超重及肥胖与精液常规参数及精浆生化指标关系研究

目的分析超重及肥胖对不育男性精液参数及精浆生化指标的影响。方法选择2011年1月至2013年6月就诊亚临床不育男性患者267例为研究对象,计算体重指数（BMI）,分为体重正常（BMI 18.5-22.9kg/m^2）、超重（BMI 23.0-27.4kg/m^2）、肥胖（BMI≥27.5 kg/m^2）3组。精液参数分析后,留取精浆检测α-葡糖苷酶（A-Glu）、酸性磷酸酶（ACP）和果糖（Fru）含量。结果符合标准资料完整者215人,平均年龄（33.7±6.9）岁,平均BMI：（24.3±3.2）kg/m^2。各BMI组间精子前向运动百分率存在显著性差异（P=0.027）,其中肥胖组与正常组相比,前向运动精子百分率差异显著（P〈0.05）;3组间的精子浓度和精液体积之间无显著性差异。精浆生化指标中,各BMI组间精浆A-Glu活性存在显著性差异（P=0.012）,精浆A-Glu活性随着BMI增加而降低,其中肥胖组与正常组相比,精浆A-Glu活性差异显著（P〈0.05）,ACP及Fru含量均无显著性差异。结论本研究表明在亚临床不育人群中精子前向运动百分率及精浆A-Glu活性会随着BMI的增加而降低。说明体重可能在一定程度上影响男性生殖能力,但是其具体机制需要进一步研究。

Influence of overweight and obesity on conventional seminal parameters and biochemical markers in subfertile males WU

Objective To examine whether seminal quality is affected by body mass index（BMI） in subfertile males. Methods From January 2011 to June 2013, 267 subfertile males were collected and reviewed as the object of study. The height and weight were measured, so as to calculate BMI. BMI was categorized as normal（BMI18.5-22.9）, overweight（BMI23.0-27.4）, and obese（BMI≥27.4）. Ejaculate volume, sperm concentration, percentage of progressive motile spermatozoa and levels of alpha-glucosidase, fructose, acid phosphatase were measured. Results A total of 215 men with integral data were selected as subject in the study. The mean age was（33.7±6.9） years old and mean BMI was（24.3±3.2）kg/m^2. BMI was not found to be associated with ejaculate volume, sperm concentration, levels of fructoseand and levels of acid phosphatase. However, a statistically significant association was observed between BMI and the percentage of progressive motility（P=0.027） and levels of alpha-glucosidase（P=0.012）. Further, obese men had lower percentage of progressive motility and levels of alpha-glucosidase than that of normal weight men（both P〈0.05）. Conclusions Our study demonstrates that increasing BMI is associated with decreased the percentage of progressive motility and alpha-glucosidase levels in subfertile males, these data suggest that obesity may negatively influence male reproductive potential. However, the effect of weight loss on sperm quality and fertility needs further investigation.