不同体重指数男性不育患者促性腺激素及性激素水平研究

Study on the levels of gonadotropin and sex hormones levels among male sterile patients with different body mass indexes

目的:探讨体重指数(BMI)对于男性精液、促性腺激素、性激素的影响。方法:随机抽取男性不育患者524例,根据BMI分成三组。即正常体重组179例,超重组219例,肥胖组126例。对不育患者进行精液常规分析,采用化学发光法测定促卵泡激素、促黄体生成素、睾酮、雌二醇水平。结果:肥胖组精液量(2.30±1.05)ml与正常体重组精液量(2.73±1.02)ml相比较,低于后者,差异有统计学意义(P<0.05)。超重组精子活动率(55.10±20.53)%与正常体重组(49.80±24.47)%相比较,高于后者,差异有统计学意义(P<0.05),但在前向运动精子率中超重组与正常体重组相比差异无统计学意义(P>0.05)。正常体重组睾酮水平(449.70±120.07)ng/dl,超重组(394.47±178.28)ng/dl,肥胖组(323.37±137.34)ng/dl,三组相比较,差异有统计学意义(P<0.05)。随着BMI增加,各组睾酮逐渐下降。雌二醇虽有增加,但各组间差异无统计学意义。BMI与促黄体生成素水平呈负相关性(r=-0.17,P<0.05)。BMI与总睾酮水平呈明显负相关性(r=-0.31,P<0.01),BMI与促卵泡生成素和雌激素水平无相关性。结论:肥胖男性不育患者在治疗中应补充雄激素,同时加强锻炼,健康饮食,减轻体重是治疗的重要部分。

Objective： To explore the effect of body mass index（BMI） on semen, gonadotropin and sex hormones of men. Methods： A total of 524 male sterile patients were randomly selected and divided into three groups according to BMI： 179 patients in normal weight group, 219 patients in overweight group, and 126 patients in obesity group. Routine semen analysis was performed among the patients, chemiluminescence was used to detect follicle-stimulating hormone （ FSH）, luteinizing hormone （ LH ）, testosterone （ T）, and estradiol levels. Results： Semen volume in obesity group was （ 2. 30 ± 1.05 ） ml, which was statistically significantly lower than that in normal weight group （2. 73±1.02 ml） （P〈0. 05 ）; sperm active rate in overweight group was （55.10±20. 53 ）% , compared with normal weight group [ （49. 80 ±24.47 ）% ], which was significantly higher （P〈 0. 05 ）, but there was no statistically significant difference in progressive sperm rate between overweight group and normal weight group （ P〉0. 05 ） . The levels of T in normal weight group, overweight group, and obesity group were （449. 70±120. 07） ng/D1, （394. 47±178.28） ng,/dL, and （323.37±137. 34） ng/dL, respectively, there was statistically significant difference among the three groups （ P〈0. 05 ） . T levels in the three groups decreased gradually with the increase of BMI. Estradiol levels in the three groups increased, but there was no statistically significant difference. BMI was negatively correlated with LH level （ r= -0. 17, P〈0.05 ） . BMI was negatively correlated with the total T level （ r=-0. 31, P〈0.01 ） . BMI was not correlated with FSH and estrogen levels. Conclusion： Estrogen should be supplemented during treatment for obese male sterile patients; strengthening excise, healthy diet, and losing weight are important parts of treatment.