超重和肥胖不育患者精浆中IGF-1、ROS水平变化及意义

Association of Insulin-like growth factor-Ⅰ with reactive oxygen species in seminal plasma and semen quality among obesity and overweight infertile male

目的观察超重和肥胖不育患者精浆中胰岛素样生长因子-1(IGF-1)、活性氧(ROS)水平变化,并探讨其临床意义。方法随机抽样抽取227例男性,其中正常体质量已经生育者58例(正常已育组),正常体质量不育者50例(正常不育组),超重不育者60例(超重不育组),肥胖不育者59例(肥胖不育组),精液常规分析,采用ELISA法检测各组入选对象精浆中IGF-1、ROS。结果与正常已育组比较,正常不育组IGF-1水平降低,超重不育组及肥胖不育组IGF-1、ROS水平升高;与正常不育组比较,超重不育组及肥胖不育组IGF-1、ROS水平升高;与超重不育组比较,肥胖不育组IGF-1、ROS水平升高(P均<0.05)。男性不育患者BMI与精液量呈负相关(B=-0.17,P<0.05),与精子畸形率呈正相关(B=0.20,P<0.05),与IGF-1呈正相关(B=0.29,P<0.05),与ROS呈正相关(B=0.41,P<0.05);ROS与IGF-1呈正相关(B=0.62,P<0.05);IGF-1与精子前向运动率呈正相关(B=0.15,P<0.05)。结论正常体质量不育患者精浆中IGF-1水平下降,超重和肥胖不育患者精浆中IGF-1、ROS水平升高,检测上述指标对于临床分析肥胖影响男性不育原因提供一定理论依据,也为临床治疗提供参考。

Objective To observe the change of insulin-like growth factor 1 （ IGF-1 ） and reactive oxygen species （ ROS） levels in the seminal plasma of overweight and obese patients with infertility , and to explore its clinical signifi-cance.Methods 227 male patients were randomly selected .They were divided into normal fertile group （58 cases who had normal weight and one or more children ）, normal infertility group（50 cases who had normal weight but nfertility ）, o-verweigh infertility group（60 cases who had overweight and nfertility ） and obese infertility group（59 cases who were obese and nfertility）.Semen specimen was performed by conventional analysis .The levels of seminal plasma IGF-1 and ROS were detected by ELISA .Results Compared with normal fertile group , the level of IGF-1 in seminal plasma of normal in-fertility group decreased （all P〈0.05）.Compared with normal fertile group and normal infertility group , the levels of IGF-1 and ROS in seminal plasma of obese infertility group and overweight infertility group increased （all P〈0.05）.Com-pared with overweight infertility group, the levels of IGF-1 and ROS in obese infertility group increased（all P〈0.05）.In all the male infertility patients, BMI had negative correlation with sperm volume （B=0.17, P〈0.05）, positive correlation with sperm malformation rate（B=0.20, P〈0.05）, positive correlation with IGF-1（B=0.285, P〈0.05）, and positive correlation with ROS（B=0.414, P〈0.05）.ROS and IGF-1 were positively correlated（B=0.619, P〈0.05）.IGF-1 and sperm forward movement rate were positively correlated （B=0.150, P〈0.05）.Conclusions The level of IGF-1 in seminal plasma decrease in patients with normal body mass and infertility .The levels of ROS and IGF-1 rise in overweight and obese patients with infertility .The above indicators can help to analyze the infertility effect of overweight and obesity and provide reference for clinical treatment .