Globalization has driven a surge in noncommunicable diseases, including metabolic disorders, which are major global health challenges. These disorders, fueled by high-calorie diets, sedentary lifestyles, and gut microbiota imbalances, disrupt energy metabolism, gastrointestinal function, and vitamin and trace element homeostasis. Sertoli cells provide the metabolic and structural support essential for germ cell development within the seminiferous epithelium. This review examines how metabolic disorders affect male reproductive health, focusing on glucose, lipid, and vitamin metabolism, as well as the gut-testis axis, in relation to Sertoli cell function and the blood-testis barrier (BTB) integrity. Glucose metabolism in Sertoli cells provides lactate to germ cells, which is crucial for spermatogenesis. However, metabolic stressors, such as diabetes, impair glucose transport and lactate production, compromising energy supply. Lipid metabolism, including fatty acid oxidation and lipid droplet dynamics, is essential for energy homeostasis in Sertoli cells. Moreover, the gut microbiota further influences Sertoli cells and BTB integrity via metabolites, such as short-chain fatty acids, which enhance barrier function and reduce inflammation. Conversely, dysbiosis and microbially derived lipopolysaccharides induce oxidative stress and immune responses, leading to BTB disruption and infertility. Deficiencies or imbalances in the levels of these vitamins and trace elements can impair spermatogenesis. This review highlights the complex interplay between metabolic pathways and Sertoli cell function, their collective impact on male fertility, and provides a basis for developing targeted therapeutic strategies, including metabolic modulators, vitamin supplementation, and gut microbiota interventions, to mitigate the effects of metabolic disorders on spermatogenesis and fertility.

Keywords: Sertoli cells; blood-testis barrier; glucose metabolism; lipid metabolism; metabolic disorders.

全球化推动了非传染性疾病（包括代谢障碍）的激增，这些疾病已成为全球健康的主要挑战。高热量饮食、久坐生活方式和肠道菌群失衡等因素导致的能量代谢紊乱、胃肠功能失调以及维生素和微量元素稳态失调是这类疾病的诱因。支持细胞为生精上皮中的精子发生提供了必需的代谢和支持结构基础。本文综述了代谢障碍如何影响男性生殖健康，重点关注葡萄糖、脂质和维生素代谢，以及肠道-睾丸轴与支持细胞功能和血-睾屏障（BTB）完整性之间的关系。支持细胞内的葡萄糖代谢为精原细胞提供乳酸，这对精子发生至关重要。然而，糖尿病等代谢压力因素会损害葡萄糖转运和乳酸生成，从而削弱能量供应。脂质代谢包括脂肪酸氧化和脂滴动力学，在支持细胞的能量稳态中起关键作用。此外，肠道菌群通过短链脂肪酸等代谢物进一步影响支持细胞和BTB的完整性，增强屏障功能并减少炎症。相反，菌群失调和由微生物产生的内毒素会诱导氧化应激和免疫反应，导致BTB破坏和不育。维生素和微量元素的缺乏或不平衡也会损害精子发生。本文综述了代谢途径和支持细胞功能之间的复杂相互作用及其对男性生育能力的整体影响，并为开发靶向治疗策略提供了依据，包括代谢调节剂、维生素补充以及肠道菌群干预措施，以减轻代谢障碍对精子生成和生育力的影响。

关键词：支持细胞；血-睾屏障；葡萄糖代谢；脂质代谢；代谢障碍。