男性不育患者精浆25羟基维生素D3水平在体重指数与精子质量关联中的中介效应  

The mediating effect of seminal plasma 25-hydroxyvitamin D3 level in the association between body mass index and sperm quality in male infertile patients

作　　者：乔少彬 于璨 马琳 洪庆文 董月稳 QIAO Shaobin;YU Can;MA Lin;HONG Qingwen;DONG Yuewen(Department of Reproductive Medicine,Xingtai Central Hospital,Xingtai 054000,Hebei,China;Department of Laboratory Medicine,Xingtai Central Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]邢台市中心医院生殖医学科,河北邢台054000 [2]邢台市中心医院检验科,河北邢台054000

出　　处：《中国性科学》2025年第1期31-35,共5页Chinese Journal of Human Sexuality

基　　金：邢台市重点研发计划自筹项目(2022ZC180)。

摘　　要：目的探究男性不育患者精浆25羟基维生素D3[25(OH)D3]水平在体重指数与精子质量关联中的中介效应。方法选取2020年11月至2023年11月邢台市中心医院收治的180例男性不育患者作为研究对象,检测患者的体重指数、精子质量(前向运动精子百分率、精子存活率、精子正常形态率、精液体积、精子总数)及精浆25(OH)D3水平。根据体重指数将其分为正常组、超重组、肥胖组。根据25(OH)D3水平将其分为缺乏组、不足组、充足组。比较不同体重组和不同25(OH)D3组精子质量参数水平,采用Pearson相关性分析25(OH)D3、体重指数与精子质量参数的关系,采用AMOS 24.0构建结构方程模型进行分析,并进行中介效应检验。结果与正常组比较,超重组、肥胖组各项精子质量参数水平更低(P<0.05);与超重组比较,肥胖组各项精子质量参数水平更低(P<0.05)。与充足组比较,不足组、缺乏组各项精子质量参数水平更低(P<0.05);与不足组比较,缺乏组各项精子质量参数水平更低(P<0.05)。Pearson相关性分析显示,精浆25(OH)D3水平与前向运动精子百分率、精子存活率、精子正常形态率、精液体积、精子总数呈正相关(P<0.05),体重指数与前向运动精子百分率、精子存活率、精子正常形态率、精液体积、精子总数呈负相关(P<0.05)。Bootstrap法结果显示间接效应95%CI为-0.446~-0.186,不跨0,中介效应占总效应的45.85%、42.64%、47.17%、41.65%、49.16%。表明25(OH)D3在体重指数与精子质量关联中发挥中介效应。结论精浆25(OH)D3水平在体重指数与精子质量关联中发挥着中介效应,鉴于此,对于伴有超重/肥胖的男性不育患者,应定期监测其的精浆25(OH)D3水平,为患者治疗方案的制定提供理论参考。Objective To explore the mediating effect of seminal plasma 25-hydroxyvitamin D3[25(OH)D3]level in the association between body mass index and sperm quality in male infertile patients.Methods A total of 180 male infertile patients admitted to Xingtai Central Hospital from November 2020 to November 2023 were selected as the study objects.The body mass index,sperm quality(percentage of forward motility sperm,sperm survival rate,sperm normal morphology rate,semen volume,total sperm count),and seminal plasma 25(OH)D3 level of the patients were detected.According to their body mass index,they were divided into normal group,overweight group and obese group.According to the 25(OH)D3 level,they were divided into deficient group,insufficient group and sufficient group.The levels of sperm quality parameters in different weight groups and different 25(OH)D3 groups were compared,and the relationship between 25(OH)D3,body mass index and sperm quality parameters was analyzed by Pearson correlation analysis.The structural equation model was constructed by AMOS 24.0 for analysis,and the mediating effect was tested.Results Compared with the normal group,the levels of sperm quality parameters in the overweight and obese groups were lower(P<0.05).Compared with the overweight group,the levels of sperm quality parameters in the obese group were lower(P<0.05).Compared with the sufficient group,the levels of sperm quality parameters in the insufficient group and deficient group were lower(P<0.05).Compared with the insufficient group,the levels of sperm quality parameters in the deficient group were lower(P<0.05).Pearson correlation analysis showed that seminal plasma 25(OH)D3 level was positively correlated with the percentage of forward motility sperm,sperm survival rate,sperm normal morphology rate,semen volume and total sperm count(P<0.05).Body mass index was negatively correlated with the percentage of forward motility sperm,sperm survival rate,sperm normal morphology rate,semen volume and total sperm count(P<0.05).The results of B

关 键 词：不育 25羟基维生素D3 体重指数 精子质量 中介效应 

分 类 号：R446.1[医药卫生—诊断学]