Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
Andrology. 2024 Mar;12(3):553-560. doi: 10.1111/andr.13505. Epub 2023 Aug 9.
Vitamin D status has been associated with sex steroid production. The question is whether vitamin D supplementation has an impact on sex steroid production in infertile men with vitamin D insufficiency?
A single-center, double-blinded, randomized clinical trial. Differences in sex steroids and reproductive hormones were predefined secondary outcomes, vitamin D status at baseline was a predefined subgroup and the primary outcome was differences in semen quality.
A total of 307 infertile men were included and randomized 1:1 to active or placebo treatment for 150 days. Men in the active group initially received an oral bolus of 300,000 IU cholecalciferol, followed by daily supplementation with 1400 IU cholecalciferol and 500 mg calcium.
After intervention, no differences were found in serum concentrations of sex steroids, luteinizing hormone, testosterone/luteinizing hormone ratio or SHBG between the vitamin D and placebo group. However, in a predefined subgroup analysis of men with serum 25OHD ≤ 50 nmol/L, men treated with vitamin D had a significantly higher testosterone/luteinizing hormone ratio [4.2 (3.8-4.4) vs. 3.7 (3.4-4.0); p = 0.033] compared with placebo treatment. In men with vitamin D deficiency, the difference between groups was larger but not significant due to few men with serum 25OHD < 25 nmol/L.
Vitamin D + calcium supplementation did not alter sex steroid production in infertile men. However, vitamin D insufficient men treated with vitamin D supplementation had a significantly higher testosterone/LH ratio compared with placebo-treated men, suggesting that optimal Leydig cell function are dependent on adequate vitamin D status.
维生素 D 状态与性激素的产生有关。问题是维生素 D 补充剂是否会对维生素 D 不足的不育男性的性激素产生影响？
一项单中心、双盲、随机临床试验。性激素和生殖激素的差异是预先设定的次要结局，基线时的维生素 D 状态是预先设定的亚组，主要结局是精液质量的差异。
共纳入 307 例不育男性，按 1:1 随机分为活性组或安慰剂组，治疗 150 天。活性组的男性最初接受 300,000 IU 胆钙化醇的口服冲击剂量，随后每天补充 1400 IU 胆钙化醇和 500mg 钙。
干预后，维生素 D 组和安慰剂组之间血清性激素、黄体生成素、睾酮/黄体生成素比值或 SHBG 浓度无差异。然而，在血清 25OHD≤50nmol/L 的男性的预先设定亚组分析中，维生素 D 治疗组的睾酮/黄体生成素比值显著高于安慰剂治疗组[4.2（3.8-4.4）比 3.7（3.4-4.0）；p=0.033]。在维生素 D 缺乏的男性中，由于血清 25OHD<25nmol/L 的男性较少，组间差异更大，但无统计学意义。
维生素 D+钙补充剂并未改变不育男性的性激素产生。然而，与安慰剂治疗组相比，接受维生素 D 补充治疗的维生素 D 不足男性的睾酮/LH 比值显著升高，提示最佳的莱迪希细胞功能依赖于充足的维生素 D 状态。
