Amer Medhat Kamel, Zohdy Wael, GamalEl Din Sameh Fayek, Moawad Hanan Hosni, Hasan El Saedy Dina Atef, Zaki Gamal Eman Ahmed, Ragab Ahmed
Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt.
Adam International Hospital, Giza, Egypt.
J Reprod Infertil. 2023 Apr-Jun;24(2):108-116. doi: 10.18502/jri.v24i2.12496.
The purpose of the current study was evaluation of the utility of seminal plasma (SP) resistin and leptin in predicting successful surgical sperm retrieval (SSR) in men with non-obstructive azoospermia (NOA).
This prospective comparative study was conducted in the andrology clinic of a specialized fertility center. In total, 53 NOA men as candidates for either first time micro-testicular sperm extraction (micro-TESE) or repeat micro-TESE and 28 normozoospermic controls were included. ELISA was used for measurement of SP resistin and leptin levels in all participants. Significance level was defined as p<0.05.
The current study demonstrated a significant positive correlation between estradiol (E2) level in serum and SP resistin (r=0.342, p=0.025). Also, there was a highly significant positive correlation between SP leptin and SP resistin (r=0.568, p= 0.001). Interestingly, SP leptin was the only variable that demonstrated a significant correlation with eventful micro-TESE outcome in men who underwent micro-TESE for the first time. Finally, ROC curve showed that SP leptin level of 4.05 predicted successful SSR in men who underwent micro-TESE for the first time with a sensitivity of 73.3% and a specificity of 75% as 11 out of 27 (41%) cases showed eventful micro-TESE at or above this cut-off level [AUC of 0.747, 95% CI, lower bound of 0.555, and upper bound of 0.939, p=0.030].
SP leptin can be used as a non-invasive biomarker to predict successful SSR in NOA cases undergoing first time micro-TESE, while SP resistin failed to play the same role.
本研究旨在评估精浆(SP)抵抗素和瘦素在预测非梗阻性无精子症(NOA)男性患者手术取精成功(SSR)方面的效用。
本前瞻性对照研究在一家专业生殖中心的男科门诊进行。共纳入53例首次接受显微睾丸精子提取术(micro-TESE)或重复显微睾丸精子提取术的NOA男性患者以及28例正常精子症对照者。采用酶联免疫吸附测定法(ELISA)检测所有参与者精浆抵抗素和瘦素水平。显著性水平设定为p<0.05。
本研究表明血清雌二醇(E2)水平与精浆抵抗素之间存在显著正相关(r=0.342,p=0.025)。此外,精浆瘦素与精浆抵抗素之间存在高度显著正相关(r=0.568,p=0.001)。有趣的是,对于首次接受micro-TESE的男性患者,精浆瘦素是唯一与显微睾丸精子提取术成功结果显著相关的变量。最后,ROC曲线显示,精浆瘦素水平为4.05时可预测首次接受micro-TESE的男性患者SSR成功,敏感性为73.3%,特异性为75%,因为27例(41%)患者中有11例在该临界值或以上出现了成功的显微睾丸精子提取术[AUC为0.747,95%CI,下限为0.555,上限为0.939,p=0.030]。
精浆瘦素可作为一种非侵入性生物标志物,用于预测首次接受micro-TESE的NOA患者SSR成功,而精浆抵抗素未能发挥同样作用。