Kuller L H, May S J, Perper J A
Am J Epidemiol. 1978 Sep;108(3):192-9. doi: 10.1093/oxfordjournals.aje.a112611.
Impotence, infertility and feminization have been frequently reported among male cirrhotic patients. Previous studies have suggested that liver disease was the basis of these effects. Recent clinical and laboratory experimental studies have suggested that alcohol consumption may have a direct effect on both testosterone metabolism and spermatogenesis. The effect may be mediated through the central nervous system or directly on the testes. The present study compared the pathology in the liver and testes and the estimated alcohol consumption among men who had died suddenly from a variety of causes. Of 137 men studied, 20(14%) had moderate to severe decrease in spermatogenesis. Only 9 of 19 with decreased spermatogenesis also had severe or very severe fatty infiltration of the liver. However, 17 of 19 were classified as heavy alcohol drinkers and 14 were estimated to consume at least 417 gm of alcohol per week. Finally, the alcohol history was reviewed in relation to liver and testicular pathology. Only a weak association between the liver and testes pathology was noted.
男性肝硬化患者中阳痿、不育和女性化现象屡有报道。既往研究表明，肝脏疾病是这些影响的基础。近期临床和实验室实验研究表明，饮酒可能对睾酮代谢和精子发生均有直接影响。这种影响可能通过中枢神经系统介导，或直接作用于睾丸。本研究比较了因各种原因突然死亡的男性的肝脏和睾丸病理情况以及估计的酒精摄入量。在研究的137名男性中，20名（14%）精子发生有中度至重度下降。精子发生下降的19人中只有9人同时伴有严重或极严重的肝脏脂肪浸润。然而，19人中有17人被归类为重度饮酒者，估计有14人每周至少摄入417克酒精。最后，结合肝脏和睾丸病理情况回顾了饮酒史。仅发现肝脏和睾丸病理之间存在微弱关联。
