糖尿病与不育男性精液质量关系

The relationship between the diabetes of infertility men and their semen quality

目的:探讨糖尿病对男性精液质量的影响。方法:回顾性收集2016年9月-2017年2月在河北生殖医学中心就诊的男性不育患者168例,根据空腹血糖水平分为正常组74例、空腹血糖受损组62例和糖尿病组32例,采用CASA系统检测精液参数。结果:正常组、空腹血糖受损组和糖尿病精子浓度、精子总数、前向运动精子百分率存在差异(P<0.05)。20~25岁年龄段糖尿病组精子总数最低,26~30岁年龄段中受损组和糖尿病组前向运动精子百分率低于正常组(均P<0.05)。相关性分析,精子浓度、精子总数、前向运动精子百分率均与空腹血糖浓度负相关(P<0.05)。logistic回归分析显示,超重或肥胖合并高血糖患者精液质量异常风险为正常者的3.667倍,超重或肥胖与高血糖同时存在的交互指数(S)为1.43,超相对危险比(RERI)为0.798,归因比(AP)为21.76%。结论:高血糖可导致男性精液质量下降,高血糖与超重或肥胖两种因素同时存在可增加精液异常的风险。

Objective:To investigate the relationship between the diabetes of men and their semen quality.Methods:The data of 168 infertility men from September 2016 to February 2017 were retrospective analyzed.The included men were divided into group A(74 cases with normal fasting glucose),group B(62 cases with fasting glucose impaired),and group C(32 cases with diabetes)according to the level of fasting blood glucose.CASA system was used to detect the semen parameters of all men.Results:There were significant difference in total number of spermatozoa,the sperm concentration,and the percentage of sperm moving forward(P<0.05).The total number of spermatozoa of men in 2025 years old was the lowest.As for the men in 2630 years old,the percentage of sperm moving forward of men in group B and C was significant lower than that of male in group A(P<0.05).Correlation analysis showed that the sperm concentration,total sperm count,and the percentage of sperm moving forward of man was significantly negative correlation to fasting glucose concentration(P<0.05).Logistic regression analysis showed that the risk of abnormal semen quality of overweight or obesity men in group C was 3.667 times of that of normal weight men in the group A,and the interaction index(S)of overweight or obesity with hyperglycemia was 1.43,RERI was 0.798,and attribution percentage(AP)was 21.76%.Conclusion:Hyperglycemia can decrease the semen quality,and hyperglycemia and overweight or obesity may increase the risk of abnormal semen.