减重对肥胖病人精液质量及生殖激素的影响  

Effect of weight loss on semen quality and reproductive hormones in obese patients

作　　者：孙军培 杜丹丽[1] 张燕[1] 杨晓东 李雪婷 丁彪 张枫 刘雷 王学故 宫莹莹 SUN Jun-pei;DU Dan-li;ZHANG Yan;YANG Xiao-dong;LI Xue-ting;DING Biao;ZHANG Feng;LIU Lei;WANG Xue-gu;GONG Ying-ying(Reproductive Medicine Center,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院生殖医学中心,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2023年第9期1199-1202,1207,共5页Journal of Bengbu Medical College

基　　金：蚌埠医学院自然科学研究项目(BYKY1785,2020BYZD091)。

摘　　要：目的:探讨肥胖病人减重对精子质量和生殖激素的影响。方法:30例肥胖病人[体质量指数(BMI)28.2~45.37 kg/m 2]进行为期14周的减重计划。对病人减重前后的精液样本及血液样本进行检测。使用计算机辅助精子分析系统检测精子常规指标[精液体积、精子浓度、总精子数量、前向运动精子率(PR)、精子总活力、精子正常形态率];使用染色质结构分析法分析精子DNA碎片指数(DFI);使用罗氏性激素分析仪测定血液中相关激素指标[睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)、抗缪勒管激素(AMH)]。结果:减重前,随着病人BMI的升高,精子浓度、精子总数、AMH及T的数值降低(P<0.01),而精子DFI及E2的数值增加(P<0.01)。减重后,精子浓度、总精子数量、PR、精子总活力、AMH及T较减重前增加(P<0.05~P<0.01);精液体积及精子DFI较减重前减少(P<0.05和P<0.01),FSH、LH及E2较减重前差异均无统计学意义(P>0.05)。结论:肥胖与精液质量差和生殖激素水平的改变有关。减重可能会导致精子质量的改善。Objective:To observe the effect of weight loss on sperm quality and reproductive hormones in obese patients.Methods:Thirty obese patients with a body mass index(BMI)of 28.2-45.37 kg/m 2 underwent a 14 weeks weight loss plan.Semen and blood samples from patients were tested before and after weight loss.Routine sperm indicators[semen volume,sperm concentration,total sperm count,progressive motility sperm rate(PR),total sperm motility,and normal sperm morphology rate]were detected using the computer assisted sperm analysis system.Sperm DNA fragmentation index(DFI)was analyzed using sperm chromatin structure assay(SCSA).Relevant hormone indicators in the blood[testosterone(T),estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),and anti-Müllerian hormone(AMH)]were measured using a Roche sex hormone analyzer.Results:Before weight loss,as the patient′s BMI increased,the values of sperm concentration,total sperm count,AMH,and T decreased(P<0.01),while the values of sperm DFI and E2 increased(P<0.01).After weight loss,the sperm concentration,total sperm count,progressive motility sperm rate,total sperm motility,AMH and T increased compared to before weight loss(P<0.05 to P<0.01).semen volume and sperm DFI decreased compared to before weight loss(P<0.05 and P<0.01),FSH,LH,and E2 showed no statistically significant differences compared to before weight loss(P>0.05).Conclusions:Obesity is related to poor semen quality and changes in reproductive hormone levels.Weight loss may lead to an improvement in sperm quality.

关 键 词：肥胖 体质量指数 减重 抗缪勒管激素 抑制素B 生殖激素 精子参数 

分 类 号：R698.2[医药卫生—泌尿科学]