Fructose as a key biomarker for prognostication in idiopathic obstructive azoospermia associated with CFTR and ADGRG2 gene variants.

IF 3.2 2区 医学 Q1 ANDROLOGY
Andrology Pub Date : 2025-03-07 DOI:10.1111/andr.70014
Zhongkun Liang, Tuerxunayi Yalikun, Xiaohui Ji, Jin Li, Ling Zhou, Jing Zhang, Jing Tian, Hui Chen, Ping Yuan
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引用次数: 0

Abstract

Background: Isolated obstructive azoospermia (iOA) is classified as a type of obstructive azoospermia (OA) where cases remain "unexplained" even after excluding congenital absence of the vas deferens and external factors. This study aimed to determine if certain semen characteristics in iOA patients could indicate underlying genetic variants.

Objectives: To investigate CFTR and ADGRG2 gene variants in patients with idiopathic obstructive azoospermia (iOA) and identify semen parameters associated with these variants to guide genetic testing.

Materials and methods: Seventy-six iOA patients were divided into three groups based on variant status: Group I, patients with at least two CFTR variants or a hemizygous ADGRG2 variant; Group II, patients with one CFTR variant and no ADGRG2 variants; Group III, patients without any CFTR or ADGRG2 variants. Associations between genotypes and clinical parameters were analyzed using univariate and multivariate logistic regression to identify potential biomarkers.

Result(s): Thirty-six of the 76 patients (47.37%) carried one or more CFTR or ADGRG2 variants. Twenty distinct variants, including three novel variants (c.1851A > T and c.2426C > T in CFTR, c.1105G > A in ADGRG2), were identified. The most common variant was c.1210-12T[5] (5T) (18.42%), followed by c.1666A > G (4.61%) and c.4056G > C (3.95%). Group I patients had significantly lower ejaculate volume, pH, and fructose levels compared with Groups II and III. The combined area under the curve (AUC) for fructose, age, pH, and volume was 0.979, with fructose alone achieving an AUC of 0.952. Diagnostic efficacy for variant detection was highest (88.1%) at a fructose cutoff of 0.591 µmol/ejaculate, with a sensitivity of 0.958, a specificity of 0.923, a positive predictive value (PPV) of 0.895 and a negative predictive value (NPV) of 0.877.

Discussion and conclusion: Approximately 47% of iOA patients carry CFTR and ADGRG2 variants, characterized by significantly lower semen volume, fructose, and pH. Fructose was identified as an independent predictor of CFTR and ADGRG2 variants, highlighting its potential utility in guiding genetic testing and clinical decision-making in iOA patients.

果糖作为与CFTR和ADGRG2基因变异相关的特发性阻塞性无精子症预后的关键生物标志物。
背景:孤立性阻塞性无精子症(iOA)被归类为阻塞性无精子症(OA)的一种,即使排除了先天性输精管缺失和外部因素,病例仍然“无法解释”。本研究旨在确定iOA患者的某些精液特征是否可能表明潜在的遗传变异。目的:研究特发性阻塞性无精子症(iOA)患者CFTR和ADGRG2基因变异,并确定与这些变异相关的精液参数,指导基因检测。材料和方法:76例iOA患者根据变异状态分为三组:I组,至少有两个CFTR变异或半合子ADGRG2变异的患者;II组,CFTR变异1例,无ADGRG2变异;III组,无CFTR或ADGRG2变异的患者。结果:76例患者中有36例(47.37%)携带一种或多种CFTR或ADGRG2变异。共鉴定出20个不同的变异体,包括3个新变异体(CFTR中的c.1851A > T和c.2426C > T, ADGRG2中的c.1105G > A)。最常见的变异是C .1210- 12t [5] (5T)(18.42%),其次是C . 1666a > G(4.61%)和C . 4056g > C(3.95%)。与II组和III组相比,I组患者的射精量、pH值和果糖水平显著降低。果糖、年龄、pH、体积的联合曲线下面积(AUC)为0.979,单独果糖的AUC为0.952。当果糖截断值为0.591µmol/射精时,变异检测的诊断效率最高(88.1%),敏感性为0.958,特异性为0.923,阳性预测值(PPV)为0.895,阴性预测值(NPV)为0.877。讨论和结论:大约47%的iOA患者携带CFTR和ADGRG2变异,其特征是精液体积、果糖和ph值显著降低。果糖被确定为CFTR和ADGRG2变异的独立预测因子,突出了其在指导iOA患者基因检测和临床决策方面的潜在效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Andrology
Andrology ANDROLOGY-
CiteScore
9.10
自引率
6.70%
发文量
200
期刊介绍: Andrology is the study of the male reproductive system and other male gender related health issues. Andrology deals with basic and clinical aspects of the male reproductive system (gonads, endocrine and accessory organs) in all species, including the diagnosis and treatment of medical problems associated with sexual development, infertility, sexual dysfunction, sex hormone action and other urological problems. In medicine, Andrology as a specialty is a recent development, as it had previously been considered a subspecialty of urology or endocrinology
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