Department of Reproductive Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Department of Pharmacy, Guangdong Provincial Fertility Hospital, Guangzhou, China.
Front Endocrinol (Lausanne). 2024 Mar 12;15:1330629. doi: 10.3389/fendo.2024.1330629. eCollection 2024.
L-carnitine therapy for idiopathic sperm abnormalities exhibits variable effectiveness, and currently, there are no established criteria to predict patient response. This study investigated correlations between seminal plasma markers and semen parameters to identify biomarkers that can guide indications for L-carnitine therapy indications in patients with idiopathic sperm abnormalities.
A retrospective review was conducted on 223 male patients with idiopathic oligoasthenoteratospermia, who sought medical attention at our clinic between January 2020 and October 2022. These patients underwent a pretreatment seminal plasma biochemical analysis, followed by a three-month continuous L-carnitine treatment. The correlation between seminal plasma biochemical parameters and pretreatment semen parameters was analyzed. Semen quality was compared between cases with normal and abnormal seminal plasma biochemical parameters, both pretreatment and posttreatment. The correlation between the changes in semen parameters after treatment and seminal plasma biochemical parameters were investigated.
Correlation analyses revealed significant associations between all pretreatment semen parameters and seminal plasma biochemical markers, except for liquefying time and the ratio of normal morphology. Subgroup analysis, stratified by seminal fructose, zinc, citric acid, and neutral glycosidase levels, demonstrated that abnormal groups exhibited significantly different levels of semen parameters compared with the normal groups. The changing difference and changing ratio in the ratio of forward motile sperm showed a negative correlation with seminal fructose levels (r=-0.165 and -0.144). The changing difference in semen volume was negatively correlated with the level of seminal neutral glycosidase (r=-0.158). The changing ratio in semen volume, sperm concentration, total sperm count, and count of forward motile sperm all exhibited negative correlations with the levels of seminal neutral glycosidase (range from -0.178 to -0.224).
Seminal plasma biochemical markers, particularly fructose and neutral glycosidase, may serve as valuable indicators for determining the eligibility of patients with idiopathic sperm abnormalities for L-carnitine therapy.
左旋肉碱治疗特发性精子异常的疗效存在差异，目前尚无确定的标准来预测患者的反应。本研究旨在探讨精液参数与精液参数之间的相关性，以确定生物标志物，指导特发性精子异常患者左旋肉碱治疗的适应证。
回顾性分析 2020 年 1 月至 2022 年 10 月在我院就诊的 223 例特发性少弱精子症患者的临床资料。这些患者在治疗前均进行了精液生化分析，随后进行了为期 3 个月的连续左旋肉碱治疗。分析精液生化参数与治疗前精液参数之间的相关性。比较治疗前后正常和异常精液生化参数患者的精液质量。分析治疗后精液参数变化与精液生化参数的相关性。
相关性分析显示，除液化时间和正常形态比例外，所有治疗前精液参数与精液生化标志物均呈显著相关。根据精液果糖、锌、柠檬酸和中性糖苷酶水平进行亚组分析，结果显示异常组与正常组相比，精液参数差异有统计学意义。前向运动精子比例的变化差异和变化率与精液果糖水平呈负相关（r=-0.165 和-0.144）。精液量的变化差异与精液中性糖苷酶水平呈负相关（r=-0.158）。精液量、精子浓度、总精子数和前向运动精子数的变化率与精液中性糖苷酶水平呈负相关（范围为-0.178 至-0.224）。
精液生化标志物，特别是果糖和中性糖苷酶，可能是评估特发性精子异常患者左旋肉碱治疗适应证的有价值指标。
