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Title: [Correlation of reproductive hormone levels and seminal plasma oxidative stress with semen quality in obese males].
Author: Han RY, Ma J, Ma J, Liu WJ, An XT, Zhang ZD, Wang SS.
Journal: Zhonghua Nan Ke Xue; 2018 May; 24(5):419-424. PubMed ID: 30171757.
Abstract:
OBJECTIVE: To investigate the correlation of the levels of reproductive hormones and oxidative stress in the seminal plasma with semen parameters in obese males. METHODS: Based on the body mass index (BMI), we divided 138 infertile men into three groups: normal (BMI <24 kg/m2, n = 48), overweight (24 kg/m2≤BMI<28 kg/m2, n = 47), and obesity (BMI ≥28 kg/m2, n = 43). We determined the concentrations of follicle-stimulating hormone (FSH), luteotropic hormone (LH), prolactin (PRL), testosterone (T) and estradiol (E2) in the serum by electrochemiluminescence and measured the levels of superoxide dismutase (SOD), glutathione-S-transferases (GSTs), reactive oxygen species (ROS) and malondialdehyde (MDA) in the seminal plasma by ELISA, compared the above indexes among the three groups, and analyzed their correlation with the semen volume, sperm concentration, total sperm count, and percentage of progressively motile sperm (PMS). RESULTS: The semen volume was significantly lower in the obesity than in the normal group (［2.63 ± 0.74］ vs ［3.37 ± 1.00］ ml, P < 0.05), and so was the percentage of PMS in the overweight and even lower in the obesity than in the normal group (［47.91 ± 12.89］ and ［41.27 ± 15.77］ vs ［54.04 ± 13.29］%, P < 0.05). Compared with the normal group, both the overweight and obesity groups showed markedly decreased levels of serum T (［4.83 ± 1.42］ vs ［3.71 ± 1.22］ and ［3.49 ± 1.12］ ng/ml, P<0.05), T/LH ratio (1.53 ± 0.57 vs 1.19 ± 0.54 and 0.97 ± 0.51, P<0.05), SOD (［112.05 ± 10.54］ vs ［105.85 ± 6.93］ and ［99.33 ± 8.39］ U/ml, P<0.05), and GSTs (［31.75±6.03］ vs ［29.54±5.78］ and ［29.02±4.52］ U/L, P<0.05), but remarkably increased seminal plasma ROS (［549.93±82.41］ vs ［620.61±96.13］ and ［701.47±110.60］ IU/ml, P<0.05) and MDA (［7.46 ± 2.13］ vs ［8.72 ± 1.89］ and ［10.47 ± 2.10］ nmol/L, P<0.05). BMI was correlated positively with ROS and MDA, but negatively with the semen volume, PMS, T, T/LH, SOD and GSTs (P<0.05); LH negatively with sperm concentration, total sperm count and GSTs (P<0.05); PRL negatively GSTs (P<0.05); E2 positively with SOD (P<0.05); T positively with SOD (P<0.05) but negatively with MDA (P<0.05); T/LH positively with PMS and SOD (P<0.05) but negatively with ROS and MDA (P<0.05); SOD positively with semen volume, PMS and GSTs (P<0.05) but negatively with ROS and MDA (P<0.05); GSTs negatively with sperm concentration; total sperm count and MDA (P<0.05); ROS positively with MDA (P<0.01) but negatively with PMS (P<0.05); and MDA negatively with semen volume (P<0.05). Multivariate logistic regression analysis showed that the independent factors influencing the semen volume were BMI and GSTs, those influencing the total sperm count were BMI and T, and those influencing PMS were BMI and MDA. CONCLUSIONS: Increased BMI induces changes in the levels of male reproductive hormones and seminal plasma oxidative stress and affects semen quality, which may be associated with male infertility. 目的: 探讨肥胖男性生殖激素及精浆氧化应激水平对精液参数的影响。方法: 将138例不育男性，根据身体体质量指数（BMI）分为正常组（BMI<24 kg/m2）48例，超重组（24 kg/m2≤BMI<28 kg/m2）47例和肥胖组（BMI≥28 kg/m2）43例。应用电化学发光法测定血清中卵泡刺激素（FSH）、黄体生成素（LH）、泌乳素（PRL）、睾酮（T）和雌二醇（E2）浓度，比较组间差异；采用酶联免疫吸附测定法（ELISA）测超氧化物歧化酶（SOD）、谷胱甘肽S-转移酶（GSTs）、精浆活性氧簇（ROS）和丙二醛（MDA）水平，比较组间差异；并分析上述指标与精液参数（精子浓度，精液体积，精子总数以及前向运动精子百分率）的相关性分析。结果： (1) 随着BMI增加，正常组、超重组和肥胖组前向运动精子百分率（PR%）（54.04±13.29、47.91±12.89、41.27±15.77）显著降低(P<0.05)；与正常组精液量（ml）（3.37±1.00）比，肥胖组精液量（2.63±0.74）降低并具有统计学差异(P<0.05)；与正常组生殖激素T（ng/ml）（4.83±1.42）相比，超重组、肥胖组T（3.71±1.22、3.49±1.12）降低(P<0.05)，3组间T/LH（1.53±0.57、1.19±0.54、0.97±0.51）降低并具有差异(P<0.05)。(2)正常组、超重组和肥胖组3组精浆SOD浓度（U/ml）(112.05±10.54、105.85±6.93、99.33±8.39)降低并具有统计学意义(P<0.05)；与正常组精浆GSTs(U/L)（31.75±6.03）相比，肥胖组精浆GSTs（29.02±4.52）降低 (P<0.05)；正常组、超重组和肥胖组3组精浆ROS（IU/ml）（549.93±82.41、620.61±96.13、701.47±110.6）、MDA(nmol/L)（7.46±2.13、8.72±1.89、10.47±2.1）含量升高并具有统计学意义 (P<0.05)。(3)BMI指数与精液量、PR%、T、T/LH、SOD、GSTs呈负相关，与ROS、MDA呈正相关（P<0.05）；LH与精子浓度、精子总数和GSTs呈负相关（P<0.05）；PRL与GSTs呈负相关（P<0.05）；E2与SOD呈正相关（P<0.05）；T与SOD呈正相关（P<0.05），与MDA呈负相关（P<0.05）；T/LH与PR%、SOD呈正相关（P<0.05），与ROS、MDA呈负相关（P<0.05）；SOD与精液量、PR%、GSTs呈正相关（P<0.05），与ROS、MDA呈负相关（P<0.05）；GSTs与精子浓度、精子总数、MDA呈负相关（P<0.05）；ROS与PR%呈负相关（P<0.05），与MDA呈正相关（P<0.01）；MDA与精液量呈负相关（P<0.05）。(4)多元回归分析显示，精液量的独立影响因素为BMI和GSTs；BMI和T是精子总数的独立影响因素，PR的独立影响因素为BMI和MDA。结论：随着BMI指数升高，男性生殖激素以及精浆中氧化应激状态的变化，表现为与精液质量的相关性，可能是肥胖男性不育的影响因素。.

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