ArticleFrontiers in endocrinology2026
Combined assessment of body mass index and triglyceride-glucose index reveals metabolic risk phenotypes associated with semen quality impairment.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Body mass index (BMI) has been associated with impaired semen quality, but evidence remains inconsistent, partly because BMI does not adequately reflect metabolic health. The triglyceride-glucose (TyG) index, a surrogate for insulin resistance (IR), is increasingly recognized as a potential contributor to impaired semen quality. However, whether BMI and TyG are jointly associated with semen quality has not been evaluated. Methods: This retrospective cross-sectional study included 804 men from a fertility clinic. Associations of BMI and TyG with semen parameters were evaluated using multivariable linear and logistic regression models. Receiver operating characteristic, net reclassification improvement (NRI), and integrated discrimination improvement analyses were performed to assess model discrimination and reclassification. Exploratory mediation analyses estimated the extent to which TyG accounted for the observed associations between BMI and semen quality. Results: Elevated BMI and TyG were independently associated with lower total motility, progressive motility, and normal morphology. Men with both high BMI and high TyG showed the highest odds of reduced total motility (OR 3.63, 95% CI:1.99, 6.61), progressive motility (OR 3.21, 95% CI:1.74, 5.90), and normal forms (OR 2.78, 95% CI:1.57, 4.92). Men with low BMI but high TyG showed numerically higher impairment rates than men with high BMI but low TyG across motility and morphology outcomes. The incremental NRI of TyG beyond BMI ranged from 0.212 to 0.321 for these parameters (all P < 0.01). Exploratory mediation analyses indicated that TyG statistically accounted for 35.9%, 33.9%, and 28.5% of the observed association between BMI and total motility, progressive motility, and normal forms, respectively. Conclusions: BMI and TyG index were independently associated with impaired sperm motility and normal morphology, while the combination of BMI and TyG provided additional risk stratification. Elevated TyG may help identify metabolically at-risk men who are not fully captured by BMI alone, although further validation is required.
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