血清25OHD水平与精液参数的关系

The relationship between serum 25OHD levels and semen parameters

目的探讨血清25羟维生素D（25OHD）水平与精液参数之间的关系。方法测定68例健康男性血清25OHD水平,将其分为25OHD正常组22例（30μg/L≤25OHD〈40μg/L）、25OHD相对不足组20例（20μg/L≤25OHD〈30μg/L）和25OHD缺乏组26例（25OHD〈20μg/L）。采用化学发光免疫分析法测定血清生殖激素,包括卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）、泌乳素（PRL）、睾酮（T）。禁欲3-7 d后手淫法获取精液标本,应用精子质量分析仪检测精子总数、精子浓度、精子前向运动百分率、精子正常形态百分率。结果 3组FSH、LH、E2、PRL、T水平差异无统计学意义,且均在正常值范围。25OHD相对不足组和25OHD缺乏组精子总数、精子浓度、精子前向运动百分率、精子正常形态百分率均低于25OHD正常组;25OHD缺乏组精子总数、精子前向运动百分率低于25OHD相对不足组（均P〈0.05）,精子浓度、精子正常形态百分率与25OHD相对不足组差异无统计学意义。结论精液质量降低可能与血清25OHD相对不足或缺乏有关。25OHD对精子参数的影响可能不是由生殖激素所介导。

Objective To analyze the relationship between serum 25 hydroxy vitamin D（25OHD） levels and semen pa-rameters. Methods The serum levels of 25 OHD were examined in 68 healthy men, who were divided into three groups.Twenty-two cases were included in 25 OHD normal group（30 μg/L≤25OHD40 μg/L）, 20 cases were in 25 OHD relativelyinsufficient group（20 μg/L≤25OHD30 μg/L）, and 26 cases were in 25 OHD deficiency group（25OHD20 μg/L）. The se-rum reproductive hormones including follicle stimulating hormone（FSH）, luteinizing hormone（LH）, estradiol（E2）, prolactin（PRL） and testosterone（T） were detected by chemiluminescence immune analysis. Semen samples were collected by mastur-bation after a period of abstinence for 3 and 7 days. The total sperm count, sperm concentration, percentage of progressivemotile sperm and percentage of normal morphology sperm were measured by sperm quality analyzer. Results There wereno significant differences in FSH, LH, E2, PRL and T levels between three groups, and which were all in normal ranges. Thetotal sperm count, sperm concentration, percentage of progressive motile sperm and percentage of normal morphology spermwere significantly lower in 25 OHD relatively insufficient group and 25 OHD deficiency group than those in 25 OHD normalgroup. The total sperm count and the percentage of progressive motile sperm were significantly lower in 25 OHD deficiencygroup than those in 25 OHD relatively insufficient group（P〈0.05）. There were no statistical differences in sperm concentra-tion and percentage of normal morphology sperm between 25 OHD deficiency group and 25 OHD relatively insufficient group.Conclusion The decrease of semen quality may be related to serum 25 OHD at the relatively insufficient and deficiency lev-els. The effect of 25 OHD on semen parameters may not be mediated by reproductive hormones.