Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men.
Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men.
复制标题
DOI：
10.1186/1742-4755-8-24
复制
发表时间：
2011-08-17
影响因子：
3.4
通讯作者：
Ramlau-Hansen CH
中科院分区：
文献类型：
--
作者：
Håkonsen LB;Thulstrup AM;Aggerholm AS;Olsen J;Bonde JP;Andersen CY;Bungum M;Ernst EH;Hansen ML;Ernst EH;Ramlau-Hansen CH
高体重指数(BMI)与精液质量下降和男性不育有关，但目前还没有关于肥胖男性减肥的研究发表。我们检查了病态肥胖男性的精液质量和生殖激素，并研究了体重减轻是否改善了生殖指标。在这项先导性队列研究中，43名体重指数为33公斤/平方米的男性接受了为期14周的住宅减肥计划。参与者提供精液样本，抽取血液样本，填写问卷，并在干预前后进行临床检查。获得常规精液特征和精子染色质结构分析(SCSA)分析的精子DNA完整性。检测血清睾酮、雌二醇、性激素结合球蛋白(SHBG)、黄体生成素(LH)、卵泡刺激素(FSH)、抗苗勒氏激素(AMH)和抑制素B(INH-B)水平。受试者年龄从20岁到59岁(中位数为32岁)，体重指数在33到61公斤/平方米之间。在基线，调整潜在的混杂因素后，体重指数与精子密度(p=0.02)、精子总数(p=0.02)、精子形态(p=0.04)、活动精子(p=0.005)以及睾酮(p=0.04)和异烟肼(p=0.04)呈负相关，与雌二醇(p<；0.005)呈正相关。干预后体重减轻的中位数(范围)百分比为15%(3.5-25.4)。体重减轻与精子总数(p=0.02)、精液量(p=0.04)、睾酮(p=0.02)、SHBG(p=0.03)和AMH(p=0.02)增加有关。体重下降最大的组在精子总数[1.93亿(95%CI：45；341)]和正常精子形态[4%(95%CI：1；7)]方面有统计学意义的增加。这项研究发现，肥胖与糟糕的精液质量和生殖激素谱改变有关。减肥可能会潜在地提高精液质量。目前尚不清楚这种改善是由于体重本身的减轻还是生活方式的改善。
A high body mass index (BMI) has been associated with reduced semen quality and male subfecundity, but no studies following obese men losing weight have yet been published. We examined semen quality and reproductive hormones among morbidly obese men and studied if weight loss improved the reproductive indicators. In this pilot cohort study, 43 men with BMI > 33 kg/m2 were followed through a 14 week residential weight loss program. The participants provided semen samples and had blood samples drawn, filled in questionnaires, and had clinical examinations before and after the intervention. Conventional semen characteristics as well as sperm DNA integrity, analysed by the sperm chromatin structure assay (SCSA) were obtained. Serum levels of testosterone, estradiol, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH) and inhibin B (Inh-B) were measured. Participants were from 20 to 59 years of age (median = 32) with BMI ranging from 33 to 61 kg/m2. At baseline, after adjustment for potential confounders, BMI was inversely associated with sperm concentration (p = 0.02), total sperm count (p = 0.02), sperm morphology (p = 0.04), and motile sperm (p = 0.005) as well as testosterone (p = 0.04) and Inh-B (p = 0.04) and positively associated to estradiol (p < 0.005). The median (range) percentage weight loss after the intervention was 15% (3.5 - 25.4). Weight loss was associated with an increase in total sperm count (p = 0.02), semen volume (p = 0.04), testosterone (p = 0.02), SHBG (p = 0.03) and AMH (p = 0.02). The group with the largest weight loss had a statistically significant increase in total sperm count [193 millions (95% CI: 45; 341)] and normal sperm morphology [4% (95% CI: 1; 7)]. This study found obesity to be associated with poor semen quality and altered reproductive hormonal profile. Weight loss may potentially lead to improvement in semen quality. Whether the improvement is a result of the reduction in body weight per se or improved lifestyles remains unknown.