High prevalence of androgen deficiency and abnormal lipid profile in infertile men with non-obstructive azoospermia
High prevalence of androgen deficiency and abnormal lipid profile in infertile men with non-obstructive azoospermia
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DOI：
10.1111/j.1365-2605.2012.01277.x
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发表时间：
2012-10-01
影响因子：
--
通讯作者：
Giwercman, A.
中科院分区：
文献类型：
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作者：
Bobjer, J.;Naumovska, M.;Giwercman, A.
在非梗阻性无精子症（NOA）的男性中，性腺功能减退的风险往往被忽视。睾丸精子提取（TESE）可能会增加这种风险。本研究的目的是阐明NOA患者性腺功能减退的患病率，TESE对激素平衡的影响以及睾酮缺乏和血脂异常之间的关系。在2004 - 2009年期间接受过TESE的NOA男性有资格参加。性腺功能减退定义为总睾酮10 IU/L和/或正在进行雄激素替代治疗。65名连续的男性谁经历了TESE由于NOA和从谁后TESE血清睾酮水平测量前1100小时可用。此外，141名有生育能力的男性作为对照。评估血清睾酮、LH和脂质浓度。计算生化性腺功能减退的比值比（OR）。比较了TESE前后的激素水平。血脂水平与睾酮水平有关。47%（95%CI，0.36，0.59）的NOA男性中发现性腺功能减退。与生育对照组相比，TESE后性腺功能减退的OR为17（95%CI 6.645）。血清LH（p = 0.03），但不是睾酮（p = 0.43），显着不同的前和后TESE。与性腺功能正常的NOA男性相比，性腺功能减退的NOA男性血脂异常的OR为3.3（95%CI为1.38.8）。NOA男性雄激素缺乏的风险非常高，即使在年轻受试者中也与血脂异常有关。因此，对这些男性的医疗管理应包括内分泌评估和不孕症治疗完成后的随访。
In men with non-obstructive azoospermia (NOA), the risk of hypogonadism is often overlooked. Testicular sperm extraction (TESE) may increase this risk. The objective of this study was to elucidate the prevalence of hypogonadism in NOA-patients, the impact of TESE on hormone balance and the association between testosterone deficiency and dyslipidaemia. Men with NOA who had undergone TESE during the period 20042009 were eligible. Hypogonadism was defined as total testosterone 10 IU/L and/or ongoing androgen replacement therapy. Sixty-five consecutive men who had undergone TESE owing to NOA and from whom post-TESE serum testosterone levels measured before 1100 h were available. Furthermore, 141 fertile men served as controls. Serum concentrations of testosterone, LH and lipids were assessed. Odds ratios (OR) for biochemical hypogonadism were calculated. Pre- and post-TESE hormone levels were compared. Lipid profile was related to testosterone levels. Hypogonadism was found in 47% (95% CI, 0.36, 0.59) of the NOA-men. As compared with fertile controls, the OR for hypogonadism post-TESE was 17 (95% CI 6.645). Serum LH (p = 0.03), but not testosterone (p = 0.43), differed significantly pre- and post-TESE. Compared with eugonadal NOA-men, the OR for having deviations in lipid profile was 3.3 (95% CI 1.38.8) for the hypogonadal NOA-men. NOA-men are at very high risk of androgen deficiency, which even in young subjects is associated with dyslipidaemia. Medical management of these men should therefore include endocrinological evaluation and follow-up after completion of infertility treatment.