–1938

    PubMed  PubMed Central  Google Scholar 

  9. Liu K, Case A, Reproductive Endocrinology, and Infertility Committee (2011) Advanced reproductive age and fertility. J Obstet Gynaecol Can 33(11):1165–1175

    PubMed  Google Scholar 

  10. Mazaheri Y, Hricak H, Fine SW, Akin O, Shukla-Dave A, Ishill NM, Moskowitz CS, Grater JE, Reuter VE, Zakian KL, Touijer KA, Koutcher JA (2009) Prostate tumor volume measurement with combined T2-weighted imaging and diffusion-weighted MR: correlation with pathologic tumor volume. Radiology 252(2):449–457

    PubMed  PubMed Central  Google Scholar 

  11. Zhao SX, Xiao YH, Lv FR, Zhang ZW, Sheng B, Ma HL (2018) Lateral ventricular volume measurement by 3D MR hydrography in fetal ventriculomegaly and normal lateral ventricles. J Magn Reson Imaging 48(1):266–273

    PubMed  Google Scholar 

  12. Zhang Y, Wang C, Duanmu Y, Zhang C, Zhao W, Wang L, Cheng X, Veronese N, Guglielmi G (2018) Comparison of CT and magnetic resonance mDIXON-Quant sequence in the diagnosis of mild hepatic steatosis. Br J Radiol 91(1091):20170587

    PubMed  PubMed Central  Google Scholar 

  13. Zhang Y, Zhou Z, Wang C, Cheng X, Wang L, Duanmu Y, Zhang C, Veronese N, Guglielmi G (2018) Reliability of measuring the fat content of the lumbar vertebral marrow and paraspinal muscles using MRI mDIXON-Quant sequence. Diagn Interv Radiol 24(5):302–307

    PubMed  PubMed Central  Google Scholar 

  14. Ford WC (2010) Comments on the release of the 5th edition of the WHO laboratory manual for the examination and processing of human semen. Asian J Androl 12(1):59–63

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Corea M, Campagnone J, Sigman M (2015) The diagnosis of azoospermia depends on the force of centrifugation. Fertil Steril 83(4):920–922

    Google Scholar 

  16. Guo RM, Lin WS, Liu WM, Zhou WY, Cao SE, Wang J, Li QL (2018) Quantification of fat infiltration in the sacroiliac joints with ankylosing spondylitis using IDEAL sequence. Clin Radiol 73(3):231–236

    PubMed  Google Scholar 

  17. Han BH, Park SB, Seo JT, Chun YK (2018) Usefulness of testicular volume, apparent diffusion coefficient, and normalized apparent diffusion coefficient in the MRI evaluation of infertile men with azoospermia. Am J Roentgenol 210(3):543–548

    Google Scholar 

  18. Guo RM, Zhao RZ, Zhang J, Yang F, Wen HQ, Wang J, Zhang Y, Li QL (2019) Quantification of fat deposition in the testis and epididymis using mDIXON Quant sequence: correlation with age and ejaculation. Abdom Radiol (NY) 44(4):1528–1534

    Google Scholar 

  19. Tsili AC, Ntorkou A, Astrakas L, Boukali E, Giannakis D, Maliakas V, Sofikitis N, Argyropoulou MI (2017) Magnetic resonance diffusion tensor imaging of the testis: preliminary observations. Eur J Radiol 95:265–270

    PubMed  Google Scholar 

  20. Tsili AC, Astrakas LG, Ntorkou A, Giannakis D, Stavrou S, Maliakas V, Sofikitis N, Argyropoulou MI (2016) MR spectra of normal adult testes and variations with age: preliminary observations. Eur Radiol 26(7):2261–2267

    PubMed  Google Scholar 

  21. Firat AK, Uğraş M, Karakaş HM, Erdem G, Kurus M, Ugras M, Celik T, Kahraman B, Doğanay S (2008) 1H magnetic resonance spectroscopy of the normal testis: preliminary findings. Magn Reson Imaging 26(2):215–220

    PubMed  Google Scholar 

  22. Chew WM, Hricak H, McClure RD, Wendland MF (1990) In vivo human testicular function assessed with P-31 MR spectroscopy. Radiology 177(3):743–747

    CAS  PubMed  Google Scholar 

  23. Kise Y, Chikui T, Yamashita Y, Kobayashi K, Yoshiura K (2017) Clinical usefulness of the method for estimation of the salivary gland fat fraction: comparison with MR spectroscopy. Br J Radiol 90(1077):20160704

    PubMed  PubMed Central  Google Scholar 

  24. Serai SD, Dillman JR, Trout AT (2017) Proton density fat fraction measurements at 1.5- and 3-T hepatic MR imaging: same-day agreement among readers and across two imager manufacturers. Radiology 284(1):244–254

    PubMed  Google Scholar 

  25. Guo RM, Li QL, Luo ZX, Tang W, Jiao J, Wang J, Kang Z, Chen SQ, Zhang Y (2018) In vivo assessment of neurodegeneration in type C Niemann-Pick disease by IDEAL-IQ. Korean J Radiol 19(1):93–100

    PubMed  PubMed Central  Google Scholar 

  26. Datar J, Regassa A, Kim WK, Taylor CG, Zahradka P, Suh M (2017) Lipid metabolism is closely associated with normal testicular growth based on global transcriptome profiles in normal and underdeveloped testis of obese Zucker (fa/fa) rats. Lipids 52(11):951–960

    CAS  PubMed  Google Scholar 

  27. Akgul O, Gulkesen A, Akgol G, Ozgocmen S (2013) MR-defined fat infiltration of the lumbar paravertebral muscles differs between non-radiographic axial spondyloarthritis and established ankylosing spondylitis. Mod Rheumatol 23(4):811–816

    CAS  PubMed  Google Scholar 

  28. Carmona R, Harish S, Linda DD, Ioannidis G, Matsos M, Khalidi NA (2013) MR imaging of the spine and sacroiliac joints for spondyloarthritis: influence on clinical diagnostic confidence and patient management. Radiology 269(1):208–215

    PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by Grants from the National Natural Science Foundation of China (no. 81801757), the Natural Science Foundation of Guangdong Province (nos. 2018A030310322, 2019A1515012051), and the Guangdong Medical Research Foundation (no. A2018106).

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Author notes

  1. Qing-ling Li and Fei Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China

    Qing-ling Li, Fei Yang, Wen-jie Tang, Yu Guo & Ruo-mi Guo

  2. Department of VIP Medical Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Qing-ling Li

  3. Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Fei Yang

  4. Department of Laboratory, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Wen-ying Zhou

  5. Department of Pathology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Na Cheng

  6. Department of VIP Medical Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China

    Yu Guo

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  1. Qing-ling Li
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Correspondence to Yu Guo or Ruo-mi Guo.

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This study was approved by the Institutional Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University.

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Li, Ql., Yang, F., Zhou, Wy. et al. Quantification of testicular fat deposition in the evaluation of middle-aged overweight male infertility. Magn Reson Mater Phy 33, 377–384 (2020). https://doi.org/10.1007/s10334-019-00803-w

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  • DOI: https://doi.org/10.1007/s10334-019-00803-w

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