From the Department of Pediatrics, New York University School of Medicine, New York, NY.
Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX.
Epidemiology. 2019 Nov;30 Suppl 2(Suppl 2):S17-S27. doi: 10.1097/EDE.0000000000001070.
Studies of body mass index and semen quality have reported mixed results, but almost all were cross-sectional and many were conducted in selected populations. Longitudinal studies in population-based cohorts are necessary to identify how timing and duration of excess adiposity may affect semen quality.
In 193 members of the Child Health and Development Studies birth cohort, we examined associations of birth weight and adiposity at six time points spanning early childhood and adulthood with sperm concentration, motility, and morphology at mean age 44 years, as well as with corresponding 2010 World Health Organization (WHO) subfertility reference levels.
Birth weight for gestational age percentile was positively associated with square-root sperm concentration (regression coefficient B [95% confidence interval] = 0.02 × 103 sperm/ml [0.004, 0.04]). Overweight/obesity in men's 20s was associated with lower percent progressive motility (B =-5.2 [-9.9, -0.63]), higher odds of low motility (odds ratio (OR) = 2.4 [1.3, 4.4]), and higher odds of poor morphology (OR = 1.9 [0.94, 3.8]). Those who were overweight/obese in their 20s were also more likely to meet two or three WHO subfertility criteria (OR = 3.9 [1.6, 9.4]) compared with normal-weight men. Each additional adult decade in which a participant was overweight/obese was associated with higher odds of low motility (OR = 1.3 [0.96, 1.6]) and higher odds of meeting two or three WHO subfertility criteria (OR = 1.5 [1.0, 2.2]).
In our data, associations among adiposity and sperm concentration, motility, and morphology varied according to timing and duration of exposure, potentially reflecting different biological mechanisms that influence these semen parameters.
研究体重指数和精液质量的结果喜忧参半,但几乎所有研究都是横断面研究,且许多研究都是在特定人群中进行的。有必要在基于人群的队列中进行纵向研究,以确定超重的时间和持续时间如何影响精液质量。
在儿童健康与发展研究队列的 193 名成员中,我们研究了儿童早期和成年期六个时间点的出生体重和肥胖程度与 44 岁时精子浓度、活力和形态的关系,以及与 2010 年世界卫生组织(WHO)的相应生育力参考标准的关系。
胎龄百分位出生体重与精子浓度的平方根呈正相关(回归系数 B[95%置信区间] = 0.02×103 个/ml[0.004, 0.04])。男性 20 多岁时超重/肥胖与较低的前向运动比例有关(B =-5.2[-9.9, -0.63])、较低活力的几率较高(比值比(OR)=2.4[1.3, 4.4])和形态较差的几率较高(OR =1.9[0.94, 3.8])。与体重正常的男性相比,20 多岁时超重/肥胖的人也更有可能符合两项或三项 WHO 生育力标准(OR =3.9[1.6, 9.4])。参与者每多一个成年超重/肥胖的十年,其较低活力的几率就越高(OR =1.3[0.96, 1.6]),且符合两项或三项 WHO 生育力标准的几率也越高(OR =1.5[1.0, 2.2])。
在我们的数据中,肥胖与精子浓度、活力和形态之间的关联因暴露的时间和持续时间而异,这可能反映了影响这些精液参数的不同生物学机制。