The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism.
The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism.
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DOI：
10.4103/1008-682x.189621
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发表时间：
2017-05
影响因子：
2.9
通讯作者：
Hypogonadotropic Hypogonadism Intervention Study (HHIS) Group
中科院分区：
文献类型：
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作者：
Liu YL;Zhang MN;Tong GY;Sun SY;Zhu YH;Cao Y;Zhang J;Huang H;Niu B;Li H;Guo QH;Gao Y;Zhu DL;Li XY;Hypogonadotropic Hypogonadism Intervention Study (HHIS) Group
进行了一项多中心、开放标签、随机、对照的优效性试验，随访18个月，以研究口服锌补充剂是否能进一步促进接受纯化尿促卵泡激素/人绒毛膜促性腺激素（uFSH/hCG）替代治疗的孤立性低促性腺激素性性腺功能减退症（IHH）男性的精子发生。选择国内8所三级医院内分泌科的男性IHH患者67例，随机分为uFSH/hCG序贯治疗组（A组，n = 34）和uFSH+补锌序贯治疗组（B组，n = 33）。A组患者接受uFSH（75 U，每周3次，每隔3个月）和hCG（2000 U，每周2次）序贯治疗。在B组中，患者除了接受A组患者的uFSH/hCG序贯治疗外，还接受口服锌补充剂（40 mg/d-1）。主要结局是18个月内精子浓度≥1.0 × 106 ml−1的患者比例。比较A、B两组疗效。意向治疗分析显示，19/34例（55.9%）接受序贯uFSH/hCG治疗的患者和20/33例（60.6%）接受序贯uFSH/hCG+补锌治疗的患者达到精子浓度≥1.0 × 106 ml−1。A组和B组的生精效果无差异（P = 0.69）。我们得出结论，序贯uFSH/hCG加补锌方案与单独序贯uFSH/hCG治疗具有相似的疗效。在男性IHH患者中，每天口服40 mg锌补充剂对精子发生和雄性化的额外改善非常微妙。
A multicenter, open-label, randomized, controlled superiority trial with 18 months of follow-up was conducted to investigate whether oral zinc supplementation could further promote spermatogenesis in males with isolated hypogonadotropic hypogonadism (IHH) receiving sequential purified urinary follicular-stimulating hormone/human chorionic gonadotropin (uFSH/hCG) replacement. Sixty-seven Chinese male IHH patients were recruited from the Departments of Endocrinology in eight tertiary hospitals and randomly allocated into the sequential uFSH/hCG group (Group A, n = 34) or the sequential uFSH plus zinc supplementation group (Group B, n = 33). In Group A, patients received sequential uFSH (75 U, three times a week every other 3 months) and hCG (2000 U, twice a week) treatments. In Group B, patients received oral zinc supplementation (40 mg day−1) in addition to the sequential uFSH/hCG treatment given to patients in Group A. The primary outcome was the proportion of patients with a sperm concentration ≥1.0 × 106 ml−1 during the 18 months. The comparison of efficacy between Groups A and B was analyzed. Nineteen of 34 (55.9%) patients receiving sequential uFSH/hCG and 20 of 33 (60.6%) patients receiving sequential uFSH/hCG plus zinc supplementation achieved sperm concentrations ≥1.0 × 106 ml−1 by intention to treat analyses. No differences between Group A and Group B were observed as far as the efficacy of inducing spermatogenesis (P = 0.69). We concluded that the sequential uFSH/hCG plus zinc supplementation regimen had a similar efficacy to the sequential uFSH/hCG treatment alone. The additional improvement of 40 mg day−1 oral zinc supplementation on spermatogenesis and masculinization in male IHH patients is very subtle.