血清与精浆维生素D水平与男性生殖功能的相关性

The relationship between serum and seminal plasma vitamin D and male reproductive function

目的在引起男性不育的众多因素中,维生素D被认为与生育能力有直接关系。文中旨在探索血清与精浆维生素D与男性生殖功能的关系,为研究维生素D对男性生殖的具体作用机制提供参考。方法回顾性分析2017年6月至2018年1月南通大学附属妇幼保健院生殖医学中心与东部战区总医院生殖医学中心进行男科检查的198例男性不育者的临床资料。应用电化学发光法检测血清和精浆维生素D水平,并分析血清和精浆维生素D与精液质量参数、睾丸支持细胞功能指标及附属性腺功能指标之间的相关性。结果血清25(OH)D水平[26.17(19.61~31.99)ng/mL]与精液量[3.8(3.1~4.8)mL]呈正相关(r=0.229,P=0.003);精浆25(OH)D水平[6.55(4.33~9.62)ng/mL]与血清25(OH)D水平无明显相关性,但与精子浓度[42.85(21.75~62.23)×106/mL]呈负相关关系(r=-0.174,P=0.016),与精液量呈正相关系(r=0.271,P=0.0001)。血清25(OH)D水平与精浆果糖浓度[(18.39±7.70)mmol/L,r=0.256、P=0.002]、精浆总果糖含量[70.62(45.00~96.85)μmol,r=0.310、P=0.0002]和精浆总锌含量[10.66(7.31~15.07)μmol,r=0.26、P=0.002]之间均呈正相关关系。血清及精浆25(OH)D水平与血清抗苗勒管激素(AMH)[48.94(6.00~14.40)ng/mL]、精浆AMH[0.365(0.16~1.08)ng/mL]以及血清抑制素B(INH B)[94.80(73.5~122.5)pg/mL]、精浆INH B[111.00(57.90~185.00)pg/mL]水平均无相关性(P>0.05)。结论维生素D与附属性腺功能相关。精液产生的精囊腺及前列腺可能是男性生殖系统局部维生素D的主要来源。

Objective Male infertility accounts for 40 to 50% of the total number of infertility in the world. Among many factors that cause male infertility, vitamin D is considered to be directly related to male fertility. The purpose of this study was to explore the relationship between serum and seminal plasma vitamin D and male reproductive function, and provide a more comprehensive research direction for studying the specific mechanism of vitamin D on male reproduction. Methods A total of 198 infertile males, receiving andrological examination from June 2017 to January 2018 in the Center for Reproductive Medicine, Jinling Hospital (Nanjing, China) was included in our study. Serum and seminal plasma vitamin D levels were measured by electrochemiluminescence immunoassay (ECLIA) kits. The associations between vitamin D and biomarkers of male reproduction were analyzed. Results Serum 25(OH) vitamin D level [26.17(19.61-31.99)ng/mL] was in positive relation with semen volume[3.8(3.1-4.8)ng/mL](r=0.229,P=0.003). Seminal plasma 25(OH) vitamin D level was not related to serum 25(OH) vitamin D level, but in negative relation with sperm concentration(r=0.174,P=0.016) and positive relation with semen volume(r=0.271,P=0.0001). Serum 25(OH) vitamin D level was in positive relation with seminal plasma fructose concentration(r=0.256,P=0.002), total fructose content (r=0.310,P=0.0002) and total zinc content(r=0.26,P=0.002). The level of serum and seminal plasma vitamin D leve was not related to serum anti-Mullerian hormone(AMH), seminal plasma AMH, serum inhibin (INH B) and seminal plasma INH B(P>0.05). Conclusion Vitamin D is associated with affiliated gland function. The seminal vesicles and prostate produced by semen may be the main source of vitamin D in the male reproductive system.