İnfertil Erkeklerde TyG İndeksi ve TG/HDL Oranının Semen Parametreleri ile Olası İlişkileri

Abstract

Amaç: Bu çalışmada infertil erkeklerde metabolik risk belirteçleri olan trigliserid-glukoz (TyG) indeksi ve trigliserid/HDL kolesterol (TG/HDL) oranı ile semen parametreleri arasındaki ilişki araştırıldı. Gereç ve Yöntemler: 2018–2024 yılları arasında semen analizi yapılan 18–60 yaş arası 275 erkek retrospektif olarak incelendi. Demografik, biyokimyasal ve semen verileri değerlendirildi. Korelasyon analizleri ve çok değişkenli lojistik regresyon yapıldı. Bulgular: Ortalama yaş 34,9 ± 6,9 yıl, VKİ 25,9 ± 3,4 kg/m² idi. Daha yüksek TyG indeksi ve TG/HDL oranı, düşük total motilite (TyG r=-0,18, p=0,004; TG/HDL r=-0,16, p=0,009), progresif motilite (TyG r=-0,22, p<0,001; TG/HDL r=-0,21, p=0,001) ve normal morfoloji (TyG r=-0,15, p=0,012; TG/HDL r=-0,13, p=0,025) ile ilişkili bulundu. Lojistik regresyon analizinde yaş (OR 1,04, p=0,016), VKİ (OR 1,07, p=0,007), TyG indeksi (OR 1,38, p=0,003) ve TG/HDL oranı (OR 1,22, p=0,021) düşük semen kalitesinin bağımsız belirleyicileri olarak saptandı. Sonuç: Bu çalışma, daha yüksek TyG indeksi ve TG/HDL oranının semen parametrelerinde, özellikle motilite ve morfoloji açısından bozulma ile ilişkili olabileceğini göstermektedir. Bu indeksler erkek infertilitesinin değerlendirilmesinde destekleyici belirteçler olarak kullanılabilir, ancak öngörücü değerleri sınırlıdır. Bu nedenle bağımsız tanısal araçlardan ziyade tamamlayıcı göstergeler olarak yorumlanmalıdır. Bulguların doğrulanması ve klinik öneminin netleştirilmesi için daha geniş ve farklı popülasyonlarda yürütülecek prospektif çalışmalara ihtiyaç vardır.

Keywords

• İnfertilite
• semen analizi
• TyG indeksi
• metabolik sendrom

Potential Associations of TyG Index and TG/HDL Ratio with Semen Parameters in Infertile Men

Abstract

Aim: This study aimed to investigate the association between metabolic risk markers, namely the triglyceride-glucose (TyG) index and triglyceride-to-HDL cholesterol (TG/HDL) ratio, and semen parameters in infertile men. Material and Methods: Data from 275 men aged 18–60 years who underwent semen analysis between 2018 and 2024 were retrospectively analyzed. Demographic, biochemical, and semen parameters were collected, and correlations were evaluated. Multivariate logistic regression analysis was performed to determine independent predictors of reduced semen quality. Results: The mean age was 34.9 ± 6.9 years and BMI 25.9 ± 3.4 kg/m². Higher TyG index and TG/HDL ratio were significantly associated with lower total motility (TyG r=-0.18, p=0.004; TG/HDL r=-0.16, p=0.009), progressive motility (TyG r=-0.22, p<0.001; TG/HDL r=-0.21, p=0.001), and normal morphology (TyG r=-0.15, p=0.012; TG/HDL r=-0.13, p=0.025). Logistic regression identified age (OR 1.04, p=0.016), BMI (OR 1.07, p=0.007), TyG index (OR 1.38, p=0.003), and TG/HDL ratio (OR 1.22, p=0.021) as independent predictors of reduced semen quality. Conclusion: This study indicates that higher TyG index and TG/HDL ratio may be linked to impaired semen parameters, particularly reduced motility and morphology. While these indices could serve as supportive markers in the evaluation of male infertility, their predictive value appears modest. Therefore, they should be interpreted as complementary rather than standalone indicators. Further prospective studies with larger and more diverse populations are needed to confirm these associations and clarify their clinical relevance.

Keywords

• Infertility
• semen analysis
• TyG index
• metabolic syndrome

References

1. 1. Vander Borght M, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2-10. doi:10.1016/j.clinbiochem.2018.03.012.
2. 2. Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update. 2015;21(4):411-26. doi:10.1093/humupd/dmv016.
3. 3. Eisenberg ML, Esteves SC, Lamb DJ, Hotaling JM, Giwercman A, Hwang K, et al. Male infertility. Nat Rev Dis Primers. 2023;9(1):49. doi:10.1038/s41572-023-00459-w.
4. 4. Sharma A, Minhas S, Dhillo WS, Jayasena CN. Male infertility due to testicular disorders. J Clin Endocrinol Metab. 2021;106(2):e442-e59. doi:10.1210/clinem/dgaa781.
5. 5. Fainberg J, Kashanian JA. Recent advances in understanding and managing male infertility. F1000Res. 2019;8:670. doi:10.12688/f1000research.17076.1.
6. 6. Choy JT, Eisenberg ML. Male infertility as a window to health. Fertil Steril. 2018;110(5):810-4. doi:10.1016/j.fertnstert.2018.08.015.
7. 7. Ma D, Xi J. Correlation study and full management of metabolic syndrome and sperm DNA fragmentation index, a regional multicentre prospective long term follow-up study from Anhui, China. Front Cell Dev Biol. 2025;13:1586069. doi:10.3389/fcell.2025.1586069.
8. 8. Mulya IC, Hasan MA, Iqhrammullah M. Impact of metabolic syndrome factors on sperm DNA fragmentation in males from infertile couples: a systematic review and meta-analysis. J Gynecol Obstet Hum Reprod. 2024;53(8):102807. doi:10.1016/j.jogoh.2024.102807

9. 9. Salvio G, Ciarloni A, Cutini M, Delli Muti N. Metabolic syndrome and male fertility: beyond heart consequences of a complex cardiometabolic endocrinopathy. Int J Mol Sci. 2022;23(10). doi:10.3390/ijms23105497.
10. 10. Yilmaz MB, Keyif B. The relation of insulin resistance with free androgen index and endothelial dysfunction marker YKL-40 and its effect on male infertility: a prospective study. Cureus. 2024;16(10):e70537. doi:10.7759/cureus.70537.
11. 11. AbbasiHormozi S, Kouhkan A, Shahverdi A, Parikar A, Shirin A, Vesali S. How much obesity and diabetes do impair male fertility? Reprod Biol Endocrinol. 2023;21(1):48. doi:10.1186/s12958-023-01058-1.
12. 12. Park M-S. Triglyceride-glucose index predicts future metabolic syndrome in an adult population, Korea: a prospective cohort study. Ann Clin Nutr Metab. 2024;16(3):168-72. doi:10.15747/ACNM.2024.16.3.168.
13. 13. Sun X, Wu Z, Guo D, Chen S, Song C, Ran X, et al. Triglyceride-glucose index as a superior marker of insulin resistance for predicting long-term major adverse cardiovascular events following coronary artery bypass grafting in China. Sci Rep. 2025;15(1):6450. doi:10.1038/s41598-025-06450-7.
14. 14. Kosmas CE, Rodriguez Polanco S. The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio as a risk marker for metabolic syndrome and cardiovascular disease. Diagnostics (Basel). 2023;13(5):929. doi:10.3390/diagnostics13050929.
15. 15. Belladelli F, Boeri L, Pozzi E, Fallara G, Corsini C. Triglycerides/glucose index is associated with sperm parameters and sperm DNA fragmentation in primary infertile men: a cross-sectional study. Metabolites. 2022;12(2):143. doi:10.3390/metabo12020143.
16. 16. Baş Aksu Ö, Özkara F. Investigation of the relationship between the triglyceride-glucose index and metabolic and hematological parameters in obese individuals. 2025;55(3):710-8. doi:10.55730/1300-0144.6019.
17. 17. Tolunay H, Fırtına S. Triglyceride glucose index and the Triglyceride/HDL ratio as predictors of coronary artery disease. Düzce Univ Sağlık Bilim Enst Derg. 2021;11(2):235-41. doi:10.33631/duzcesbed.882401.
18. 18. Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16(3):231-45. doi:10.1093/humupd/dmp048.
19. 19. Zhao J, Li N, Li S, Dou J. The predictive significance of the triglyceride-glucose index in forecasting adverse cardiovascular events among type 2 diabetes mellitus patients with co-existing hyperuricemia: a retrospective cohort study. Cardiovasc Diabetol. 2025;24(1):218. doi:10.1186/s12933-025-02783-9.
20. 20. Won KB, Park GM, Lee SE, Cho IJ, Kim HC, Lee BK, et al. Relationship of insulin resistance estimated by triglyceride glucose index to arterial stiffness. Lipids Health Dis. 2018;17(1):268. doi:10.1186/s12944-018-0914-2.
21. 21. Keihani S, Verrilli LE, Zhang C, Presson AP, Hanson HA, Pastuszak AW. Semen parameter thresholds and time-to-conception in subfertile couples: how high is high enough? Hum Reprod. 2021;36(8):2121-33. doi:10.1093/humrep/deab133.
22. 22. Karabulut A, Tekin A. Alterations in the morphology and motility of spermatozoa: relation with total sperm count. Pamukkale Medical Journal. 2013;1:1-4.
23. 23. Pan LY, Jin L. Association between triglyceride glucose index and biological aging in U.S. adults: National Health and Nutrition Examination Survey. Cardiovascular diabetology. 2025;24(1):100. doi:10.1186/s12933-025-02631-w.
24. 24. Atlihan U, Erkilinc S, Ersak B, Acet F, Ozay AC, Yavuz O, et al. The role of Triglyceride/Glucose index in patients with Polycystic Ovary Syndrome. Gynecol. Obstet. Reprod. Med. 2025;31(2):130-6. doi:10.21613/GORM.2025.1586.
25. 25. Keyif B, Yavuzcan A. Visceral and Dysfunctional Adiposity Indices as predictors of insulin resistance and metabolic syndrome in women with Polycystic Ovary Syndrome: a cross-sectional study. Medicina. 2025;61(3):424. doi:10.3390/medicina61030424.
26. 26. Pakpahan C, Rezano A. The association between lipid serum and semen parameters: a systematic review. Reprod Sci. 2023;30(3):761-71. doi:10.1007/s43032-022-01040-8.
27. 27. Chen YY, Kao TW, Peng TC, Yang HF, Wu CJ, Chen WL. Metabolic syndrome and semen quality in adult population. 2020;12(4):294-304. doi:10.1111/1753-0407.12995.
28. 28. Liu CY, Chou YC, Lin SH, Wu ST, Cha TL, Chen HI, et al. Serum lipid profiles are associated with semen quality. Asian J Androl. 2017;19(6):633-8. doi:10.4103/1008-682x.195240.
29. 29. Guo T, Zou Q, Wang Q, Zhang Y, Zhong X, Lin H, et al. Association of TyG Index and TG/HDL-C Ratio with Trajectories of Depressive Symptoms: Evidence from China health and retirement longitudinal study. Nutrients. 2024;16(24):4300. doi:10.3390/nu16244300.