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It is well-known that T2DM alters spermatogenesis in males, decreasing both sperm number and quality (5860), resulting in reduced fertility

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That includes vitamin D and calcium intake ( 800 IU vitamin D + 700-1200 mg/day of calcium), smoking cessation, and moderation of alcohol intake, which are all modifiable risk factors for osteoporosis progression

In terms of metabolic parameters, all the treated arms had beneficial changes in their HbA1c%, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels, with the Sema+-MSTN+-ActA arm, which showed the largest combination of fat decrease and lean mass increase, showing the biggest beneficial changes (Fig

Cushing syndrome , whether from excess cortisol production or chronic steroid use, causes characteristic central weight gain

While biological plausibility exists, clinicians should recognize that laboratory findings do not automatically translate into proven clinical benefit