肥胖对男性生育力及相关激素水平的影响  

Effects of Obesity on Male Fertility and Related Hormone Levels

作　　者：张振刚 李晓娜[1] 王文娟[1] 李斌业[1] ZHANG Zhen-gang;LI Xiao-na;WANG Wen-juan;LI Bin-ye(Reproductive Center of Qinghai Provincial People's Hospital,Xining 810000,Qinghai,China)

机构地区：[1]青海省人民医院生殖医学中心,青海西宁810000

出　　处：《医学信息》2023年第17期119-122,共4页Journal of Medical Information

基　　金：青海省卫健委指导性课题(编号:2021-wjzdx-11)。

摘　　要：目的探讨肥胖对男性生育力及相关激素水平的影响。方法回顾性收集2021年1月-2022年4月于青海省人民医院生殖医学中心进行检查的461例研究对象,根据体重指数(BMI)标准分为低体重组(<18.5 kg/m^(2))、正常组(18.5~24 kg/m^(2))、超重组(24.0~28.0 kg/m^(2))、肥胖组(≥28 kg/m^(2)),了解BMI对精液质量(精子总数、精子浓度、前向运动率、畸形率)、精子DNA碎片的影响;并分析体重指数与性激素、甲状腺激素的关系。结果低体重组14例、正常组202例、超重组187例、肥胖组58例,四组间年龄、畸形率、精子DNA碎片率比较,差异有统计学意义(P<0.05),且随着BMI的增加,畸形率与精子DNA碎片率呈上升趋势。四组间T、PRL、T/E_(2)、T_(4)比较,差异有统计学意义(P<0.05)。相关性分析显示,BMI与T、PRL、FT_(4)呈负相关(P<0.05),而E_(2)、FSH、LH、FT_(3)、TSH、T/E_(2)比值与BMI无相关性(P>0.05)。结论肥胖可影响精子形态与精子DNA碎片率,导致男性生育力降低,同时肥胖可导致睾酮水平、泌乳素水平、游离甲状腺素水平降低,使男性相关激素水平失衡,其可能是造成男性不育的重要因素之一。Objective To explore the effect of obesity on male fertility and related hormone levels.Methods A total of 461 subjects who were examined in the Reproductive Medicine Center of Qinghai Provincial People's Hospital from January 2021 to April 2022 were retrospectively collected.According to the body mass index(BMI)standard,they were divided into low body weight group(<18.5 kg/m^(2)),normal group(18.5-24 kg/m^(2)),overweight group(24.0-28.0 kg/m^(2))and obese group(≥28 kg/m^(2))to assess the effect of BMI on semen quality(total sperm count,sperm concentration,forward movement rate,deformity rate)and sperm DNA fragmentation.The relationship between body mass index and sex hormones and thyroid hormones was analyzed.Results There were 14 cases of low weight group,202 cases of normal group,187 cases of overweight group and 58 cases of obesity group.There were significant differences in age,deformity rate and sperm DNA fragment rate among the four groups(P<0.05),and with the increase of BMI,the deformity rate and sperm DNA fragment rate showed an upward trend.There were significant differences in T,PRL,T/E_(2) and T_(4) among the four groups(P<0.05).Correlation analysis showed that BMI was negatively correlated with T,PRL and FT_(4)(P<0.05),while E_(2),FSH,LH,FT_(3),TSH and T/E_(2) ratio were not correlated with BMI(P>0.05).Conclusion Obesity can affect sperm morphology and sperm DNA fragmentation rate,resulting in reduced male fertility and increased abortion rate.Meanwhile,obesity can reduce testosterone level,prolactin level and free thyroxine level,resulting in imbalance of male related hormone level,which may be one of the important factors causing male infertility.

关 键 词：体重指数 男性生育力 性激素 甲状腺激素 

分 类 号：R698[医药卫生—泌尿科学]