Rehman Rehana, Lalani Salima, Baig Mukhtiar, Nizami Iman, Rana Zohaib, Gazzaz Zohair Jamil
Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
Front Endocrinol (Lausanne). 2018 Oct 16;9:607. doi: 10.3389/fendo.2018.00607. eCollection 2018.
The prevalence of infertility and vitamin D deficiency is common in Pakistan. Therefore, our study aims were to assess and compare Vitamin D; 25-hydroxyvitamin (25OHD) and reproductive hormone levels in male fertile and infertile subjects with normal and abnormal sperm parameters. Furthermore, the study is aimed to explore the association of 25OHD levels with these sperm parameters in a selected population of Karachi, Pakistan. The cross-sectional study was carried out from August 2016 till December 2017, 313 study subjects were recruited from an Infertile Clinic from Islamabad, Pakistan, and the general population. First, we took the couples' history of parenting and then carried out a semen analysis and infertile and fertile male subjects were then subgrouped into "normal" and "altered sperm parameter/s." Forward linear regression was done for selection of 25OHD as a significant predictor of sperm parameters. The median values of the total count, motility, morphology as well as serum 25OHD were significantly higher in the group with "normal" (186) as compared to subjects (127) in "abnormal sperm parameters" group. The 25OHD levels were significantly high in males with "normal sperm parameters"; 80.90 ± 23.33 nmol/L vs. "altered sperm parameter/s," 64.68 ± 24.21 nmol/L (mean ± SD) with < 0.001. Serum testosterone level had a significant positive correlation with 25OHD while LH had a significant negative correlation with 25OHD ( < 0.001), and FSH level had a non-significant negative correlation with 25OHD. Results of regression model showed one unit increase of motility would give 0.15-unit positive significant impact on 25OHD; 20% variation in 25OHD was explained by the total count, motility, and morphology, while the model was adjusted for BMI. The impact of 25OHD levels on sperm parameters can be emphasized on the basis of detection of its high serum levels in "normal" subjects in both fertile as well as infertile males in comparison to subjects that had altered sperm parameters; total sperm count, motility, and normal morphology. The considerably positive association between 25OHD, testosterone, total count, motility, and morphology further accentuates its impact on normal spermatogenesis and the male reproductive functions required for acquiring fertility.
在巴基斯坦，不孕症和维生素D缺乏症很常见。因此，我们的研究目的是评估和比较维生素D；25-羟基维生素（25OHD）以及精子参数正常和异常的男性不育和生育人群的生殖激素水平。此外，该研究旨在探讨巴基斯坦卡拉奇特定人群中25OHD水平与这些精子参数之间的关联。横断面研究于2016年8月至2017年12月进行，从巴基斯坦伊斯兰堡的一家不孕不育诊所和普通人群中招募了313名研究对象。首先，我们了解了夫妻的育儿史，然后进行了精液分析，不育和生育男性受试者随后被分为“正常”和“精子参数改变”两组。采用向前线性回归来选择25OHD作为精子参数的显著预测因子。“正常”组（186）的总精子数、活力、形态以及血清25OHD的中位数显著高于“精子参数异常”组（127）的受试者。“精子参数正常”的男性25OHD水平显著较高；80.90±23.33nmol/L，而“精子参数改变”组为64.68±24.21nmol/L（均值±标准差），P<0.001。血清睾酮水平与25OHD呈显著正相关，而促黄体生成素（LH）与25OHD呈显著负相关（P<0.001），促卵泡生成素（FSH）水平与25OHD呈非显著负相关。回归模型结果显示，活力每增加一个单位，对25OHD会产生0.15单位的正向显著影响；总精子数、活力和形态可解释25OHD中20%的变异，同时该模型针对体重指数（BMI）进行了调整。与精子参数改变的受试者（总精子数、活力和正常形态）相比，在生育和不育男性的“正常”受试者中检测到较高的血清25OHD水平，由此可以强调25OHD水平对精子参数的影响。25OHD、睾酮、总精子数、活力和形态之间相当显著的正相关进一步突出了其对正常精子发生以及获得生育能力所需的男性生殖功能的影响。
