高脂血症患者血清TC,TG 和HDL-C 水平与精液质量相关性研究

目的 探讨高脂血症患者血清总胆固醇( total cholesterol , TC )，三酰甘油( triglyceride , TG ) 及高密度脂蛋白胆固醇( high-density lipoprotein cholesterol, HDL-C ) 与男性精液质量之间的关系。方法 选取2019 年9 月～ 2020 年10 月来广州市番禺区中心医院男性科就诊的126 例成年男性，根据血脂水平将其分为两组，86 例高血脂患者作为高脂血症组，40 例血脂正常男性作为对照组。对比分析两组受检者精液质量参数、血清TC, TG 和HDL-C 水平，分析血清血脂水平与精液质量之间的相关性。结果 高脂血症组患者精子浓度54.2(25.10，88.85)×106/ml]、精子总数167.31(81.51，256.99)×106/ml]、前向运动精子百分率 (PR) ( 31.29% ±16.37%) 和精子总活力( 39.22%±16.69%) 均低于对照组63.9(49.25, 114.20)×106/ml, 258.24(209.19, 349.99)×106/ml, 36.39%±9.43%, 44.31%±10.07%]，差异有统计学意义( t/Z= -3.404，-4.271，2.206，2.115, 均P＜ 0.05)。与对照组相比，高脂血症组患者血清TC水平(5.83±1.04 mmol/L vs 4.41±0.60mmol/L), TG 水平(2.59±0.58 mmol/L vs 1.05 ± 0.18mmol/L) 和 HDL-C 水平(0.96±0.11 mmol/L vs 1.37 ±0.22 mmol/L)，差异均有统计学意义(t= 9.015，7.123， 19.845, 均P ＜ 0.01)。相关性分析显示，精子浓度与血清TG 和 TC 水平呈负相关( r =-0.185, -0.192, 均P ＜ 0.05)，精子总数与血清TG 和 TC 水平呈负相关 ( r =-0.235, -0.233, 均P ＜ 0.05)，精子浓度、精子总数与血清HDL-C 水平呈正相关 ( r =0.267, 0.354, 均P ＜ 0.01)，前向运动精子百分率及精子总活力与血清HDL-C水平呈正相关 ( r=0.183, 0.178, 均P ＜ 0.05)。结论 高脂血症会导致男性精液质量下降，育龄期男性应关注血脂水平的控制。

Study on Correlation between the Level of Serum TC,TG and HDL-C and Semen Quality of Patients with Hyperlipidemia

Objective To investigate the correlation between the serum total choles-terol(TC), triglceride(TG) and highdensity lipoprotein cholesterol(HDL-C) contents of patients with hyperlipidemia with semen quality. Methods A total of 126 adult men from the Andrology Aparetment of Panyu District Central Hospital of Guangzhou from September 2019 to October 2020 were selected. According to the blood lipid level, they were divided into two groups, 86 patients with hyperlipidemia as the hyperlipidemia group and 40 men with normal blood lipid as the control group. The sperm qualities, levels of serum TC, TG and HDL-C were detected, and the correlations between blood lipids contents and sperm qualities were analyzed. Results the sperm concentration of patients with hyperlipidemia were 54.2(25.10, 88.95)×106/ml], total number of spermatozoa were 167.31(81.51, 256.99)×106/ml], progressive motility were (31.29%±16.37%) and activate rate were( 39.22% ± 16.69% ), and those of patients with hyperlipidemia were significantly lower than those of people of control group 63.9(49.25, 114.20)×106/ ml, 258.24(209.19, 349.99)×106/ml, 36.39%±9.43%, 44.31%±10.07%], the differences were statistically significant( t/Z = -3.404, -4.271, 2.206, 2.115, all P ＜ 0.05). Compared with the control group, contents of serum TC of patients with hyperlipidemia were (5.83 ± 1.04 mmol/L vs 4.41 ± 0.60mmol/L), contents of serum TG were (2.59 ± 0.58 mmol/L vs 1.05 ± 0.18 mmol/L), contents of serum HDL-C were (0.96 ± 0.11 mmol/L vs 1.37 ± 0.22 mmol/L), and there were statistical difference between the groups (t= 9.015, 7.123 ,19.845, all P ＜ 0.01). Spearman analysis showed that the contents of serum TC and TG were negatively correlated with the sperm concentration ( r= -0.185, -0.192, all P ＜ 0.05), and those were also negatively correlated with total number of spermatozoa (r=-0.235, -0.233, all P ＜ 0.05) . The sperm concentration and total number of spermatozoa were positively correlated with the serum HDL-C level (r=0.267, 0.354, all P ＜ 0.01), and the progressive motility and activate rate were also positively correlated with the serum HDL-C level( r = 0.183, 0.178, all P ＜ 0.05). Conclusion Hyperlipidemia would cause a decrease in the quality of male semen , men of childbearing age should control the blood lipids level.