Association of blood biomarkers with p53 gene expression in male infertility.

Abstract

Objectives: To investigate the association between p53 gene expression, prostate-specific antigen (PSA), and oxidative stress markers (sialic acid and vitamin C) in infertile men.

Methods: This case-control study involved 150 infertile men and 150 fertile controls from Kerala, India. Serum sialic acid, PSA, and vitamin C were measured by ELISA, and p53 expression was quantified by real-time PCR (2^-ΔΔCt method). Non-parametric tests, correlation analyses, regression models, and ROC curves were used to assess associations, predictive value, and diagnostic performance.

Results: Infertile men showed significantly lower serum sialic acid and vitamin C levels and higher PSA concentrations and p53 gene expression than fertile controls (all p<0.05). p53 expression was significantly associated with PSA, sialic acid, and vitamin C in infertile men. Although no biomarker independently predicted infertility in logistic regression, robust linear regression identified vitamin C as a strong negative predictor and PSA as a positive predictor of p53 expression. ROC analysis revealed moderate discriminative ability for vitamin C, PSA, and sialic acid, while p53 expression alone showed limited diagnostic accuracy.

Conclusions: The concurrent elevation of p53 expression, increased PSA levels, and antioxidant depletion in infertile men reflects activation of cancer-related cellular stress and genomic surveillance pathways rather than evidence of malignancy.