亚临床甲状腺功能减退与精子DNA碎片化：一项对5401名寻求不孕不育治疗男性的横断面研究。

Subclinical Hypothyroidism and Sperm DNA Fragmentation: A Cross-sectional Study of 5401 Men Seeking Infertility Care.

作者信息

Zhao Shuhua, Tang Li, Fu Jingyun, Yang Zexing, Su Cunmei, Rao Meng

机构信息

Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China.

Department of Endocrinology, the First Affiliated Hospital of Kunming Medical University, Kunming, China.

出版信息

J Clin Endocrinol Metab. 2022 Sep 28;107(10):e4027-e4036. doi: 10.1210/clinem/dgac458.

DOI:10.1210/clinem/dgac458

PMID:35906991

Abstract

CONTEXT

Our previous study showed that paternal subclinical hypothyroidism (SCH) had a detrimental effect on the clinical outcomes of assisted reproductive technologies. However, it remains to be determined whether paternal SCH affects sperm DNA integrity.

OBJECTIVE

To investigate the association between SCH and sperm DNA fragmentation in men seeking infertility care.

METHODS

This cross-sectional study included 4983 men with euthyroidism and 418 men with SCH seeking infertility treatment in a tertiary care academic medical center between January 2017 and December 2021. The outcome measures were the absolute DNA fragmentation index (DFI) and the risk of abnormal DFI (defined as DFI ≥ 25% or ≥ 30%).

RESULTS

The mean (SD) age of men with euthyroidism and men with SCH was 34.20 (5.97) and 35.35 (6.48) years, respectively (P < 0.001). The difference in DFI was not statistically significant (adjusted mean: 19.7% vs 18.9% in the SCH and euthyroidism groups, respectively; P = 0.07) after confounder adjustment. A DFI ≥25% was significantly more frequent in men with SCH (20.57%) than in men with euthyroidism (14.49%) after confounder adjustment [odds ratio (OR) 1.43 (95% CI 1.09-1.88)]. DFI ≥ 30% was also significantly more common in men with SCH (11.72%) than in men with euthyroidism [6.74%; OR 1.84 (95% CI 1.34-2.52)]. In addition, thyroid-stimulating hormone concentration was significantly associated with an increased risk of having a DFI ≥25% (P < 0.001) or ≥30% (P = 0.011).

CONCLUSION

SCH was significantly associated with an increased risk of an abnormal DFI.

摘要

背景

我们之前的研究表明，父亲亚临床甲状腺功能减退（SCH）对辅助生殖技术的临床结局有不利影响。然而，父亲SCH是否会影响精子DNA完整性仍有待确定。

目的

探讨寻求不孕治疗的男性中SCH与精子DNA片段化之间的关联。

方法

这项横断面研究纳入了2017年1月至2021年12月期间在一家三级医疗学术中心寻求不孕治疗的4983名甲状腺功能正常的男性和418名SCH男性。结局指标为绝对DNA片段化指数（DFI）和DFI异常风险（定义为DFI≥25%或≥30%）。

结果

甲状腺功能正常的男性和SCH男性的平均（标准差）年龄分别为34.20（5.97）岁和35.35（6.48）岁（P<0.001）。在调整混杂因素后，DFI的差异无统计学意义（调整后均值：SCH组和甲状腺功能正常组分别为19.7%和18.9%；P=0.07）。在调整混杂因素后，SCH男性中DFI≥25%的比例（20.57%）显著高于甲状腺功能正常的男性（14.49%）[比值比（OR）1.43（95%CI 1.09-1.88）]。DFI≥30%在SCH男性中（11.72%）也比甲状腺功能正常的男性更常见[6.74%；OR 1.84（95%CI 1.34-2.52）]。此外，促甲状腺激素浓度与DFI≥25%（P<0.001）或≥30%（P=0.011）风险增加显著相关。