男性体质指数对精子质量及性激素水平影响的Meta分析

The impacts of male BMI on sperm parameters and sexual hormone levels:a Metaanalysis

目的就男性体质指数(BMI)对精子质量及性激素水平的影响进行Meta分析。方法通过计算机检索CNKI、VIP、CBM、万方数据库及PubMed、Medline、EMBASE、Cochrane图书馆建库至2018年4月有关男性BMI与精子质量及性激素水平的文献,由2位研究者按照纳入和排除标准进行文献筛选、资料提取和质量评价,并采用RevMan5.3软件进行Meta分析。结果共纳入7项队列研究,包括各种级别BMI的男性共15256名。Meta分析结果显示:①超重组与正常体重组男性相比较,其促卵泡生成素(FSH)水平(WMD=-0.22,95%CI:-0.37^-0.07,P<0.05)、促黄体生成素(LH)水平(WMD=-0.30,95%CI:-0.34^-0.25,P<0.00001)差异有统计学意义;②肥胖组与正常体重组相比较,其精子浓度(WMD=-5.83,95%CI:-9.07^-2.59,P<0.05)、前向运动精子百分率(WMD=-1.83,95%CI:-2.66^-0.99,P<0.0001)、总活力(WMD=-2.69,95%CI:-3.96^-1.42,P<0.00001)、LH水平(WMD=-0.30,95%CI:-0.34^-0.25,P<0.00001)差异有统计学意义。结论对于超重人群,FSH、LH水平可能与BMI有一定关系;而对于肥胖人群,BMI的增高可能影响精子浓度、前向运动精子、总活力、LH水平与BMI有一定关系,从而影响生育能力。BMI可能是一个更全面,敏感的评价肥胖人群生育力的指标。

Objective To evaluate the effects of male body mass index (BMI) on the sperm parameters and levels of sexual hormones. Methods We searched CNKI,VIP,CBM,Wanfang Data,PubMed,Medline,EMBASE and Cochrane from inception up to April 2018 for published studies on male BMI,sperm quality and sexual hormones.According to the inclusion and exclusion criteria,two independent reviewers screened the studies,extracted the data,assessed the quality,and conducted Meta -analysis with RevMan5.3 software. Results A total of 7 cohort studies were identified,involving 15 256 males.The overweight males exhibited a significant higher levels of follicle-stimulating hormone (FSH)(WMD=-0.22,95 % CI :(-0.37)-(-0.07), P <0.05 ) and luteinizing hormone (LH)(WMD=-0.30,95 % CI :(-0.34)-(-0.25), P <0.000 01) than normal BMI males.The obese males exhibited a significant lower sperm concentration (WMD=-5.83,95 % CI :(-9.07)-(-2.59), P <0.05) and motility (WMD=-2.69,95 % CI :(-3.96)-(-1.42), P <0.000 01),and higher LH level (WMD=-0.30,95 % CI :(-0.34)-(-0.25), P <0.000 01) than normal BMI males. Conclusions For overweight males,FSH and LH levels may be related with BMI.For obese males,high BMI could affect sperm concentration,sperm forward movement and total motility.LH level is related with BMI and affects the fertility of obese males.BMI can serve as a comprehensive and sensitive index to evaluate the fertility of obese population.