Department of Urology, Skåne University Hospital, Malmö, Sweden.
Department of Translational Medicine, Molecular Reproductive Medicine, Lund University, Malmö, Sweden.
Hum Reprod. 2018 Dec 1;33(12):2168-2174. doi: 10.1093/humrep/dey310.
Are chemerin levels different in subfertile men compared to men from the general population, and how does chemerin relate to reproductive hormonal status?
Chemerin is negatively associated to LH, SHBG and estradiol and lower levels of chemerin are detected among subfertile men compared to controls.
Adipokines have pleiotropic effects on tissue homeostasis and have been shown to affect both sex steroid production and action. Among adipokines the newly characterized chemokine chemerin is suggested to influence testosterone production in males, but whether serum levels associate with testosterone or male subfertility has not yet been reported.
STUDY DESIGN, SIZE, DURATION: Case control study comprising a consecutive group of men from infertile couples referred to Reproductive Medicine Centre at Skane University Hospital from 2006 through 2012, and age-matched controls. Participants were enrolled in years 2011-2013.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Males from infertile couples (n = 180) aged 18-50 years with sperm concentration <20 × 106/ml and age-matched controls (n = 139) from the general population were enrolled. Serum concentrations of total testosterone (TT), calculated free testosterone (cFT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2) and sex-hormone binding globuline (SHBG) as well as the adipokines chemerin, adiponectin and leptin were measured. Anthropometrics and biochemical parameters of glucose and lipid metabolism were assessed.
Chemerin levels were lower in subfertile men compared to controls (mean diff. 7.1 ng/ml; 95% CI, 3.7; 11 ng/ml; P < 0.001) even after adjustment for BMI. After adjustment for age, BMI, smoking, leptin and adiponectin, chemerin associated negatively with LH (ß = -4.2; P = 0.02), E2 (ß = -10; P = 0.004) and SHBG (ß = -7.4, P = 0.003). Men with elevated LH levels had lower chemerin levels compared to those with LH levels within the normal range (mean diff. 4.8 ng/ml; 95% CI, 0.16; 9.4 ng/ml; P = 0.04).
LIMITATIONS, REASONS FOR CAUTION: Single sample blood test with immunoassays for determination of hormone levels. Heterogeneous group of subfertile subjects.
Even though chemerin has been positively associated with BMI, inverse association with subfertility suggests that it is independently linked to reproductive function, a hypothesis that warrants further assessment.
STUDY FUNDING/COMPETING INTEREST(S): This work was supported by grants from EU Interreg V (ReproUnion) program as well as Swedish Governmental Fund for Clinical Research. The authors have no conflicts of interest.
与一般人群相比,不育男性的趋化素水平是否不同,趋化素与生殖激素状态有何关系?
趋化素与 LH、SHBG 和雌二醇呈负相关,与对照组相比,不育男性的趋化素水平较低。
脂肪因子对组织稳态具有多效性,并且已显示出影响甾体激素的产生和作用。在脂肪因子中,新表征的趋化因子趋化素被认为会影响男性的睾丸酮产生,但血清水平是否与睾丸酮或男性不育有关尚未报道。
研究设计、大小、持续时间:这是一项病例对照研究,包括 2006 年至 2012 年期间因不孕夫妇就诊于斯科讷大学医院生殖医学中心的连续组男性和年龄匹配的对照组。参与者于 2011 年至 2013 年期间招募。
参与者/材料、设置、方法:招募了 180 名年龄在 18-50 岁之间、精子浓度<20×106/ml 的不孕夫妇男性(n=180)和年龄匹配的一般人群对照组(n=139)。测量了血清总睾丸酮(TT)、计算游离睾丸酮(cFT)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)和性激素结合球蛋白(SHBG)以及脂肪因子趋化素、脂联素和瘦素的浓度。评估了人体测量学和葡萄糖及脂质代谢的生化参数。
与对照组相比,不育男性的趋化素水平较低(平均差异 7.1ng/ml;95%CI,3.7;11ng/ml;P<0.001),即使在调整 BMI 后也是如此。在调整年龄、BMI、吸烟、瘦素和脂联素后,趋化素与 LH(β=-4.2;P=0.02)、E2(β=-10;P=0.004)和 SHBG(β=-7.4,P=0.003)呈负相关。与 LH 水平在正常范围内的男性相比,LH 水平升高的男性趋化素水平较低(平均差异 4.8ng/ml;95%CI,0.16;9.4ng/ml;P=0.04)。
局限性、谨慎的原因:单次采血样,采用免疫测定法测定激素水平。不育患者群体异质性。
尽管趋化素与 BMI 呈正相关,但与不育的负相关表明它与生殖功能独立相关,这一假设需要进一步评估。
研究资金/利益冲突:这项工作得到了欧盟区域间(ReproUnion)计划和瑞典政府临床研究基金的支持。作者没有利益冲突。