CAFFEINE AND HUMAN REPRODUCTION

拟议的研究的目的是检查两者之间的关系 咖啡因摄入和人类生殖之间的关系。初步数据 表明咖啡因可能会对女性和男性的生殖产生不利影响 性能。咖啡因的高摄取率表明， 很大一部分人口可能会受到影响。这 研究旨在评估咖啡因对患心脏病的风险的影响。 对自然流产和精液质量的影响，并检查 咖啡因代谢和荷尔蒙功能可能在调节 咖啡因对生殖的影响。它有四个组成部分：(1) 咖啡因与自然流产的关系将通过 分析从5300名孕妇的前瞻性研究中收集的数据。 受试者是一个种族多元化的健康维护机构的成员 组织，在第一次产前任命时招聘，并在 妊娠7-13周。访谈数据将提供有关 咖啡因消费和潜在的混杂变量。咖啡因 将对患有和不患有的女性的摄入量和其他风险因素进行比较 自然流产。是否存在某些因素，例如 恶心，咖啡因摄入量的变化或咖啡因的类型 饮料消费的影响风险也将被检查。(2) 咖啡因代谢在决定自然流产风险中的作用 通过表征咖啡因代谢在样本中的咖啡因 大约140例病例和140例对照来自组成部分1。 会在摄入测试剂量后第一天早上提交一次尿液 咖啡因。咖啡因的主要代谢物将被测定，以及 咖啡因代谢率和三种特定酶的活性 根据代谢物比率计算。无论是较慢的新陈代谢速度 或酶活性的改变改变自然流产的风险 与咖啡因摄取有关的问题将被确定。(3)效果 咖啡因对荷尔蒙功能和排卵的影响将通过 分析在一项约400人的前瞻性研究中收集的数据 (来自同一健康计划的)有怀孕风险的妇女。每天 第一次早晨的尿样收集了长达六个月的时间，并将 对雌激素和孕激素代谢物进行分析，提供 排卵的发生情况和卵泡和卵巢的长度 黄体期。采访数据将提供有关咖啡因的信息 消费和潜在的混杂变量。咖啡因是不是 与荷尔蒙功能改变有关，无排卵增加 周期，尿类固醇结合水平的变化，或特异性 将检查荷尔蒙变化的模式。这些女性的唾液 将被检测咖啡因，以提供接触的生物标志物。(4) 咖啡因对精液质量的影响将通过分析数据来检验 从一组妇女的丈夫那里收集的第三部分。精液 已经从大约160名男子身上收集了样本，并将 分析精子数量、活动率和形态测量，而精液和 将对唾液进行咖啡因分析。访谈数据将提供 关于咖啡因消费和潜在混杂变量的信息。 组件1、3和4的数据收集已完成。组件 2是一项新提出的研究。从这些研究中获得的信息 可用于预防对生殖系统的不良影响 咖啡因。

The objective of the proposed research is to examine the relationship between caffeine intake and human reproduction. Preliminary data indicate that caffeine may adversely affect female and male reproductive performance. The high prevalence of caffeine intake suggests that a large proportion of the population is potentially affected. This research is intended to estimate the effects of caffeine on risk of spontaneous abortion and on semen quality, and to examine the roles that caffeine metabolism and hormonal function might play in mediating any effects of caffeine on reproduction. There are four components: (1) The relationship of caffeine to spontaneous abortion will be examined by analyzing data collected from a prospective study of 5300 pregnant women. Subjects were members of an ethnically diverse health maintenance organization, recruited at first prenatal appointment and interviewed at 7-13 weeks gestation. Interview data will provide information on caffeine consumption and potential confounding variables. Caffeine intake and other risk factors will be compared in women with and without spontaneous abortion. Whether certain factors, such as the presence of nausea, changes in caffeine consumption or the type of caffeinated beverage consumed affect risk will also be examined. (2) The role of caffeine metabolism in determining the risk of spontaneous abortion will be examined by characterizing caffeine metabolism in a sample of approximately 140 cases and 140 controls from component 1. Each woman will submit a single first morning urine after ingestion of a test dose of caffeine. The major metabolites of caffeine will be determined, and the rate of caffeine metabolism and activities of three specific enzymes calculated from metabolite ratios. Whether a slower rate of metabolism or alteration in enzyme activity modify the risk for spontaneous abortion associated with caffeine ingestion will be determined. (3) The effect of caffeine on hormonal function and ovulation will be studied by analyzing data collected in a prospective study of approximately 400 women (from the same health plan) at risk of becoming pregnant. Daily first morning urine samples were collected for up to six months and will be analyzed for estrogen and progesterone metabolites, providing information on occurrence of ovulation and length of follicular and luteal phases. Interview data will provide information on caffeine consumption and potential confounding variables. Whether caffeine is associated with alteration in hormonal function, increases in anovulatory cycles, alterations in urinary steroid conjugate levels, or specific patterns of hormonal change will be examined. Saliva from these women will be assayed for caffeine to provide a biomarker of exposure. (4) The effect of caffeine on semen quality will be examined by analyzing data collected from a group of husbands of women from component 3. Semen samples have been collected from approximately 160 men, and will be analyzed for sperm count, motility, and morphometry, while semen and saliva will be analyzed for caffeine. Interview data will provide information on caffeine consumption and potential confounding variables. Data collection for components 1, 3, and 4 has been completed. Component 2 is a newly proposed study. The information gained from these studies could be used in the prevention of adverse reproductive effects of caffeine.