超重及肥胖男性不育患者精子早期凋亡研究

Study on early sperm apoptosis in male infertility with overweight and obesity

目的 为进一步了解超重及肥胖对男性生育力影响,探究男性不育患者精子早期凋亡发生情况及原因.方法 通过随机抽样抽取对照组26人;男性不育患者26人,其中超重不育组12人;肥胖不育组14人.入选对象完成精液常规及Annexin V-FITC/PI双染精子,流式细胞仪检测精子早期凋亡率,酶联免疫法ELISA检测精浆中活性氧、谷胱甘肽过氧化物酶检测.结果 精子早期凋亡率超重不育组（15.73±6.49）％与对照组（10.48±6.21）％相比,高于后者,差异有显著性（P＜0.05）.肥胖不育组（16.16±6.57）％与对照组相比,高于后者,差异有显著性（P＜0.05）.超重不育组和肥胖不育组相比,两者差异无显著性（P＞0.05）.体质指数与精子活动率负相关（R=-0.31,P＜0.05）,与不动精子率呈正相关（R=0.31,P＜0.05）,与精子早期凋亡率呈明显正相关（R=0.41,P＜0.01）.活性氧与精子早期凋亡率呈正相关（R=0.61,P＜0.01）,谷胱甘肽过氧化物酶与精子早期凋亡率呈负相关（R=-0.46,P＜0.01）.结论 超重及肥胖男性不育患者精浆中活性氧水平增高,而谷胱甘肽过氧化物酶下降导致精子早期凋亡率增高,导致超重、肥胖影响男性不育原因之一.

Objective To investigate early sperm apoptosis occurrence and influence factor for better understand the overweight and obesity in male fertility. Methods Semen samples were collected from 26 normal males（the control group） and 12 male infertility patients with overweight（overweight group）, as well as 14 male infertility with obesity（ obesity group）. Semen routine analysis was carried out. Early apoptosis of sperm was detected by flow cytometry. Levels of reactive oxygen species and glutathione peroxidase in the seminal plasma were assayed by ELISA. Results Early apoptosis rates of sperm in overweight group （15.73±6.49） % and obesity group （16.16±L6.57） % were all significantly higher than that in the control group （10.48±6.21） % （P〈0.05）, but there was no significant difference in early apoptosis rate between overweight group and obese group （P〉0.05）. Body mass index （BMI） was negatively related with the rate of sperm activity in semen analysis （R =- 0.31, P〈 0.05）, and positively correlated with the inactivity rate of sperm （R = 0.31, P〈0.05） and early apoptosis rate of sperm （R = 0.41, P〈0.01）, Reactive oxygen species was positively correlated with early apoptosis rate of sperm （R = 0.61, P〈0.01）, glutathione peroxidase and early apoptosis rate of sprm showed a negative correlation （R =-0.46, P〈0.01）. Conclusion The level of reactive oxygen species in seminal plasma were increased in male infertility with overweight and obesity, and low level of glutathione peroxidase caused early apoptosis of sperm may result in ocurrence of male infertility with overweight and obesity.