体重指数与不育男性生育力指标的相关性分析  

Association of body mass index with semen parameters and hormonal proifle among infertile males

作　　者：朱宏[1] 陈斌[1] 王鸿祥[1] 胡凯[1] 金炎[1] 杨昊[1] 冯坦[1] 张涛[1] 韩银发[1] 王益鑫[1] 黄翼然[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,上海市男科学研究所,上海200001

出　　处：《中国男科学杂志》2014年第2期36-39,共4页Chinese Journal of Andrology

基　　金：国家自然科学基金资助项目（81270741）;上海市浦东新区卫生系统重点学科群建设项目（PWZxkq2010-03）

摘　　要：目的：探究不育男性体重指数（body mass index, BMI）与精液参数、血清性激素及抑制素B（Inhibin B）水平的关系。方法随机选择2012年1月至2012年12月就诊上海交通大学医学院附属仁济医院男科门诊的男性不育症患者317例，按照BMI≥28为肥胖，BMI 24~27.9为超重，BMI 18.5~23.9为正常进行分组。检测常规精液参数、血清性激素水平，并进行统计学分析。结果超重组精子浓度、精子总数、活动精子总数、c级精子百分数、血清T、Inhibin B水平及T/E2均低于正常体重组，d级精子百分数血清E2水平高于正常体重组。肥胖组精子浓度、精子总数、活力、活动精子总数、a级、b级、c级精子百分数、血清T、Inhibin B水平及T/E2均低于正常体重组，d级精子百分数、血清E2水平高于正常体重组。BMI与年龄、血清E2水平呈正相关，BMI与精子浓度、精子总数、c级精子百分数、血清T、T/E2及Inhibin B水平均呈负相关。差异均有统计学意义。结论随着男性BMI的增加，精液参数可发生不同程度下降，同时伴有血清性激素的改变，BMI的增加可能是影响男性生育能力的因素之一，其中具体的分子机制仍有待进一步探究。Objective To study the association between body mass index and semen parameters, gonadotropic and sex hormone, Inhibin B levels in infertile men. Methods 317 infertile men visited outpatient clinic for reproductive treatment and preconception counseling in Renji hospital from January 2012 to December 2012. BMI was assessed and the subjects stratified into subgroups according to BMI, normal-weight：18.5~23.9, overweight：24~27.9 and obese：≥28. The sperm parameters were detected by computer assisted sperm analysis （CASA） and a morning blood sample was taken to assess the levels of serum FSH, LH, testosterone, estradiol and Inhibin B. Results Overweight group had significant decrease in sperm concentration, total sperm count, total motile sperm count, the percentage of immotility type C, serum T level, Inhibin B level and T/E2 ratio compared with normal-weight group, while increase in the percentage of immotility type D and serum E2 level. Obese group had significant decrease in sperm concentration, total sperm count, sperm motility, total motile sperm count, the percentage of progressive motility type A＋B, the percentage of immotility type C, serum T level, Inhibin B level, T/E2 ratio compared with normal-weight group, while increase in the percentage of immotility type D and serum E2 level. BMI was significant positively associated with age, serum E2 level and significant negatively associated with sperm concentration, total sperm count, the percentage of immotility type C, serum T level, Inhibin B level, T/E2 ratio. Conclusion The association explored between BMI and some semen characteristics and sexual hormones, as well as different patterns of this association between overweight and obsess infertile men, will be of help to broaden our understanding of the effect of obesity on some male reproductive physiologic characteristics among infertile men.

关 键 词：人体质量指数 生育力 不育 男性 

分 类 号：R698.2[医药卫生—泌尿科学]