孕前男性血清脂溶性维生素水平与精液质量相关性研究

Study on the correlation between the expression of serum lipid-soluble vitamin and semen quality in pre-pregnancy males

目的探讨血清脂溶性维生素A、D、E及K水平与男性精液质量的相关性,指导男性孕前保健。方法回顾性分析2021年1月-6月在南京市妇幼保健院孕前保健门诊就诊的备孕前检查男性1028例,收集个人病史资料,统计检测的血清维生素A、D、E及K水平以及精液质量参数,并分析相关性。采用单因素分析、多因素Logistic回归分析血清脂溶性维生素与男性精液质量的关系。结果1028例研究对象中,精液异常者占60.5%(622/1028)。孕前男性普遍缺乏维生素D(99.03%,1018/1028),其中严重缺乏者占16.34%(168/1028),而维生素A、E、K正常分别占87.16%、82.49%、82.20%。血清维生素D水平与精子浓度存在相关性(r=0.065,P=0.037),补充维生素D后精子形态正常率平均值由原来的3.40%提高到4.34%(P<0.05)。其余维生素A、E、K水平与精液质量参数均无明显相关性(P>0.05)。多因素Logistic回归分析显示,维生素A、D、E、K为男性精液质量影响因素,但非独立影响因素。结论血清脂溶性维生素A、E及K与孕前男性精液质量无明显关联性,孕前男性血清维生素D水平普遍缺乏,与精子浓度存在相关性。适当补充维生素D可能对改善精子形态有益。

Objective To explore the correlation between the expression of serumlipid-soluble vitamin A,D,E and K values and semen quality,and to protect male fertility.Methods We retrospectively analyzed the clinical data of men who were examined in the pre-pregnancy health clinic from January 2021 to June 2021,collected their personal history information,and detected the expression of serum vitamin A,vitamin D,vitamin E,vitamin K and sperm quality,and analyzed the correlations.The relationship between the expression of serum lipid-soluble vitamin and the quality of male semen were analyzed by univariate analysis and multivariate logistic regression.Results A total of 1028 men was included in this study.622 cases(622/1028,60.5%)had abnormal semen quality.The pre-pregnancy males were generally deficient in vitamin D level(99.03%)(1018/1028).168 cases(168/1028,16.34%)were severely deficient,but the normal levels of vitamin A,E and K accounted for 87.16%,82.49%and 82.20%,respectively.The serum vitamin D level had a correlation with sperm concentration(r=0.065,P<0.05).The mean value of sperm morphology was raised from 3.40%to 4.34%after rising of vitamin D level,manifesting its benefit to the sperm morphology improvement(P<0.05).There were no significant correlations between vitamin A,E,K levels and semen quality parameters(P>0.05).Multivariate logistic regression analysis showed that vitamins A,D,E,and K were influencing factors of male semen quality,but not the independent influencing factors.Conclusion Serum lipid-soluble vitamins A,E and K are not significantly related to male semen quality.It is common to see the lack of vitamin D in pre-pregnancy males.The vitamin D level is correlated to sperm concentration,and appropriate supplementation of it may improve sperm morphology.