Cito Gianmartin, Cocci Andrea, Micelli Elisabetta, Gabutti Alejandro, Russo Giorgio Ivan, Coccia Maria Elisabetta, Franco Giorgio, Serni Sergio, Carini Marco, Natali Alessandro
Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
Department of Gynecology and Obstetrics, St. Claire Hospital, University of Pisa, Pisa, Italy.
World J Mens Health. 2020 Apr;38(2):164-177. doi: 10.5534/wjmh.190057. Epub 2019 May 17.
To date, the key role of vitamin D in male reproductive system has been suggested, since the expression of vitamin D receptors and metabolizing enzymes was demonstrated in the testis and spermatozoa. Nevertheless, a general consensus about the role of vitamin D in male fertility is still debated. The aim of this review is to provide an updated systematic revision of the current available literature, discussing the experimental and clinical evidence on the role of vitamin D in the regulation of testis hormone production, seminal parameters and male fertility. The consequences of vitamin D deficiency on serum levels of testicular hormones have been analysed by several observational and interventional studies, with controversial results. Equally, the experimental researches not were able to state a certain relationship between vitamin D status and testis hormone production. Possible bias, including age, body mass index, and baseline vitamin D status justified the differences among studies. As well as concerning the effect of vitamin D on semen parameters, most of the studies agreed in the possibility that vitamin D might have a positive effect on human male fertility potential, particularly through better sperm motility. Regarding pregnancy outcomes, normal level of vitamin D seems to be related to better pregnancies. However, all the previous studies displayed a wide heterogeneity in study design, population, methodology, and cut off values used for the evaluation of vitamin D status. Future studies are needed to better clarify the exact role of vitamin D on hormonal and seminal panel in both fertile and infertile men.
迄今为止，维生素D在男性生殖系统中的关键作用已被提出，因为在睾丸和精子中已证实有维生素D受体和代谢酶的表达。然而，关于维生素D在男性生育能力方面的作用仍存在广泛争议。本综述的目的是对当前现有文献进行更新的系统修订，讨论关于维生素D在调节睾丸激素产生、精液参数和男性生育能力方面作用的实验和临床证据。多项观察性和干预性研究分析了维生素D缺乏对血清睾丸激素水平的影响，结果存在争议。同样，实验研究也未能确定维生素D状态与睾丸激素产生之间的特定关系。包括年龄、体重指数和基线维生素D状态在内的可能偏倚解释了各研究之间的差异。关于维生素D对精液参数的影响，大多数研究一致认为维生素D可能对人类男性生育潜力有积极影响，特别是通过改善精子活力。关于妊娠结局，正常水平的维生素D似乎与更好的妊娠情况相关。然而，此前所有研究在研究设计、人群、方法以及用于评估维生素D状态的临界值方面都存在很大异质性。未来需要开展更多研究，以更好地阐明维生素D在有生育能力和不育男性的激素和精液指标方面的确切作用。
