Education Program in Reproduction & Development, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria 3168, Australia.
Teungku Peukan General Hospital, Aceh Barat Daya 32764, Indonesia.
J Gynecol Obstet Hum Reprod. 2024 Oct;53(8):102807. doi: 10.1016/j.jogoh.2024.102807. Epub 2024 May 31.
To investigate the impact of metabolic syndrome factors on sperm DNA fragmentation (sDF) in males from infertile couples.
A systematic literature search was performed across ten databases for literature published from January 1, 2013 until September 13, 2023. The protocol has been registered on PROSPERO (CRD42023458359), and the literature search strategy is adhered to the PRISMA framework. Studies that evaluated sDF, as indicated by DNA fragmentation index (%DFI), in males from infertile couples in relation to metabolic syndrome factors were included. Meta-analysis, using random effects model and Bayesian framework network, was performed, and data were presented as Standardized Mean Differences (SMD) with corresponding 95 % Confidence Interval (CI).
Of the 2579 citations identified, eleven studies were included in this meta-analysis. The findings revealed that the %DFI was not associated with overall metabolic syndrome factors (p-tot = 0.235; SMD = 0.57 [95 %CI: -0.37, 1.52]), metabolic syndrome status (p-tot = 0.337; SMD = 0.08 [95 %CI: -0.08, 0.24), increased body mass index (p-tot = 0.237; SMD = 0.71 [95 %CI: -0.47, 1.89]), or glycaemic profile (p-tot = 0.93; SMD = 0.13 [95 %CI: -2.72, 2.98]). High levels of heterogeneity were observed (p < 0.01) in all subgroups, except for metabolic syndrome status.
The association between metabolic syndrome factors and sDF is conflicting. However, interpreting the association requires caution, as confounding factors, indicated by high heterogeneity, may conceal the outcome. Metabolic syndrome may influence other factors contributing to male infertility, highlighting the importance of promoting a healthy lifestyle.
研究代谢综合征因素对不孕夫妇男性精子 DNA 碎片化（sDF）的影响。
对 2013 年 1 月 1 日至 2023 年 9 月 13 日期间发表的文献，在 10 个数据库中进行了系统性文献检索。该方案已在 PROSPERO（CRD42023458359）中注册，文献检索策略遵循 PRISMA 框架。纳入评估不孕夫妇男性 sDF（用 DNA 碎片化指数[DFI]表示）与代谢综合征因素之间关系的研究。使用随机效应模型和贝叶斯框架网络进行荟萃分析，并以标准化均数差（SMD）及其相应的 95%置信区间（CI）表示数据。
在 2579 条引文中共纳入 11 项研究。研究结果表明，%DFI 与总体代谢综合征因素无关联（p-总=0.235；SMD=0.57[95%CI：-0.37，1.52]）、代谢综合征状态（p-总=0.337；SMD=0.08[95%CI：-0.08，0.24]）、体重指数增加（p-总=0.237；SMD=0.71[95%CI：-0.47，1.89]）或血糖谱（p-总=0.93；SMD=0.13[95%CI：-2.72，2.98]）。所有亚组均观察到高度异质性（p<0.01），除代谢综合征状态亚组外。
代谢综合征因素与 sDF 之间的关联存在争议。然而，由于高度异质性所表明的混杂因素可能掩盖了结果，因此解释这种关联需要谨慎。代谢综合征可能会影响导致男性不育的其他因素，这凸显了促进健康生活方式的重要性。
