不育症患者精浆金属雌激素与精子质量的关联

The association between metalloestrogens in seminal plasma and sperm quality in infertile patients

目的分析不育症患者精浆金属雌激素(MEs)水平与精子质量的关联,为研究MEs对精子质量的影响提供依据。方法选择2020年3—4月在浙江省人民医院生殖中心确诊的不育症男性患者,检测精子浓度、前向活动率(PR)、正常形态率(NMR)和DNA碎片指数(DFI);采用电感耦合等离子体质谱法测定精浆中的砷(As)、镉(Cd)、钴(Co)、铬(Cr)、铜(Cu)、汞(Hg)和镍(Ni)等MEs,分析精子质量异常患者精浆MEs分布以及不同MEs浓度组(按四分位数分组)精子参数。结果纳入男性不育症患者105例,其中精子质量正常组28例;精子质量异常组77例,包含少精子症、弱精子症、畸形精子症和DFI异常,分别为22、47、54和30例。精子质量正常组和异常组精浆As、Cr、Cu、Hg和Ni检出率均为100%,Cd、Co检出率为78.57%~90.91%。与正常组比较,少精子症组As含量较高[(18.96±12.56)μg/L vs.(13.67±4.19)μg/L,P<0.05],弱精子症、畸形精子症和DFI异常组的Cr含量较高[(386.62±81.92)、(378.02±81.46)、(393.88±77.03)μg/L vs.(343.12±55.08)μg/L,P均<0.05]。精浆Cr含量Q_(3)和Q_(4)组精子PR低于Q_(2)组[(32.95±18.22)%、(27.74±22.77)%vs.(54.18±24.64)%,P均<0.05],Q_(3)和Q_(4)组DFI高于Q_(2)组[(26.91±14.77)%、(29.91±16.93)%vs.(9.87±10.93)%,P均<0.05],Q_(4)组NMR低于Q_(2)组[1.00%(2.50%)vs.4.00%(4.00%),P<0.05]。Cu含量Q_(3)组精子浓度高于Q_(2)组[(115.87±88.22)×10^(6)/mL vs.(61.91±66.16)×106/mL,P<0.05]。结论不育症患者精浆中As和Cu与精子浓度异常有关,Cr与精子形态、PR及DFI异常有关。

Objective To analyze the association between the concentration of metalloestrogens(MEs)in seminal plasma and sperm quality in infertile patients,so as to provide the basis for the study of MEs on human sperm quality.Methods The spermatozoa concentration,progressive rate(PR),normal morphology rate(NMR)and DNA fragmentation index(DFI)were determined in the infertile male patients from Zhejiang Provincial People’s Hospital from March to April,2020.The contents of As,Cd,Co,Cr,Cu,Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry(ICP-MS).The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs(grouped by quartiles)were analyzed.Results Among 105 cases recruited,28 cases were normal in sperm parameters and 77 cases were abnormal,including 22 cases of oligospermia,47 cases of asthenospermia,54 cases of dysspermia and 30 cases of abnormal DFI.As,Cr,Cu,Hg and Ni were detected in all samples,the detection rates of Cd and Co were 78.57%-90.91%.Compared with the normal group,the concentration of As in oligospermia group was higher[(18.96±12.56)μg/L vs.(13.67±4.19)μg/L,P<0.05],the concentration of Cr was higher in asthenospermia,dysspermia and abnormal DFI in Q_(3)and Q_(4)groups groups[(386.62±81.92),(378.02±81.46),(393.88±77.03)μg/L vs.(343.12±55.08)μg/L,P<0.05].The PRs in Q_(3)and Q_(4)groups of Cr were lower than that in Q_(2)group[(32.95±18.22)%,(27.74±22.77)%vs.(54.18±24.64)%,P<0.05],the DFI in Q_(3)and Q_(4)groups was higher than that in Q_(2)group[(26.91±14.77)%,(29.91±16.93)%vs.(9.87±10.93)%,P<0.05],and the NMR in Q_(4)group was lower than that in Q_(2)group[(1.62±1.72)%vs.(3.36±1.97)%,P<0.05].The concentration of sperm in Q_(3)group of Cu was higher than that in Q_(2)group[(115.87±88.22)×106/mL vs.(61.91±66.16)×10^(6)/mL,P<0.05].Conclusion As and Cu in seminal plasma are associated with abnormal sperm concentration,and Cr is associated with NMR,PR and DFI.