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二十二碳六烯酸和维生素 E 联合用药对弱精子症男性精液常规、精液氧化应激及精子磷脂的影响:一项随机对照试验。

Effects of coadministration of DHA and vitamin E on spermatogram, seminal oxidative stress, and sperm phospholipids in asthenozoospermic men: a randomized controlled trial.

机构信息

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Andrology and Embryology, Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.

出版信息

Am J Clin Nutr. 2020 Sep 1;112(3):707-719. doi: 10.1093/ajcn/nqaa124.

Abstract

BACKGROUND

It is unknown which compounds in spermatozoa or seminal plasma may be involved in the regulation of sperm motility.

OBJECTIVES

The aim of this study was to investigate the effects of DHA (22:6n-3), vitamin E, and their probable interactions in men with asthenozoospermia.

METHODS

A factorial, randomized, double-blind, placebo-controlled trial was conducted in infertility clinics in Tehran, Iran. The participants were idiopathic asthenozoospermic men aged 20-45 y, with normal endocrine function. Their concentration of spermatozoa and percentage of morphologically normal spermatozoa were equal to or above the lower reference limits, according to the fifth edition of the WHO guideline. Out of 717 men referred to the infertility clinics, 180 asthenozoospermic men were randomly assigned to 1 of 4 groups according to stratified blocked randomization by age and sperm concentration. Participants took daily 465 mg DHA plus 600 IU vitamin E (DE), 465 mg DHA plus placebo (DP), 600 IU vitamin E plus placebo (EP), or both placebo capsules (PP) for 12 wk. Sperm characteristics, oxidative stress of seminal plasma, serum and sperm membrane fatty acids, dietary intakes, anthropometric measurements, and physical activity were measured at baseline and after 12 wk.

RESULTS

After the intervention, mean ± SD sperm progressive motility was greater in the DE group (27.9 ± 2.8) than in the DP (25.7 ± 3.4), EP (26.1 ± 2.8), and PP (25.8 ± 2.6) groups (P < 0.05). Sperm count (P = 0.001) and concentration (P = 0.044) increased significantly in the DE group compared with the other 3 groups, whereas other semen parameters were not significantly different between the groups after the intervention. Serum concentrations of n-3 PUFAs were significantly higher in the DE and DP groups than in the EP and PP groups.

CONCLUSIONS

Combined DHA and vitamin E supplements led to increased sperm motility; however, no significant changes occurred in sperm morphology and vitality in asthenozoospermic men.This trial was registered at clinicaltrials.gov as NCT01846325.

摘要

背景

目前尚不清楚精子或精浆中的哪些化合物可能参与调节精子运动。

目的

本研究旨在探讨二十二碳六烯酸(22:6n-3)、维生素 E 及其可能的相互作用对弱精症男性的影响。

方法

这是一项在伊朗德黑兰的不孕不育诊所进行的、基于因子的、随机、双盲、安慰剂对照试验。参与者为年龄在 20-45 岁之间的特发性弱精症男性,内分泌功能正常。根据世界卫生组织第五版指南,他们的精子浓度和形态正常精子百分比等于或高于下限参考值。在被介绍到不孕不育诊所的 717 名男性中,有 180 名弱精症男性根据年龄和精子浓度进行分层分组随机分配到 4 组中的 1 组。参与者每日服用 465 mg DHA 加 600 IU 维生素 E(DE)、465 mg DHA 加安慰剂(DP)、600 IU 维生素 E 加安慰剂(EP)或两者均为安慰剂胶囊(PP),持续 12 周。在基线和 12 周后测量精子特征、精液氧化应激、血清和精子膜脂肪酸、饮食摄入、人体测量和身体活动。

结果

干预后,DE 组(27.9±2.8)的精子前向运动平均值显著高于 DP(25.7±3.4)、EP(26.1±2.8)和 PP(25.8±2.6)组(P<0.05)。与其他 3 组相比,DE 组的精子计数(P=0.001)和浓度(P=0.044)显著增加,而其他精液参数在干预后组间无显著差异。DE 和 DP 组血清 n-3PUFA 浓度显著高于 EP 和 PP 组。

结论

联合补充 DHA 和维生素 E 可提高精子运动能力,但对弱精症男性的精子形态和活力无显著影响。本试验在 clinicaltrials.gov 注册,编号为 NCT01846325。

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