Association of Body Mass Index with Circulating Leptin and Irisin in Infertile Men: A Systematic Review
BMI, Leptin and Irisin in Infertile Men
Keywords:
Body Mass Index, Fibronectins, Infertility, Leptin, ObesityAbstract
Background: Obesity is linked to male infertility, but how adiposity relates to the adipokine leptin and the myokine irisin in infertile men is unclear. This review synthesized the evidence on the association of body mass index (BMI) with serum leptin and irisin in infertile males.
Methods: PubMed/MEDLINE, Scopus, Web of Science and the Cochrane Library were searched between April and September 2026, supplemented by Google Scholar and citation searching. Observational studies of adult infertile men reporting BMI and circulating leptin or irisin were eligible. Two reviewers independently screened records, extracted data and assessed risk of bias with ROBINS-E. Narrative synthesis followed SWiM; certainty was rated with GRADE.
Results: Ten studies (2007–2022; 1,749 men, 1,398 infertile) were included: eight on leptin and two on irisin. All eight leptin studies found higher leptin with higher BMI, significant in seven. Within infertile men, correlations ranged from r = 0.31 to 0.72, and leptin rose stepwise across WHO BMI categories. Leptin–semen associations weakened after BMI adjustment. Both irisin studies suggested lower irisin at higher BMI, but one correlation was non-significant on recalculation and the other confounded obesity with subfertility. No study was at low risk of bias; four had some concerns, three were high and three very high. Certainty was low for leptin and very low for irisin.
Conclusion: Higher BMI may be associated with higher serum leptin in infertile men, largely reflecting adiposity rather than an independent fertility marker. Evidence for irisin is very uncertain. Within-infertile studies with body-composition measures and standardized assays are needed.
DOI: https://doi.org/10.59564/amrj/04.04/013
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