男性不育患者血清及精浆维生素D、抗苗勒管激素与精液参数及性激素水平相关性

The association the levels of vitamin D and anti-Müllerian hormone in serum and in seminal plasma of male infertile patients with their semen parameters and sex hormone levels

目的:探讨男性不育患者血清及精浆维生素D[25(OH)D]、抗苗勒管激素(AMH)水平与精液参数、性激素关系。方法:选取2017年1月—2019年12月本院收治的144例男性不育患者,按照精液参数分为少精子组(n=37)、弱精子组(n=39)、少弱精子组(n=32)和正常参数组(n=36),分析患者血清及精浆25(OH)D、AMH表达关系及与各精液参数间相关性。结果:少精子组、少弱精子组精子浓度、血清T、精浆AMH及25(OH)D水平均低于弱精子组和正常参数组,精液体积、血清卵泡刺激素高于弱精子组和正常参数组,弱精子组、少弱精子组精子向前运动比例低于少精子组和正常参数组(P<0.05),各精液参数组血清促黄体生成素、雌二醇、泌乳素、25(OH)D、AMH水平均无差异(P>0.05)。Spearman相关性分析显示,精浆25(OH)D、AMH水平与精液体积呈负相关(r=-0.352、-0.309,P<0.05),与精子浓度、睾酮水平呈正相关(r=0.410、0.403、0.287、0.329,P<0.05),而血清及精浆25(OH)D与AMH之间两两分析无相关性(P>0.05)。结论:男性不育患者精浆中25(OH)D、AMH水平与患者精液参数及性激素有一定相关性,表达水平能反映患者的睾丸生精功能。

Objective:To explore the association of the levels of vitamin D[25(OH)D]and anti-Müllerian hormone(AMH)in serum and in seminal plasma of male infertile patients with their semen parameters and sex hormone levels.Methods:A total of 144 male infertile patients were selected and divided into group A(37 patients with oligospermia),group B(39 patients with weak sperm),group C(32 patients with less weak sperm),and group D(36 patients with normal semen parameter)according to semen parameters from January 2017 to December 2019.The association of the levels of vitamin D and AMH in serum and in seminal plasma of the patients with their semen parameters was analyzed.Results:The sperm concentration value,serum T level,and serum AMH and 25(OH)D levels of the patients in group A and group B were significant lower than those of the patients in group C and group D,but the semen volume and serum FSH level of the patients in group A and group B were significant higher.The PR value of the patients in group B and group C was significant lower than those of the patients in group A and group D(P<0.05).There were no significant different in the serum levels of luteinizing hormone,estradiol,prolactin,25(OH)D,and AMH of the patients among the four groups(P>0.05).Spearman correlation analysis showed that the levels of 25(OH)D and AMH of the patients were negatively correlated with their semen volume(r=-0.352,-0.309,P<0.05),but were positively correlated with their sperm concentration and testosterone level(r=0.410,0.403,0.287,0.329,P<0.05).There was no correlation between serum and seminal plasma 25(OH)D level of the patients and their serum and seminal plasma AMH level(P>0.05).Conclusion:The levels of 25(OH)D and AMH in seminal plasma of male infertile patients have certain correlation with their semen parameters and sex hormone levels,and the expression levels of which can reflect the testicular spermatogenic function of the patients.