Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Hum Reprod. 2021 Nov 18;36(12):3036-3048. doi: 10.1093/humrep/deab179.
Is intake of sugar-sweetened beverages (SSB) or artificially sweetened beverages (ASB) associated with testicular function in young men?
Among young men unaware of their semen quality and reproductive hormone levels, intake of SSBs was associated with lower sperm concentration, lower total sperm count, and a lower ratio of serum inhibin-B/FSH.
SSBs may adversely impact testicular function, but results are not consistent across studies. Moreover, the associations of ASB, energy-drinks or fruit juices with testicular function are unclear.
STUDY DESIGN, SIZE, DURATION: Young healthy men and unselected for fertility status men enrolled in a cross-sectional study between 2008 and 2017.
PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 2935 young (median age: 19 years) men enrolled in the study. Intake of SSBs, ASBs, fruit juices, and energy-drinks was assessed with a validated food frequency questionnaire. Testicular function was assessed through conventional semen quality parameters (semen volume, sperm concentration, total count, motility and morphology), testicular volume assessed with ultrasound, and serum reproductive hormone concentrations (total testosterone, free testosterone, E2, inhibin-B, LH, FSH, sex hormone-binding globulin) were measured.
In multivariable-adjusted analyses, men in the highest category of SSB intake (median: 1.1 servings (∼220 ml)/day) had a 13.2 million/ml lower median sperm concentration (95% CI: -21.0, -5.5) than non-consumers. A similar pattern was observed with total sperm count (-28 million (95% CI: -48, -9)), serum inhibin-B (-12 pg/ml (95% CI: -21, -4)), and inhibin-B/FSH ratio (-9 (95% CI: -18, 0)). The adjusted median difference in sperm concentration and inhibin-B associated with increasing SSB intake by 1 serving (∼200ml)/day at the expense of water was -3.4 million sperm/ml (95% CI: -5.8, -1.0) and -7 pg/ml (95% CI: -11, -3), respectively.
LIMITATIONS, REASONS FOR CAUTION: Inferring causality is limited owing to the cross-sectional design. We adjusted for a number of potential confounders but cannot exclude that unmeasured lifestyle and behavior associated with soft drink intake is associated with testicular function in these young men.
In the largest study to date, intake of SSBs was associated with lower sperm concentration, total sperm count, and serum inhibin-B/FSH ratio, consistent with a direct suppressive effect of SSB intake on testicular function among otherwise healthy men, potentially affecting fertility. However, the observed association between higher SSB intake and lower semen quality does not necessarily imply a decrease in fertility.
STUDY FUNDING/COMPETING INTEREST(S): Supported by research from the Danish Council for Strategic Research (2101-08-0058), Independent Research Fund Denmark (8020-00218B), European Union (212844), the Kirsten and Freddy Johansen's Foundation (95-103-72087), the Research Fund of the Capital Region of Denmark (A6176), and the NIH (P30DK046200). The authors report no conflict of interest.
N/A.
糖饮料（SSB）或人工甜味饮料（ASB）的摄入是否与年轻男性的睾丸功能有关？
在不了解精液质量和生殖激素水平的年轻男性中，SSB 的摄入与精子浓度降低、总精子数降低和血清抑制素 B/FSH 比值降低有关。
SSB 可能对睾丸功能产生不利影响，但不同研究的结果并不一致。此外，ASB、能量饮料或果汁与睾丸功能的关系尚不清楚。
研究设计、规模、持续时间：2008 年至 2017 年间，健康的年轻男性和未选择生育状况的男性参加了一项横断面研究。
参与者/材料、设置、方法：共有 2935 名年轻男性（中位数年龄：19 岁）参加了这项研究。通过验证后的食物频率问卷评估 SSB、ASB、果汁和能量饮料的摄入量。睾丸功能通过常规精液质量参数（精液量、精子浓度、总计数、活力和形态）、超声评估的睾丸体积以及血清生殖激素浓度（总睾酮、游离睾酮、E2、抑制素-B、LH、FSH、性激素结合球蛋白）进行评估。
在多变量调整分析中，最高 SSB 摄入量组（中位数：1.1 份（约 220ml/天））的精子浓度中位数比非消费者低 1320 万/ml（95%CI：-21.0，-5.5）。总精子计数（-2800 万（95%CI：-48，-9））、血清抑制素-B（-12pg/ml（95%CI：-21，-4））和抑制素-B/FSH 比值（-9（95%CI：-18，0））也观察到类似的模式。与以水为代价，每增加 1 份（约 200ml/天）SSB 摄入，精子浓度和抑制素-B 的调整后中位数差异分别为-340 万/ml（95%CI：-5.8，-1.0）和-7pg/ml（95%CI：-11，-3）。
局限性、谨慎的原因：由于横断面设计，推断因果关系受到限制。我们调整了许多潜在的混杂因素，但不能排除与软饮料摄入相关的未测量的生活方式和行为与这些年轻男性的睾丸功能有关。
在迄今为止最大的研究中，SSB 的摄入与精子浓度、总精子计数和血清抑制素 B/FSH 比值降低有关，这与 SSB 摄入对睾丸功能的直接抑制作用一致，可能会影响生育能力。然而，较高的 SSB 摄入与较低的精液质量之间的观察到的关联并不一定意味着生育能力下降。
研究资金/利益冲突：得到丹麦战略研究理事会（2101-08-0058）、独立研究基金丹麦（8020-00218B）、欧盟（212844）、克里斯滕和弗雷迪·约翰森基金会（95-103-72087）、哥本哈根首都地区研究基金（A6176）和 NIH（P30DK046200）的研究支持。作者没有报告利益冲突。
无。
