精索静脉曲张对实验动物睾丸氧化应激和精子参数的影响：系统评价与荟萃分析
Impact of Varicocele on Testicular Oxidative Stress and Sperm Parameters in Experimental Animals: A Systematic Review and Meta-Analysis.
作者信息
Russo Giorgio Ivan, Saleh Ramadan, Finocchi Federica, Juma Almas Ramadhani, Durairajanayagam Damayanthi, Kahraman Oguzhan, Söğütdelen Emrullah, Sokolakis Ioannis, Vishwakarma Ranjit B, Bahar Fahmi, Harraz Ahmed M, Kavoussi Parviz, Atmoko Widi, Chung Eric, Kumar Naveen, Zohdy Wael, Rambhatla Amarnath, Arafa Mohamed, Phuoc Nguyen Ho Vinh, Salvio Gianmaria, Calogero Aldo E, Toprak Tuncay, Pinggera Germar-Michael, Cannarella Rossella, Colpi Giovanni, Hamoda Taha Abo-Almagd Abdel-Meguid, Shah Rupin, Agarwal Ashok
机构信息
Urology Section, Department of Surgery, University of Catania, Catania, Italy.
Global Andrology Forum, Moreland Hills, OH, USA.
出版信息
World J Mens Health. 2024 Jul;42(3):563-573. doi: 10.5534/wjmh.230260. Epub 2024 Feb 7.
PURPOSE
Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta-analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele.
MATERIALS AND METHODS
A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (×10), sperm vitality (%), total sperm motility (%), and sperm DNA fragmentation (SDF) (%). Standardized mean difference (SMD) (95% confidence interval [CI]) was chosen to express the effect size. The quality of the included studies was evaluated using the Cambridge Quality Checklist.
RESULTS
Out of 76 identified articles, 6 studies on rats were included in the meta-analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high.
CONCLUSIONS
This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.
目的
精索静脉曲张与高精液氧化应激（OS）、精液质量受损及男性生育潜力降低有关。然而，精索静脉曲张介导的不育症发生的确切机制以及精索静脉曲张与睾丸功能障碍之间的因果关系尚未完全明确。本系统评价和荟萃分析（SRMA）的目的是研究与无精索静脉曲张的动物相比，精索静脉曲张对实验性精索静脉曲张动物睾丸OS标志物和精子参数的影响。
材料与方法
使用Scopus和PubMed数据库对研究精索静脉曲张动物睾丸OS标志物和精子参数的研究进行文献检索。主要结局包括丙二醛（MDA）（nmol/mg）水平，次要结局包括精子总数（×10）、精子活力（%）、总精子活力（%）和精子DNA碎片率（SDF）（%）。选择标准化均数差（SMD）（95%置信区间[CI]）来表示效应量。使用剑桥质量清单评估纳入研究的质量。
结果
在76篇已识别的文章中，有6项关于大鼠的研究纳入了荟萃分析。分析显示，与对照组相比，精索静脉曲张大鼠的MDA显著增加（SMD：15.61[1.93，29.29]；p=0.03）。我们还观察到，与对照组相比，精索静脉曲张大鼠的精子总数显著减少（SMD：-17.45[-28.97，-5.93]；p<0.01）、精子活力显著降低（SMD：-16.41[-26.30，-6.52]；p<0.01）、总精子活力显著降低（SMD：-17.67[-24.90，-10.44]；p<0.01），而SDF显著增加（SMD：7.41[1.23，13.59]；p=0.02）。纳入研究的质量被评为高。
结论
本SRMA表明，实验性精索静脉曲张动物的睾丸MDA和SDF水平显著升高，精子质量降低。这些发现支持睾丸OS在精索静脉曲张诱导的睾丸损伤发生中的潜在作用。
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