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青春期与精液特征、睾丸体积和生殖激素的关系:一项队列研究。

Timing of puberty in relation to semen characteristics, testicular volume, and reproductive hormones: a cohort study.

机构信息

Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark; Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark.

Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.

出版信息

Fertil Steril. 2023 Oct;120(4):823-833. doi: 10.1016/j.fertnstert.2023.05.164. Epub 2023 May 29.

Abstract

OBJECTIVE

To investigate whether the timing of puberty is associated with semen characteristics, testicular volume, and reproductive hormone levels.

DESIGN

Cohort study.

SETTING

Not applicable.

PATIENTS

The Danish National Birth Cohort and its subcohort, the Fetal Programming of Semen Quality cohort of 1,058 young men.

INTERVENTION(S): Self-reported information on the timing (younger, same age, older than peers) of the pubertal markers: voice break (primary exposure), pubic hair growth, regular shaving, and axillary hair growth.

MAIN OUTCOME MEASURES(S): We estimated the relative differences with 95% confidence intervals for semen characteristics (semen volume, sperm concentration, total sperm count, sperm motility, percentage of morphologically normal spermatozoa), testicular volume, and reproductive hormones (follicle stimulating hormone [FSH], luteinizing hormone, sex hormone-binding globulin [SHBG], testosterone, estradiol, and free androgen index [FAI]) obtained at a median age of 19.2 years according to timing of pubertal development.

RESULT(S): Compared with men reporting voice break "same age as peers," men reporting voice break "older than peers" tended to have lower total sperm count (-12% [-25%, 4%]) and lower percent morphologically normal spermatozoa (-10% [-20%, 2%]), whereas men reporting voice break "younger than peers" tended to have a lower proportion of nonprogressive and immotile spermatozoa (-6% [-13%, 1%]) and larger testicular volume (7% [1%, 13%]). The pattern was less consistent for the other pubertal markers. For reproductive hormones, voice break "older than peers" tended to have higher FSH levels (24% [-1%, 55%]), higher SHBG levels (7% [0, 15%]), lower estradiol levels (-14% [-23%, -5%]), and lower FAI (-8% [-14%, -1%]), whereas voice break "younger than peers" tended to have higher luteinizing hormone levels (4% [-2%, 11%]), higher testosterone levels (5% [0%, 11%]), higher estradiol levels (17% [6%, 29%]), and higher FAI (4% [-2%, 11%]). When the categorical pubertal markers were analyzed as a linear term to assess dose dependence, older age at pubertal development was associated with higher FSH levels, higher SHBG levels, lower testosterone levels, lower estradiol levels, and lower FAI for most pubertal markers.

CONCLUSION(S): These results lend weak support to the hypothesis that older age at pubertal development is associated with markers of reduced male fecundity, especially reproductive hormone levels, although associations with semen characteristics and testicular volume were statistically insignificant.

摘要

目的

研究青春期的时间是否与精液特征、睾丸体积和生殖激素水平有关。

设计

队列研究。

地点

不适用。

患者

1058 名年轻男性的丹麦国家出生队列及其子队列,即精液质量的胎儿编程队列。

干预措施

自我报告青春期标志(变声、阴毛生长、定期剃须、腋毛生长)出现的时间(早于同龄人、同龄人、晚于同龄人)。

主要观察指标

根据 19.2 岁时的精液特征(精液量、精子浓度、总精子数、精子活力、形态正常精子百分比)、睾丸体积和生殖激素(卵泡刺激素[FSH]、黄体生成素、性激素结合球蛋白[SHBG]、睾酮、雌二醇和游离雄激素指数[FAI]),估计相对差异及其 95%置信区间。

结果

与报告变声“与同龄人同龄”的男性相比,报告变声“晚于同龄人”的男性总精子数(-12%[-25%,4%])和形态正常精子百分比(-10%[-20%,2%])较低,而报告变声“早于同龄人”的男性非进展性和不动精子比例(-6%[-13%,1%])较低,睾丸体积较大(7%[1%,13%])。对于其他青春期标志,这种模式不太一致。对于生殖激素,变声“晚于同龄人”的男性 FSH 水平(24%[-1%,55%])、SHBG 水平(7%[0,15%])、雌二醇水平(-14%[-23%,-5%])和 FAI(-8%[-14%,-1%])较高,而变声“早于同龄人”的男性黄体生成素水平(4%[-2%,11%])、睾酮水平(5%[0%,11%])、雌二醇水平(17%[6%,29%])和 FAI(4%[-2%,11%])较高。当将分类青春期标志物作为线性项进行分析以评估剂量依赖性时,青春期发育年龄较大与大多数青春期标志物的 FSH 水平升高、SHBG 水平升高、睾酮水平降低、雌二醇水平降低和 FAI 降低有关。

结论

这些结果微弱支持青春期发育年龄较大与男性生育力降低的标志物有关的假设,尤其是生殖激素水平,尽管与精液特征和睾丸体积的关联无统计学意义。

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