Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Training Centre of the European Academy of Andrology, 04103 Leipzig, Germany.
Reproduction. 2013 Mar 1;145(3):237-44. doi: 10.1530/REP-12-0415.
Inhibin B is an important serum marker of spermatogenesis, whereas sensitivity and predicting power for the spermatogenic situation at several ages are under debate. We performed a retrospective analysis of data from 2448 men who attended our University-based male infertility clinic to evaluate inhibin B in relation to age and semen sample qualities in comparison with FSH. Moreover, the range of inhibin B in 82 nonobstructive azoospermic patients was correlated with the sperm retrieval in testicular sperm extraction procedures. Inhibin B correlated with FSH (Spearman rank correlation (R)=-0.50; P<0.00001). Inhibin B and inhibin B/FSH ratio (IFR) showed an inverse U-shaped dependence on age, whereas FSH showed a U-shaped dependence on age (optimum 20-40 years). However, in men with normal spermiograms inhibin B concentrations did not differ between age groups. Their levels of inhibin B amounted to 130.5, 54.5-247 ng/l (median, 10th-90th precentile), and of IFR to 38.3, 12.5-104.8 (median, 10th-90th percentile), which might be taken as the reference range. Using the 10th percentile of IFR, correct classification in normal or pathological semen groups was achieved in 99.1%. The percentage of aniline blue-negative spermatozoa, i.e. mature spermatozoa with protamines, did not correlate with FSH (P>0.05) but with inhibin B (R=0.15, P<0.001). The probability of retrieving testicular spermatozoa decreased with declining inhibin B: <20 ng/l sperm could never be found. Our results from a large group of men with a wide spectrum of semen qualities allow estimating reference values for inhibin B and IFR. Inhibin B and especially the IFR are more sensitive markers of male infertility than FSH alone.
抑制素 B 是生精作用的一个重要血清标志物，但其在不同年龄段的生精状况的敏感性和预测能力仍存在争议。我们对 2448 名来我院男性不育门诊就诊的男性患者的数据进行了回顾性分析，以评估抑制素 B 与年龄和精液样本质量的关系，并与 FSH 进行了比较。此外，82 例非梗阻性无精子症患者的抑制素 B 范围与睾丸精子提取术的精子获取相关。抑制素 B 与 FSH 相关（Spearman 等级相关（R）=-0.50；P<0.00001）。抑制素 B 和抑制素 B/FSH 比值（IFR）呈反 U 形依赖于年龄，而 FSH 呈 U 形依赖于年龄（最佳 20-40 岁）。然而，在精子正常的患者中，抑制素 B 浓度在不同年龄组之间没有差异。他们的抑制素 B 水平为 130.5、54.5-247ng/l（中位数，10-90 百分位数），IFR 为 38.3、12.5-104.8（中位数，10-90 百分位数），可作为参考范围。使用 IFR 的第 10 百分位数，可正确分类正常或病理精液组，准确率为 99.1%。苯胺蓝阴性精子的比例，即具有鱼精蛋白的成熟精子，与 FSH 不相关（P>0.05），但与抑制素 B 相关（R=0.15，P<0.001）。精子获取率随抑制素 B 的降低而降低：<20ng/l 时从未发现精子。我们从精液质量广泛的男性中获得的大量数据结果允许估计抑制素 B 和 IFR 的参考值。抑制素 B 尤其是 IFR 比单独的 FSH 更能敏感地反映男性不育。
