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Updated: Aug 26, 2026
Combined Supine and Standing Imaging for Varicocele: An Improved Diagnostic Approach
Published on: November 22, 2024
Systemic Signatures Differentiating Varicocele-Associated Semen Quality Heterogeneity: An Exploratory Multi-Omics
Jun Zhang1, Jie Yang2, Yu Liang1
1Department of Urology, The 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army (PLA), Hefei, Anhui, China.
Background:
Significant semen-quality heterogeneity exists among varicocele (VC) patients with similar macro-anatomical backgrounds.
Objectives:
This exploratory pilot study characterized and compared fecal microbial configurations and relative serum metabolomic signatures associated with individual phenotypic divergence in left-sided clinical VC.
Materials And Methods:
Twenty-five young males with left-sided VC were stratified into low semen quality (VC_L, n = 17) and normal semen quality (VC_N, n = 8) groups. Multi-omics profiling was performed via fecal 16S rRNA sequencing and serum untargeted LC-MS/MS metabolomics.
Results:
Fecal microbiota alpha and beta diversity metrics were comparable between groups. LEfSe analysis revealed taxonomic differentiation: the VC_N group showed enrichment of Fusobacteriota lineages and Faecalimonas, whereas the VC_L group showed higher discriminative abundance of the Ruminococcus gauvreauii group and UCG_003. Cross-domain integrative profiling revealed distinct modular patterns: a cluster dominated by Bacteroides and Blautia aligned positively with circulating carbohydrate-related metabolites (inositol and D-ribose), whereas potential opportunistic taxa such as Escherichia_Shigella showed inverse associations with these metabolites and positive associations with lipid-related features (palmitoylcarnitine). Serum untargeted metabolomics further showed distinct relative ion intensities: VC_L exhibited higher signals of lipid-, amino acid-, and TCA cycle-related features (oleoyl ethanolamide, palmitoylcarnitine, taurine, and L-malate), whereas VC_N showed higher intensities of arachidonic acid, citric acid, choline, and D-ribose.
Discussion And Conclusion:
Semen-quality-defined subgroups of left-sided VC patients exhibit distinct gut microbial taxonomic distributions and relative serum metabolic profiles. These preliminary, associative findings provide a descriptive multi-omics landscape of individual phenotypic heterogeneity and generate hypotheses regarding the gut-testis axis.
