肥胖相关代谢性内毒素血症对精子畸形率的影响因素分析  

Influencing factors of metabolic endotoxemia on sperm deformity index in obese population

作　　者：刘春辉 朱晨[1] 陕文生[1] 王志强[1] 王海 周于娜 李少君 金莉娅[3] LIU Chunhui;ZHU Chen;SHAN Wensheng(Department of Andrology,Gansu Provincial Maternity and Child-Care Hospital,Gansu,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院男科,兰州市730050 [2]甘肃省妇幼保健院生殖泌尿科,兰州市730050 [3]甘肃省妇幼保健院健康管理中心,兰州市730050

出　　处：《河北医药》2023年第7期981-985,共5页Hebei Medical Journal

基　　金：兰州市科技发展指导性计划项目(编号:2020-ZD-4);甘肃省自然科学基金项目(编号:20JR10RA425)。

摘　　要：目的探讨肥胖人群的代谢性内毒素血症对精子畸形率影响的高危因素分析。方法选取2021年1~12月就诊的畸形精子症患者453例作为观察组,选取同期精子畸形率正常人员231例作为对照组。检测身高、体重、血清人连蛋白(Zonulin)、血清脂多糖结合蛋白(LBP)、人精液弹性蛋白酶(Elastase)、精液8-羟基脱氧鸟苷(8OHdG)、精子畸形率。采用多因素Logistic回归分析法、Pearson相关分析法探究肥胖人群相关的代谢性内毒素血症对精子畸形率影响的高危因素。结果观察组肥胖率显著高于对照组(72.4%∶25.1%,χ^(2)=8.231,P=0.009);观察组8OHdG异常率高于对照组(73.5%∶19.9%,χ^(2)=5.964,P=0.018);观察组Zonulin异常率显著高于对照组(79.7%∶8.2%,χ^(2)=9.635,P=0.002);观察组LBP异常率高于对照组(69.3%∶29.4%,χ^(2)=7.524,P=0.013);观察组雌二醇(E2)异常率高于对照组(43.5%∶10%,χ^(2)=6.954,P=0.019);在年龄、Elastase、FSH、LH、TT等观察指标方面,2组差异无统计学意义。多因素Logistic回归分析结果显示,BMI(OR=5.984,P=0.004)、8OhdG(OR=3.521,P=0.001)、Zonulin(OR=3.241,P=0.017)、LBP(OR=5.511,P=0.001)、E2(OR=4.671,P=0.026)是影响精子畸形率的高危因素。BMI与Zonulin、LBP、8OhdG、E2存在相关关系(P<0.05)。结论肥胖可诱发代谢性内毒素血症,肠道通透性的增加以及内毒素水平的升高可造成全身炎性反应,诱导氧化应激的出现。由氧化应激造成白细胞释放的活性氧将会造成精子畸形率升高。因此,肥胖诱导的代谢性内毒素血症可引起Zonulin、LBP、8OHdG、E2升高,它们是影响精子畸形率的高危因素。Objective To explore the high-risk factors of metabolic endotoxemia on sperm deformity index(SDI)in obese population.Methods A total of 453 patients with abnormal spermatozoa from January 2021 to December 2021 were selected as the observation group,and 231 people with normal SDI in the same period were selected as the control group,a total of 684 people.Their height,weight,serum Zonulin,serum lipopolysaccharide binding protein(LBP),human semen elastase,semen 8-hidroxy-2-deoxyguanosine(8-OHdG)and SDI were measured and detected.Multivariate logistic regression analysis and Pearson correlation analysis were used to explore the high-risk factors of obesity-induced metabolic endotoxemia on SDI.Results The obesity rate in the observation group was significantly higher than that in the control group(72.4%vs 25.1%,χ^(2)=8.231,P=0.009);The abnormal rate of 8OHdG in the observation group was higher than that in the control group(73.5%vs 19.9%,χ^(2)=5.964,P=0.018);The abnormal rate of Zonulin in the observation group was significantly higher than that in the control group(79.7%vs 8.2%,χ^(2)=9.635,P=0.002);The abnormal rate of LBP in the observation group was significantly higher than that in the control group(69.3%vs 29.4%,χ^(2)=7.524,P=0.013);The abnormal rate of E2 in the observation group was significantly higher than that in the control group(43.5%vs 10%,χ^(2)=6.954,P=0.019);There was no difference between the two groups in age distribution,elastase,follicle-stimulating hormone(FSH),luteinizing hormone(LH),total testosterone(TT)and other observation indexes.Multivariate logistic regression analysis showed that BMI(OR=5.984,P=0.004),8-OHdG(OR=3.521,P=0.001),Zonulin(OR=3.241,P=0.017),LBP(OR=5.511,P=0.001),E2(OR=4.671,P=0.026)were the high-risk factors affecting SDI.BMI was correlated with Zonulin,LBP,8-OHdG and E2(P<0.05).Conclusion Obesity can induce metabolic endotoxemia.The increase of intestinal permeability and endotoxin levels can cause systemic inflammatory response and induce oxidative stress.Reactive oxygen

关 键 词：代谢性内毒素血症 血清脂多糖结合蛋白 精子畸形 肠道通透性 氧化应激 

分 类 号：R698[医药卫生—泌尿科学]