Gu Ben-Hong, Liu Feng, Li Jun, Zhu Zi-Jue, Ni Yong-Tao, Li Peng, Chen Min, Duoji Zhuoma, Xue Yun-Jing, Chen Hui-Xing, Ouzhu Luobu, Li Zheng
Department of Andrology, Center of Urologic Medicine, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China.
Department of Surgery, Pudong New District Hospital of Traditional Chinese Medicine, Shanghai 201299, China.
Zhonghua Nan Ke Xue. 2018;24(1):27-32.
To investigate the characteristics of the semen parameters of native Tibetans and immigrated Tibetan Hans in the high-altitude area and analyze the influence of altitude adaptation on male fertility.
This study included 1 563 infertile male patients, including 698 native Tibetans and 865 immigrated Tibetan Hans, and 56 normal fertile men, including 33 native Tibetans and 23 Tibetan Hans. We obtained semen samples from the subjects for routine semen analysis and sperm DNA fragmentation index (DFI) examination and collected peripheral blood for determination of the reproductive hormone levels.
In the infertile patients, the native Tibetans, as compared with the immigrated Hans, showed significantly higher incidence rates of azoospermia (5.87% vs 2.89%, P <0.05), severe oligozoospermia (3.15% vs 1.73%, P <0.05) and abnormal seminal viscosity (43.12% vs 25.89%, P<0.01), but no statistically significant differences in the percentages of normozoospermia (81.08% vs 87.39%, P >0.05), oligozoospermia (5.44% vs 3.93%, P >0.05), severe asthenozoospermia (4.44% vs 4.04%, P >0.05) or severe teratozoospermia (4.58% vs 6.59%, P >0.05). In the normal fertile men, there were no statistically significant differences between the native Tibetans and immigrated Hans in age (［32.42 ± 4.82］ vs ［34.57 ± 6.01］ yr, P >0.05), sperm concentration (［143.69 ± 85.74］ vs ［155.11 ± 82.56］ ×10⁶/ml, P >0.05), straight line velocity (［25.74 ± 3.94］ vs ［27.24 ± 3.46］ μm/s, P >0.05), percentage of morphologically normal sperm (［8.22 ± 4.35］ vs ［7.28±2.46］ %, P >0.05), total testosterone concentration (［17.97 ± 2.98］ vs ［15.72 ± 6.38］ nmol/L, P >0.05), or follicle stimulating hormone level (［5.51 ± 1.62］ vs ［4.17 ± 2.08］ IU/L, P >0.05). However, the immigrated Hans, in comparison with the native Tibetans, exhibited a higher sperm motility (［79.75 ± 14.67］ vs ［66.58 ± 17.21］%, P <0.05), a lower curvilinear velocity (［60.97 ± 2.71］ vs ［71.14 ± 82.13］ μm/s, P <0.05) and a lower level of luteinizing hormone (［4.28 ± 1.20］ vs ［5.84 ± 1.15］ IU/L, P <0.05).
During the acclimatization to the plateau hypoxia environment, the immigrated Tibetan Hans undergo adaptive changes in sperm concentration and motility and have lower incidence rates of azoospermia and severe oligozoospermia than native Tibetan males.
探讨高海拔地区藏族原住民和藏族汉族移民精液参数的特征，并分析高原适应对男性生育能力的影响。
本研究纳入1563例不育男性患者，其中藏族原住民698例，藏族汉族移民865例，以及56例正常生育男性，其中藏族原住民33例，藏族汉族23例。我们采集了受试者的精液样本进行常规精液分析和精子DNA碎片指数（DFI）检测，并采集外周血测定生殖激素水平。
在不育患者中，与汉族移民相比，藏族原住民无精子症（5.87%对2.89%，P<0.05）、严重少精子症（3.15%对1.73%，P<0.05）和精液粘度异常（43.12%对25.89%，P<0.01）的发生率显著更高，但在正常精子症（81.08%对87.39%，P>0.05）、少精子症（5.44%对3.93%，P>0.05）、严重弱精子症（4.44%对4.04%，P>0.05）或严重畸形精子症（4.58%对6.59%，P>0.05）的百分比方面无统计学显著差异。在正常生育男性中，藏族原住民和汉族移民在年龄（［32.42±4.82］对［34.57±6.01］岁，P>0.05）、精子浓度（［143.69±85.74］对［155.11±82.56］×10⁶/ml，P>0.05）、直线速度（［25.74±3.94］对［27.24±3.46］μm/s，P>0.05）、形态正常精子百分比（［8.22±4.35］对［7.28±2.46］%，P>0.05）、总睾酮浓度（［17.97±2.98］对［15.72±6.38］nmol/L，P>0.05）或促卵泡激素水平（［5.51±1.62］对［4.17±2.08］IU/L，P>0.05）方面无统计学显著差异。然而，与藏族原住民相比，汉族移民的精子活力更高（［79.75±14.67］对［66.58±17.21］%，P<0.05），曲线速度更低（［60.97±2.71］对［71.14±82.13］μm/s，P<0.05），黄体生成素水平更低（［4.28±1.20］对［5.84±1.15］IU/L，P<0.05）。
在适应高原低氧环境的过程中，藏族汉族移民的精子浓度和活力发生适应性变化，无精子症和严重少精子症的发生率低于藏族男性原住民。
