[精浆脂质组学分析在预测无精子症男性显微睾丸取精术成功率中的预后能力]

[Prognostic ability of seminal plasma lipidomic analysis in predicting the success of microTESE in men with azoospermia].

作者信息

Gamidov S I, Shatylko T V, Tambiev A Kh, Tokareva A O, Chagovets V V, Bitsoev T B, Starodubtseva N L, Popova A Yu, Frankevich V E

机构信息

Acad. V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia.

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.

出版信息

Urologiia. 2022 Sep(4):32-37.

PMID:36098587

Abstract

INTRODUCTION

The aim of this work is to assess the possibility of metabolomic (specifically lipidomic) analysis of seminal plasma to identify patients with preserved focal spermatogenesis in the testes who may have a reasonable chance of sperm retrieval during the microTESE procedure.

MATERIALS AND METHODS

lipid composition of semen plasma samples from 64 men with azoospermia and 24 fertile control men was analyzed. Lipids were isolated from semen by a modified Folch extraction method. Lipid extracts were analyzed by reverse phase liquid chromatography coupled to mass spectrometry. Lipidomic data were compared with the results of the microTESE procedure.

RESULTS

Comparison of two groups revealed a statistically significant difference in concentration for 23 lipids detected in positive ion mode and 37 lipids detected in negative ion mode. Those lipids mainly belong to hexosylceramides, sphingomyelins and phosphatidylcholines, phosphatidylethanolamines and their ethers. In multivariate analysis content of SM d16: 1/18:0 lipid (beta coefficient: -7.23; 95% confidence interval [95% CI]: -11.93 to - 2.53; odds ratio: 7.23e-04; CI for odds ratio: 6.59e-06 to 7.93e-02; Walds test: -3.02; p=0.003), content of TG 14: 1_16 : 0_18: 3 lipid (beta 2.95; 95% CI 0.98 to 4.93; odds ratio: 1.92e + 01; CI for odds ratio: 2.66e + 00 to 1.39e + 02 ; Walds test: 2.93; p=0.003) and testicular volume (beta: 0.14; 95% CI: 0.04 to 2.45; odds ratio: 1.15e + 00; CI odds ratio: from 1.04e + 00 to 1.27e + 00; Walds test: 2.65; p=0.008) were significantly associated with positive MicroTESE outcome. The sensitivity of this regression model was 61%, the specificity was 83%, and the AUC was 0.75.

CONCLUSIONS

seminal plasma serves as a rich source of biological markers for identifying patients with preserved focal spermatogenesis in the testes. Seminal plasma lipidomic profile of the of patients in the control group with normal spermatogenesis clearly differs from the profile of patients with azoospermia, also there was a significant difference in content of a difference in lipids between patients with positive and negative microTESE outcomes. These are preliminary results and further research is needed to confirm the validity of the resulting lipid panel.

摘要

引言

本研究旨在评估对精浆进行代谢组学（特别是脂质组学）分析的可能性，以识别睾丸中局灶性生精功能保留的患者，这些患者在显微睾丸精子提取（microTESE）手术中可能有合理的机会获取精子。

材料与方法

分析了64例无精子症男性和24例生育能力正常男性的精浆样本的脂质组成。采用改良的Folch提取法从精液中分离脂质。脂质提取物通过反相液相色谱-质谱联用进行分析。脂质组学数据与microTESE手术结果进行比较。

结果

两组比较显示，在正离子模式下检测到的23种脂质和负离子模式下检测到的37种脂质的浓度存在统计学显著差异。这些脂质主要属于己糖神经酰胺、鞘磷脂、磷脂酰胆碱、磷脂酰乙醇胺及其醚类。在多变量分析中，SM d16:1/18:0脂质含量（β系数：-7.23；95%置信区间[95%CI]：-11.93至-2.53；比值比：7.23e-04；比值比的CI：从6.59e-06至7.93e-02；Wald检验：-3.02；p=0.003）、TG 14:1_16:0_18:3脂质含量（β 2.95；95%CI 0.98至4.93；比值比：1.92e+01；比值比的CI：2.66e+00至1.39e+02；Wald检验：2.93；p=0.003）和睾丸体积（β：0.14；95%CI：0.04至2.45；比值比：1.15e+00；比值比的CI：从1.04e+00至1.27e+00；Wald检验：2.65；p=0.008）与microTESE阳性结果显著相关。该回归模型的敏感性为61%，特异性为83%，曲线下面积（AUC）为0.75。