Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China.
Hum Reprod. 2023 Apr 3;38(4):537-548. doi: 10.1093/humrep/dead010.
Is dietary total antioxidant capacity (DTAC) associated with the odds of developing asthenozoospermia in Chinese men?
There is no statistically significant association between DTAC indices and the odds of developing asthenozoospermia.
Both diet and oxidative stress may be related to sperm quality; however, few studies have investigated the association between DTAC and sperm quality.
STUDY DESIGN, SIZE, DURATION: This case-control study was conducted from June 2020 to December 2020. Those diagnosed with asthenozoospermia were assigned to the case group, whereas those with normal sperm parameters were assigned to the control group. Data from a total of 553 cases and 586 controls were included in the final analysis.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Men who had been referred to the infertility clinic of Shengjing Hospital of China Medical University were enrolled. Dietary intake was assessed using a validated food frequency questionnaire. DTAC was based on ferric-reducing ability of plasma (FRAP), total oxygen radical absorbance capacity (T-ORAC), hydrophilic oxygen radical absorbance capacity (H-ORAC), lipophilic oxygen radical absorbance capacity (L-ORAC), total phenolics (TP), total radical-trapping antioxidant parameter (TRAP), and Trolox equivalent antioxidant capacity (TEAC). Asthenozoospermia was defined according to the criteria published in the fifth edition of the World Health Organization laboratory manual for the examination and processing of human semen.
No significant association was observed between the DTAC indices and the odds of asthenozoospermia after multivariable adjustment (T3 vs T1, odds ratio (OR) = 0.99, 95% CI: 0.73-1.33 for FRAP; OR = 1.05, 95% CI: 0.77-1.42 for T-ORAC; OR = 0.88, 95% CI: 0.65-1.18 for H-ORAC; OR = 0.98, 95% CI: 0.71-1.34 for L-ORAC; OR = 1.03, 95% CI: 0.76-1.39 for TP; OR = 1.18, 95% CI: 0.87-1.59 for TRAP; and OR = 1.15, 95% CI: 0.85-1.55 for TEAC). Both additive and multiplicative interaction analyses suggested that smoking might modify the association of T-ORAC with the odds of developing asthenozoospermia (relative excess risk due to interaction = 0.45, 95% CI: 0.07-0.83, attributable proportion due to interaction = 0.46, 95% CI: 0.07-0.84 for additive interaction; P = 0.033 for multiplicative interaction).
LIMITATIONS, REASONS FOR CAUTION: Recall bias and protopathic bias were inevitable in this retrospective case-control study. The estimation accuracy of the DTAC indices may have also affected the findings.
To the best of our knowledge, this is the first study to specifically investigate whether an association exists between DTAC and the odds of developing asthenozoospermia. Although no significant association was found, this study provides novel information pertaining to the fields of nutrition and human reproduction.
STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the JieBangGuaShuai Project of Liaoning Province (2021JH1/10400050), the Shengjing Hospital Clinical Research Project (M0071), and the Outstanding Scientific Fund of Shengjing Hospital (M1150). All authors have no competing interests to disclose.
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膳食总抗氧化能力（DTAC）与中国男性发生弱精子症的几率是否相关？
DTAC 指数与发生弱精子症的几率之间没有统计学意义上的关联。
饮食和氧化应激都可能与精子质量有关；然而，很少有研究调查 DTAC 与精子质量之间的关系。
研究设计、大小和持续时间：本病例对照研究于 2020 年 6 月至 12 月进行。被诊断为弱精子症的患者被分配到病例组，而精子参数正常的患者被分配到对照组。共有 553 例病例和 586 例对照的资料被纳入最终分析。
参与者/材料、设置、方法：在中国医科大学附属盛京医院不孕不育科招募男性。使用经过验证的食物频率问卷评估膳食摄入量。DTAC 基于血浆铁还原能力（FRAP）、总氧自由基吸收能力（T-ORAC）、亲水性氧自由基吸收能力（H-ORAC）、疏水性氧自由基吸收能力（L-ORAC）、总酚类（TP）、总自由基捕获抗氧化参数（TRAP）和 Trolox 等效抗氧化能力（TEAC）。根据世界卫生组织第五版人类精液检查和处理实验室手册的标准定义弱精子症。
多变量调整后，DTAC 指数与弱精子症的几率之间没有显著关联（T3 与 T1 相比，比值比（OR）=0.99，95%置信区间：0.73-1.33 用于 FRAP；OR=1.05，95%置信区间：0.77-1.42 用于 T-ORAC；OR=0.88，95%置信区间：0.65-1.18 用于 H-ORAC；OR=0.98，95%置信区间：0.71-1.34 用于 L-ORAC；OR=1.03，95%置信区间：0.76-1.39 用于 TP；OR=1.18，95%置信区间：0.87-1.59 用于 TRAP；OR=1.15，95%置信区间：0.85-1.55 用于 TEAC）。加性和乘法交互作用分析均表明，吸烟可能会改变 T-ORAC 与发生弱精子症几率之间的关联（交互作用引起的相对超额风险=0.45，95%置信区间：0.07-0.83，交互作用归因比例=0.46，95%置信区间：0.07-0.84 用于加性交互作用；P=0.033 用于乘法交互作用）。
局限性、谨慎的原因：在这项回顾性病例对照研究中，不可避免地存在回忆偏倚和前病偏倚。DTAC 指数的估计准确性也可能影响研究结果。
据我们所知，这是第一项专门研究 DTAC 与发生弱精子症几率之间是否存在关联的研究。尽管没有发现显著关联，但本研究为营养和人类生殖领域提供了新的信息。
研究资金/利益冲突：本研究得到了辽宁省杰霸卦帅项目（2021JH1/10400050）、盛京医院临床研究项目（M0071）和盛京医院杰出科学基金（M1150）的支持。所有作者均无利益冲突。
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