糖尿病对精子形态和精液质量的影响及相关机制研究

Effects of diabetes on sperm morphology and semen quality and related mechanisms

目的探讨糖尿病(diabetes mellitus,DM)对男性精子形态和精液质量的影响,初步阐明DM影响精液质量的相关机制。方法选取100例2014年-2015年来我院生殖中心就诊的成年男性,分为两组,一组为50例DM男性患者,另一组为50例健康成年男性,对比分析两组患者的精子形态和精液质量,以及血清中促卵泡激素(FSH)、促黄体生成素(LH)、泌乳素(PRL)、睾酮(T)等各项激素及精液中抗精子抗体。结果⑴DM组精液精子浓度低于对照组精液精子浓度(P<0.01),DM组精液精子总数低于对照组(P<0.01),DM组精液精子总活动率低于对照组(P<0.05)。⑵DM组和对照组畸精症和抗精子抗体阳性的发生率无统计学差异,但是单独对畸精症组与非畸精症组进行血糖及糖化血红蛋白浓度对比,发现畸精症组血糖值高于非畸精症组(P<0.05);糖化血红蛋白浓度高于非畸精症组(P<0.05)。⑶DM组相比对照组T显著性下降(P<0.01),而FSH、LH、PRL无明显改变。结论 DM可下调男性患者的精子浓度、精子总数及总活动率,但对精子形态无显著影响,提示DM主要通过影响精子生成或抑制精子活力从而导致男性生育力的下降。

Objective To investigate the effect of DM on male sperm morphology and sperm quality,and illustrate its possible mechanism. Methods A total of 100 adult male who come to our reproductive center for test in 2014-2015 year. 50 DM patients were designed as DM group,and another 50 healthy adult males were designed as control group. Comparative Analysis of the dia-betic male patients and healthy controls’s sperm morphology and sperm quality and peripheral blood serum follicle stimulating hormone （FSH）,luteinizing hormone （LH）,prolactin （PRL）,testosterone （T）,anti-sperm antibodies. Results ⑴Through comparative analysis of the indicators DM and control groups semen found that DM significantly lower in patients with sperm concentration ,to-tal sperm count and total motility. DM Group’s sperm concentration was lower than the control group（P〈0.01）. The total number of sperm in semen DM group was lower than control group（P〈0.01）. DM Group’s sperm total motility（PR＋NP,%） was lower than the control group （P〈0.05）. ⑵The study found that abnormal sperm azoospermia and anti-antibody-positive rate were no significant difference between DM group and the control group. But separately abnormal azoospermia azoospermia group and non-group ab-normal blood glucose and glycated hemoglobin concentration contrast,found that abnormal blood glucose levels higher than those set azoospermia azoospermia non-abnormal group（P〈0.05）. Glycated hemoglobin concentration is higher than the non-abnormal a-zoospermia group （P〈0.05）.⑶DM group compared to the control group T was significantly decreased,while FSH,LH,PRL did not change significantly. Conclusion DM can cut men with sperm concentration,total sperm count and total motility,but had no sig-nificant effect on sperm morphology,suggests that DM mainly through inhibition affect sperm production or sperm motility causing male reproductive dysfunction.