Liu J, Zhang S, Liu M, Wang Q, Shen H, Zhang Y, Yan D
Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing, China.
Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China.
Andrology. 2017 May;5(3):562-567. doi: 10.1111/andr.12345.
Varicocoele is a common cause of male infertility. We undertook a population-based cross-sectional study to evaluate the prevalence of varicocoele among rural men in eastern China and its association with body mass index. A total of 39,559 rural men in six counties in Beijing, Guangdong and Shandong provinces were recruited from 2011 to 2012. The presence and severity of varicocoele were measured by physical examinations. Univariate and multivariate logistic regression models were constructed to assess the association between varicocoele and body mass index after adjusting for possible confounders. Varicocoele was diagnosed in 1911 of 39,559 participants with an overall prevalence of 4.83%. The prevalence of varicocoele was highest in underweight (6.29%) and lowest in obese patients (3.71%, p < 0.05). The prevalence also decreased as body mass index increased in all three varicocoele grades. In multivariate logistic regression analysis after adjusting for region, age, height, occupation, cigarette smoking and alcohol consumption, body mass index was still inversely and independently associated with varicocoele (p < 0.001). Compared with normal weight men, underweight men (OR = 1.34; 95% CI, 1.10-1.63) were more likely to have varicocoele, whereas overweight men (OR = 0.88; 95% CI, 0.79-0.99) and obese men (OR = 0.75; 95% CI, 0.58-0.97) were less likely to have varicocoele. This study revealed that the prevalence of varicocoele was 4.83% among rural men in eastern China; body mass index was inversely and independently associated with the presence of varicocoele. Future efforts should be made to validate the risk factors for varicocoele and strengthen the prevention and treatment of varicocoele, especially in underweight men.
精索静脉曲张是男性不育的常见原因。我们开展了一项基于人群的横断面研究,以评估中国东部农村男性精索静脉曲张的患病率及其与体重指数的关系。2011年至2012年,在北京、广东和山东三省的六个县共招募了39559名农村男性。通过体格检查来测量精索静脉曲张的存在情况和严重程度。在对可能的混杂因素进行调整后,构建单因素和多因素逻辑回归模型来评估精索静脉曲张与体重指数之间的关联。在39559名参与者中,有1911人被诊断为精索静脉曲张,总体患病率为4.83%。精索静脉曲张的患病率在体重过轻的人群中最高(6.29%),在肥胖患者中最低(3.71%,p<0.05)。在所有三个精索静脉曲张等级中,患病率也随着体重指数的增加而降低。在对地区、年龄、身高、职业、吸烟和饮酒进行调整后的多因素逻辑回归分析中,体重指数仍与精索静脉曲张呈负相关且独立相关(p<0.001)。与体重正常的男性相比,体重过轻的男性(OR=1.34;95%CI,1.10-1.63)患精索静脉曲张的可能性更大,而超重男性(OR=0.88;95%CI,0.79-0.99)和肥胖男性(OR=0.75;95%CI,0.58-0.97)患精索静脉曲张的可能性较小。这项研究表明,中国东部农村男性精索静脉曲张的患病率为4.83%;体重指数与精索静脉曲张的存在呈负相关且独立相关。未来应努力验证精索静脉曲张的危险因素,并加强精索静脉曲张的预防和治疗,尤其是在体重过轻的男性中。