1.Buzhong Yiqitang Regulates Mitochondrial Homeostasis of Skeletal Muscle via PINK1 Pathways to Resist Exercise-induced Fatigue
Huani WEI ; Ting JIANG ; Juan PENG ; Chunxiang JING ; Wei LIU ; Huashan PAN ; Daorui CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):31-39
ObjectiveTo explore the effect of Buzhong Yiqitang on exercise-induced fatigue and its potential mechanism. MethodsSixty male SPF-grade C57BL/6J mice were randomized into blank, model, low-, medium-, high-dose (4.1, 8.2, 16.4 g·kg-1, respectively) Buzhong Yiqitang, and vitamin C (0.04 g·kg-1) groups. The blank and model groups were administrated with normal saline. Each group was administrated with corresponding agents by gavage at a dose of 0.2 mL once a day. Except the blank group, other groups underwent a 6-weeks exhaustive swimming test under negative gravity. At the end of the experiment, blood was collected, and the thymus, spleen, liver, and kidney weights were measured. Serum levels of lactic acid (LD), blood urea nitrogen (BUN), creatine kinase (CK), and malondialdehyde (MDA) were assessed by kits to evaluate fatigue. Hematoxylin-eosin staining was performed to observe pathological changes in the skeletal muscle. Electron microscopy was used to examine the skeletal muscle cell ultrastructure, with a focus on mitochondrial morphological changes. The adenosine triphosphate (ATP) content and activities of mitochondrial respiratory chain complexes Ⅰ, Ⅱ, and Ⅴ in skeletal muscle were determined by kits. The expression levels of key genes and proteins in the PTEN-induced putative kinase 1 (PINK1)-mediated mitochondrial homeostasis pathways in the skeletal muscle were evaluated via Real-time PCR and Western blot, respectively. ResultsCompared with the blank group, the model group showed reductions in weight gain rate (P<0.01) and thymus index (P<0.01), rises in serum levels of LD, BUN, MDA, and CK (P<0.01), disarrangement of skeletal muscle, broken muscle fibers, inflammatory cell infiltration in muscle fiber gaps, abnormal morphological changes (increased vacuolated mitochondria and disappearance of cristae) of mitochondria in skeletal muscle cells, and decreased mitochondria. In addition, the skeletal muscle in the model group showed reduced content of ATP, weakened activities of mitochondrial respiratory chain complexes Ⅰ, Ⅱ, and Ⅴ (P<0.05), up-regulated mRNA levels of PINK1, E3 ubiquitin-protein ligase (Parkin), hairy/enhancer-of-split related with YRPW motif 1 (HEY1), dynamin-related protein 1 (Drp1), sequestosome 1 (p62), and hypoxia-inducible factor 1 alpha (HIF-1α) (P<0.05), and down-regulated protein level of microtubule-associated protein 1-light chain 3B (LC3B) (P<0.01). Compared with the model group, Buzhong Yiqitang prolonged the swimming exhaustion time (P<0.01), increased the weight gain rate (P<0.01) and thymus index (P<0.01), lowered the serum levels of LD, BUN, MDA, and CK (P<0.05, P<0.01). The skeletal muscle in the Buzhong Yiqitang groups showed neat arrangement, reduced inflammatory cells, intact mitochondria with dense cristae, and increased mitochondria. In addition, the skeletal muscle in the Buzhong Yiqitang groups showcased increased ATP content, enhanced activities of mitochondrial respiratory chain complexes Ⅰ, Ⅱ, and Ⅴ (P<0.05, P<0.01), up-regulated protein levels of PINK1, Parkin, HEY1, LC3B, and Drp1 and mRNA level of HIF-1α (P<0.05, P<0.01), and down-regulated expression level of p62 (P<0.05, P<0.01). ConclusionBuzhong Yiqitang can prevent and treat exercise-induced fatigue by regulating the mitochondrial homeostasis of skeletal muscle via the HIF-1α/PINK1/Parkin and HIF-1α/HEY1/PINK1 signaling pathways.
2.Buzhong Yiqitang Regulates Mitochondrial Homeostasis of Skeletal Muscle via PINK1 Pathways to Resist Exercise-induced Fatigue
Huani WEI ; Ting JIANG ; Juan PENG ; Chunxiang JING ; Wei LIU ; Huashan PAN ; Daorui CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):31-39
ObjectiveTo explore the effect of Buzhong Yiqitang on exercise-induced fatigue and its potential mechanism. MethodsSixty male SPF-grade C57BL/6J mice were randomized into blank, model, low-, medium-, high-dose (4.1, 8.2, 16.4 g·kg-1, respectively) Buzhong Yiqitang, and vitamin C (0.04 g·kg-1) groups. The blank and model groups were administrated with normal saline. Each group was administrated with corresponding agents by gavage at a dose of 0.2 mL once a day. Except the blank group, other groups underwent a 6-weeks exhaustive swimming test under negative gravity. At the end of the experiment, blood was collected, and the thymus, spleen, liver, and kidney weights were measured. Serum levels of lactic acid (LD), blood urea nitrogen (BUN), creatine kinase (CK), and malondialdehyde (MDA) were assessed by kits to evaluate fatigue. Hematoxylin-eosin staining was performed to observe pathological changes in the skeletal muscle. Electron microscopy was used to examine the skeletal muscle cell ultrastructure, with a focus on mitochondrial morphological changes. The adenosine triphosphate (ATP) content and activities of mitochondrial respiratory chain complexes Ⅰ, Ⅱ, and Ⅴ in skeletal muscle were determined by kits. The expression levels of key genes and proteins in the PTEN-induced putative kinase 1 (PINK1)-mediated mitochondrial homeostasis pathways in the skeletal muscle were evaluated via Real-time PCR and Western blot, respectively. ResultsCompared with the blank group, the model group showed reductions in weight gain rate (P<0.01) and thymus index (P<0.01), rises in serum levels of LD, BUN, MDA, and CK (P<0.01), disarrangement of skeletal muscle, broken muscle fibers, inflammatory cell infiltration in muscle fiber gaps, abnormal morphological changes (increased vacuolated mitochondria and disappearance of cristae) of mitochondria in skeletal muscle cells, and decreased mitochondria. In addition, the skeletal muscle in the model group showed reduced content of ATP, weakened activities of mitochondrial respiratory chain complexes Ⅰ, Ⅱ, and Ⅴ (P<0.05), up-regulated mRNA levels of PINK1, E3 ubiquitin-protein ligase (Parkin), hairy/enhancer-of-split related with YRPW motif 1 (HEY1), dynamin-related protein 1 (Drp1), sequestosome 1 (p62), and hypoxia-inducible factor 1 alpha (HIF-1α) (P<0.05), and down-regulated protein level of microtubule-associated protein 1-light chain 3B (LC3B) (P<0.01). Compared with the model group, Buzhong Yiqitang prolonged the swimming exhaustion time (P<0.01), increased the weight gain rate (P<0.01) and thymus index (P<0.01), lowered the serum levels of LD, BUN, MDA, and CK (P<0.05, P<0.01). The skeletal muscle in the Buzhong Yiqitang groups showed neat arrangement, reduced inflammatory cells, intact mitochondria with dense cristae, and increased mitochondria. In addition, the skeletal muscle in the Buzhong Yiqitang groups showcased increased ATP content, enhanced activities of mitochondrial respiratory chain complexes Ⅰ, Ⅱ, and Ⅴ (P<0.05, P<0.01), up-regulated protein levels of PINK1, Parkin, HEY1, LC3B, and Drp1 and mRNA level of HIF-1α (P<0.05, P<0.01), and down-regulated expression level of p62 (P<0.05, P<0.01). ConclusionBuzhong Yiqitang can prevent and treat exercise-induced fatigue by regulating the mitochondrial homeostasis of skeletal muscle via the HIF-1α/PINK1/Parkin and HIF-1α/HEY1/PINK1 signaling pathways.
3.Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study
I-Shen HUANG ; Li-Hua LI ; Wei-Jen CHEN ; Chi-Chang JUAN ; William J. HUANG
The World Journal of Men's Health 2025;43(1):142-153
Purpose:
The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes.
Materials and Methods:
We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA.
Results:
Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher.
Conclusions
The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.
4.Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study
I-Shen HUANG ; Li-Hua LI ; Wei-Jen CHEN ; Chi-Chang JUAN ; William J. HUANG
The World Journal of Men's Health 2025;43(1):142-153
Purpose:
The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes.
Materials and Methods:
We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA.
Results:
Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher.
Conclusions
The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.
5.Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study
I-Shen HUANG ; Li-Hua LI ; Wei-Jen CHEN ; Chi-Chang JUAN ; William J. HUANG
The World Journal of Men's Health 2025;43(1):142-153
Purpose:
The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes.
Materials and Methods:
We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA.
Results:
Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher.
Conclusions
The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.
6.Decision-making behavior in patients with depressive disorder and its relationship with depressive and anxiety symptoms
Yuxiang WANG ; Luoya ZHANG ; Maomao ZHANG ; Juan DENG ; Yanjie PENG ; Xiaotong CHENG ; Kezhi LIU ; Wei LEI ; Jing CHEN
Sichuan Mental Health 2025;38(1):22-27
BackgroundPatients with depressive disorder often exhibit impaired decision-making functions. However, the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear. ObjectiveTo explore the characteristics of decision-making behavior in patients with depressive disorder, and to analyze its relationship with clinical symptoms. MethodsA total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023. Concurrently, 52 healthy individuals matched for age and gender were recruited from Luzhou as the control group. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used for assessment, and decision-making behavior was evaluated using Probabilistic Reversal Learning (PRL) task. Indicators assessed included the number of trials to criterion, perseverative errors, win-stay rate and lose-shift rate. Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators. ResultsThe depression group showed a significantly higher lose-shift rate compared with the control group (t=3.684, P<0.01). There were no statistically significant differences between two groups in trials to criterion, perseverative errors and win-stay rate (t=0.329, 0.132, 0.609, P>0.05). In depression group, BDI and BAI scores were positively correlated with the win-stay rate(r=0.450, 0.398, P<0.01). ConclusionPatients with depressive disorder are more likely to change their decision-making strategies following negative outcomes. Furthermore, the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback. [Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University (number, 2019LZXNYDJ39]
7.Analysis of depressive symptoms and associated factors among primary and secondary school students in the in depth monitoring counties Rural Nutrition Improvement Program
Chinese Journal of School Health 2025;46(2):219-222
Objective:
To understand the prevalence and related factors of depressive symptoms among primary and secondary school students in the in depth monitoring counties of China s Rural Compulsory Education Nutrition Improvement Program, so as to provide a basis for prevention and psychological intervention of depressive symptoms among children and adolescents in rural areas.
Methods:
In November 2022, a stratified random sampling method was adopted to collect height and weight data, basic personal and family information of 7 949 primary and secondary school students from grade three to grade nine through physical measurements and questionnaires in 56 key monitoring schools implementing the Student Nutrition Improvement Program in 7 in depth monitoring counties (Jalaid Banner in Inner Mongolia, Jinzhai County in Anhui, Mao Xian in Sichuan, Tiandeng County in Guangxi, Mian County in Shaanxi, Zhaozhou County in Heilongjiang and Youxi County in Fujian), and to obtain the information related to their depressive symptoms through the self assessment questionnaire on depression. Multivariate Logistic regression analysis was conducted to analyze the prevalence of depressive symptoms among primary and secondary school students, as well as their related factors.
Results:
The detection rate of depressive symptoms among primary and secondary school students in the in depth monitored counties was 23.5%. Logistic regression analysis showed that the probability of detecting depressive symptoms was higher among female students, middle school students, students whose video screen duration per day was >2 h, and students whose parents marital status was divorced or widowed ( OR =1.40, 1.64, 1.60, 1.24), and students whose sleep duration reached the recommended standard, whose parents usually accompanied them daily for time was 60-<120 min and ≥120 min, and students whose mothers literacy level was middle school graduation had lower probability of detecting depressive symptoms ( OR =0.85, 0.84, 0.71, 0.76) ( P < 0.05 ).
Conclusion
The detection rate of depressive symptoms among students in the in depth monitoring area is high, and targeted interventions need to be developed for students to reduce the risk of mental health problems.
8.Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study
I-Shen HUANG ; Li-Hua LI ; Wei-Jen CHEN ; Chi-Chang JUAN ; William J. HUANG
The World Journal of Men's Health 2025;43(1):142-153
Purpose:
The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes.
Materials and Methods:
We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA.
Results:
Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher.
Conclusions
The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.
9.Analysis of health-related lifestyles among primary and secondary school students in nutrition improvement program regions of China between 2021 and 2023
Chinese Journal of School Health 2025;46(6):788-791
Objective:
To analyze the features of unhealthy lifestyle patterns among primary and secondary school students in the nutrition improvement program for rural compulsory education students (NIPRCES) areas in China in 2021 and 2023, so as to provide data support for lifestyle promotion and healthy development among primary and secondary school students.
Methods:
Adopting a cluster random sampling method, data on primary and secondary students aged 7-15 years from nutrition and health surveillance of China NIPRCES in 2021 and 2023 were collected. The prevalence of unhealthy lifestyles among primary and secondary students such as physical inactivity, outdoor inactivity, excessive screen time, and sleep deprivation by gender, school section, urban/rural, and region were analyzed. The reporting rates of the above indicators among primary and secondary students were compared by Chi-square test.
Results:
In 2021 and 2023, the rates of moderate to vigorous physical inactivity among primary and secondary school students were 79.2% and 80.4%, the rates of outdoor inactivity were 42.8% and 49.3%, the rates of excessive video time were 2.6% and 2.9%, the rates of sleep deprivation were 32.9% and 22.6%, and the differences were statistically significant( χ 2=51.86,1 071.48,18.36,3 296.99, P <0.05). In 2023, the rate of outdoor inactivity for primary and secondary students increased by 6.5 percentage points compared with 2021, and the rate of sleep deprivation decreased by 10.3 percentage points compared with that in 2021. In 2021 and 2023, the reporting rates of moderate to vigorous physical inactivity, outdoor inactivity, and sleep deprivation among girls and junior high school students were higher than those among boys ( χ 2=174.41,180.11; 175.75, 85.46 ;92.22,151.35) and elementary school students ( χ 2=136.64,5.75; 40.55,4.71;162.80,3 291.61); the reporting rates of moderate to vigorous physical inactivity( χ 2=194.43,118.60) and sleep deprivation ( χ 2=969.66,983.72) among urban students were higher than those among rural students; the reporting rates of excessive video time for boys and junior high school students were higher than those for girls ( χ 2=103.62,84.85) and elementary school students ( χ 2=810.09,626.51)( P <0.05). From a regional distribution perspective, the reporting rates of moderato to vigorous physical inactivity, outdoor inactivity, and excessive video time among primary and seconday school students in the central and western regions were lower than those in the eastern region ( χ 2= 663.44,302.78; 356.97,82.10;50.89,81.83) ( P <0.05).
Conclusions
Unhealthy lifestyles remain prevalent among primary and secondary students in NIPRCES areas of China. These findings underscore the need to strengthen policy implementation for promoting healthy lifestyles among primary and secondary school students.
10.Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study
I-Shen HUANG ; Li-Hua LI ; Wei-Jen CHEN ; Chi-Chang JUAN ; William J. HUANG
The World Journal of Men's Health 2025;43(1):142-153
Purpose:
The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes.
Materials and Methods:
We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA.
Results:
Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher.
Conclusions
The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.


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