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目的探讨代谢综合征与男性不育症的关系。方法按照国际糖尿病联盟(IDF)诊断代谢综合征的标准,筛选252例代谢综合征的男性不育症患者作为实验研究组,选取妻子处于自然受孕体检期、符合代谢综合征的25例生育男性作为对照组,分别检测血糖、血脂、胰岛素、性激素和精子质量参数等,比较两组人群上述检测参数之间的关系。结果(1)男性不育B组和C组的BMI和WC均大于不育A组和对照组,且不育C组大于B组,差异有显著性(P<0.05);(2)不育C组SBP、DBP、TG、FBG、FINS、HOMA-IR、E2、PRL、FSH均大于其他三组,且C组HDL-c、T低于A组和生育对照组,差异有显著性(P<0.05);不育A组的BMI、WC、FBG、HOMA-IR、LH与生育对照组比较,差异没有显著性(P>0.05);(3)男性不育组的精子活率、前向运动率均低于生育对照组,且不育C组低于A组;不育C组的精子浓度、精子总数均低于其他三组,差异有显著性(P<0.05);(4)不育B组、c组的精子正常形态率均低于生育对照组,且不育组间比较,差异有显著性(P<0.05);不育三组精子DNA碎片化指数均高于生育对照组,且不育C组高于A组和B组,差异有显著性(P<0.05)。结论代谢综合征与男性不育存在着相关性,特别是代谢综合征重度异常的患者存在血压、血糖、血脂、胰岛素及胰岛素抵抗、性激素及精子质量参数的改变,这些可能是代谢综合征引起男性不育症的重要机制之一。
Objective To investigate the relationship between metabolic syndrome and male infertility. Methods According to IDF diagnostic criteria of metabolic syndrome, 252 male infertility patients with metabolic syndrome were screened as the experimental group. Twenty-five pregnant males with metabolic syndrome were enrolled in this study. In the control group, the blood glucose, blood lipid, insulin, sex hormone and sperm quality parameters were detected respectively. The relationship between the above parameters was compared between the two groups. Results (1) The BMI and WC of male infertility group B and C were greater than that of sterile A and control groups, and the difference between male and female infertility group C was greater than that of group B (P <0.05). (2) The levels of SBP, DBP, TG, FBG, FINS, HOMA-IR, E2, PRL and FSH in group C were significantly higher than those in other three groups, and the HDL-c and T in group C were lower than those in group A and fertility control group <0.05). There was no significant difference between BMI, WC, FBG, HOMA-IR and LH in infertile group A and fertility control group (P> 0.05). (3) The sperm motility, (P <0.05). (4) No significant difference was found in the rate of exercise between the two groups (P <0.05), and the rate of exercise was lower than that of the control group. The level of sperm and sperm in the infertile group C was lower than that of the control group The normal morphology of sperm in groups B and C were lower than that of the control group, and there was significant difference between the groups of infertility (P <0.05). The sperm DNA fragmentation index of the three groups were higher than that of the control group , And the level of sterility in C group was higher than that in A group and B group (P <0.05). Conclusion There is a correlation between metabolic syndrome and male infertility. Especially in patients with severe metabolic syndrome, blood pressure, blood glucose, blood lipids, insulin and insulin resistance, sex hormones and sperm quality parameters may change, which may be caused by metabolic syndrome One of the important mechanisms of infertility.