Leptin Status and some Biochemical Parameters in Germ Cell Aplasia among Infertile Men in Gaza Strip

Background: Germ cell aplasia is a type of azoospermia which contains only Sertoli cells and no other cells involved in spermatogenesis. Recently leptin has been suggested to be linked to regulation of reproduction including spermatogenesis, controlling gonadotropins, testosterone secretion and directing the spermatocytes to full development to spermatids. Objective: To assess leptin status and some biochemical parameters in germ cell aplasia among infertile men in Gaza Strip. Design: Case control study. Setting: Specialized Medical Centers inGaza Strip. Study Subjects: A total of 78 infertile men with germ cell aplasia were interviewed to fill a questionnaire. Hormonal analysis (serum leptin, LH, FSH and testosterone) and biochemical analysis (serum cholesterol, triglyceride, HDL-C and LDL-C) were analyzed. Data analyzed using SPSS statistical package version 18. Seventy eight apparently healthy fertile men were served as controls. Results: The mean ages of controls and patients were 31.7 ± 3.9 and 32.8 ± 6.4 years old, respectively. Sexual history showed that problems with erection and ejaculation, and gonadal infection were significantly associated with infertility (P=0.000). Medical history revealed that Orchitis, trauma, cryptorchidism, varicocele and hormonal problems are associated with male infertility (P=0.000). In addition, exposure to thermal and chemical conditions were significantly related to infertiliy (P=0.000 and P=0.003, respectively). treatment of the antifungal Ketoconazole and the steroid were also significantly associated with infertility (P=0.000). The number of obese patients were 28 (35.9) whereas for controls were 6 (7.7%) with c2=19.338, P=0.000 indicating there was strong association between infertility and obesity. Serum leptin was significantly increased in patients compared to controls with percentage difference of 52.4% (21.2 ± 26.1 vs. 12.4 ± 7.6 ng/ml, t=2.019, P=0.047). In contrast, testosterone was significantly decreased in patients compared to controls with percentage difference of 45.5% (3.9 ± 2.8 vs. 6.2 ± 1.7 ng/ml, t=4.529, P=0.000). Serum LH and FSH were increased in patients compared to controls showing percentage differences of 100.6% and 130.5%, respectively (12.4 ± 6.7 vs. 4.1 ± 1.8 mIU/ml, t=7.460, P=0.000 and 25.7 ± 16.7 vs. 5.4 ± 2.6 mIU/ml, t=7.491, P=0.000, respectively). Serum cholesterol, triglycerides and low density lipoprotein (LDL-C) were significantly higher in patients compared to controls registering % differences of 28.8, 47.3 and 43.6, respectively (206.1 ± 45.5, 211.1 ± 129.0 and 123.4 ± 45.2 mg/dl vs. 154.2 ± 33.2, 130.3 ± 70.3 and 79.2 ± 33.6 mg/dl, P=0.000). In contrast, high density lipoprotein (HDL-C) was significantly lower in patient than in controls (40.4 ± 7.6 vs. 49.0 ± 4.0 mg/dl, % difference=19.2 and P=0.000). Leptin was negatively correlated with testosterone (r=-0.223 and P=0.049) and positively correlated with LDL-C and body mass index (BMI) (r=0.222, r=0.368 and P=0.05, P=0.001, respectively). Conclusions: Leptin play an important role in regulation of testicular function among patients with germ cell aplasia by direct action on testes by binding to specific receptor on leydig cell leading to inhibition of testosterone secretion and indirect action where it bind to specific receptor in hypothalamus and induce secretion gonadotropin releasing hormone