Department of Urology, Shanghai Institute of Andrology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Urology, Weifang Yi Du Center Hospital, Weifang, China.
Am J Reprod Immunol. 2019 Jul;82(1):e13126. doi: 10.1111/aji.13126. Epub 2019 May 13.
The aim of this study was to ascertain the associations between serum leptin levels and chronic epididymitis and semen parameters in patients with infertility.
A total of 846 patients who were diagnosed as primary infertility were enrolled and divided into four groups. The general information, blood lipids, reproductive hormones, and semen parameters were collected. Receiver operating characteristic (ROC) curves of leptin were plotted for diagnosis of the poor sperm quality. We used Student's t test and the chi-squared test to analyze their relationships and used logistic regression analysis to evaluate potential confounding factors.
Receiver operating characteristic curve revealed that leptin had better sensitivity and specificity at the concentration of 6.02 (0.565 and 0.917). Isolated epididymitis or elevated leptin had no effect on sperm concentration and sperm membrane function, but the combination of these conditions would reduce the concentration and normal morphology rate both (P = 0.002, P = 0.005). Epididymitis or elevated leptin can affect the motility of sperms, the former presented more significance (P = 0.000), and the co-existence would further reduce the sperm motility (P = 0.001).
Low sperm motility and sperm normal morphology were found to be associated with chronic epididymitis and high leptin. Simultaneously suffering from chronic epididymitis and high leptin could produce a more serious effect on sperm quality.
本研究旨在确定血清瘦素水平与慢性附睾炎和不育患者精液参数之间的关系。
共纳入 846 例原发性不育症患者,分为 4 组。收集一般资料、血脂、生殖激素和精液参数。绘制瘦素的受试者工作特征(ROC)曲线,以诊断精子质量差。采用 Student's t 检验和卡方检验分析其关系,采用logistic 回归分析评估潜在的混杂因素。
ROC 曲线显示,瘦素浓度为 6.02 时具有更好的敏感性和特异性(0.565 和 0.917)。单纯附睾炎或瘦素升高对精子浓度和精子膜功能无影响,但两者同时存在会降低精子浓度和正常形态率(P = 0.002,P = 0.005)。附睾炎或瘦素升高均可影响精子的运动能力,前者更为显著(P = 0.000),两者同时存在会进一步降低精子运动能力(P = 0.001)。
低精子活力和精子正常形态与慢性附睾炎和高瘦素有关。同时患有慢性附睾炎和高瘦素会对精子质量产生更严重的影响。