Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute, Guangdong Provincial Fertility Hospital, Guangzhou, Guangdong, China.
Andrology. 2024 Feb;12(2):316-326. doi: 10.1111/andr.13471. Epub 2023 Jun 15.
General obesity classified by body mass index has been linked to a reduction in semen quality; however, evidence on the adverse effect of central obesity on semen quality remains limited.
To investigate the association between central obesity and semen quality.
We conducted a cross-sectional study of 4513 sperm donation volunteers in Guangdong Provincial Human Sperm Bank during 2018-2021. Three central obesity indicators, including waist circumference, waist-to-hip ratio, and waist-to-height ratio, were measured using a multi-frequency bioelectrical impedance analysis for each subject. Semen analysis was conducted according to the World Health Organization laboratory manual for the examination and processing of human semen 5th edition. Linear regression models and unconditional logistic regression models were used to quantify the association between central obesity and semen parameters.
With adjustment for age, race, education level, marital status, fertility status, occupation, year of semen collection, abstinence period, ambient temperature, and relative humidity, central obesity defined as waist circumference ≥90 cm, waist-to-hip ratio ≥0.9, or waist-to-height ratio ≥0.5 was significantly associated with a 0.27 (95% confidence interval: 0.15, 0.38) mL, 14.47 (3.60, 25.34) × 10 , 7.06 (0.46, 13.76) × 10 , and 6.80 (0.42, 13.18) × 10 reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number, respectively, and a 53% (10%, 112%) increase in odds of below the World Health Organization 2010 reference value for semen volume. These associations did not significantly vary across age. Similar results were observed for central obesity defined using each of the three indicators, except that subjects with a waist circumference ≥90 cm had a slightly higher total motility (estimated change: 1.30%; 95% confidence interval: 0.27%, 2.34%) and progressive motility (estimated change: 1.27%; 95% confidence interval: 0.23%, 2.31%).
We found that central obesity was significantly associated with a reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number. Future studies are warranted to confirm our results in other regions and populations.
基于身体质量指数的一般肥胖与精液质量下降有关；然而，关于中心性肥胖对精液质量的不良影响的证据仍然有限。
探讨中心性肥胖与精液质量之间的关系。
我们对 2018 年至 2021 年间在广东省人类精子库的 4513 名捐精志愿者进行了横断面研究。使用多频生物电阻抗分析对每位受试者测量了 3 项中心性肥胖指标，包括腰围、腰臀比和腰高比。根据世界卫生组织第 5 版人类精液检查和处理实验室手册进行精液分析。使用线性回归模型和非条件逻辑回归模型来量化中心性肥胖与精液参数之间的关联。
在调整年龄、种族、教育水平、婚姻状况、生育状况、职业、精液采集年份、禁欲期、环境温度和相对湿度后，腰围≥90cm、腰臀比≥0.9 或腰高比≥0.5 的中心性肥胖与精液量减少 0.27（95%置信区间：0.15，0.38）mL、总精子数减少 14.47（3.60，25.34）×10⁶、总活力精子数减少 7.06（0.46，13.76）×10⁶和总前向运动精子数减少 6.80（0.42，13.18）×10⁶分别相关，并且精液量低于世界卫生组织 2010 年参考值的几率增加 53%（10%，112%）。这些关联在年龄上没有显著差异。使用三个指标中的每一个来定义中心性肥胖时，也观察到了类似的结果，除了腰围≥90cm 的受试者的总活力（估计变化：1.30%；95%置信区间：0.27%，2.34%）和前向运动活力（估计变化：1.27%；95%置信区间：0.23%，2.31%）略有升高。
我们发现中心性肥胖与精液量、总精子数、总活力精子数和总前向运动精子数减少显著相关。未来的研究需要在其他地区和人群中证实我们的结果。
