非阻塞性无精子症伴精子成熟阻滞患者精浆脂质组学特征

Vestnik Urologii Pub Date : 2021-12-24 DOI:10.21886/2308-6424-2021-9-4-30-39

S. Gamidov, T. Shatylko, A. Tambiev, A. Tokareva, V. Chagovets, T. Bitsoev, N. Starodubtseva, A. Popova, V. Frankevich

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Comparison of two groups revealed a statistically significant concentration differences for 22 lipids detected in positive-ion mode and 11 lipids detected in negative-ion mode. Those lipids mainly belong to the classes hexosylceramides, sphingomyelins and phosphatidylcholines — simple ethers and oxidized lipids. In multivariate analysis, the following lipids were found to be statistically significant predictors of sperm maturation arrest: PC 16: 0_22: 6 lipid (β-coefficient: -0.73; 95% confidence interval (95% CI): -1.42 to -0.27; odds ratio (OR): 0.48; OR CI: 0.24 to 0.76; Wald's test: -2.58; p = 0.01), SM d20: 1/22:2 lipid (β-coefficient 4.96; 95% CI 2.29 to 9.13; OR: 142.31; OR CI: 9.90 to 9.22^103; Wald's test: 2.93; p = 0.003); PG 20:3_22: 6 lipid (β-coefficient 2.52; 95% CI 1.13 to 4.49; OR: 12.37; OR CI: 3.10 to 89.27; Wald's test: 3.02; p = 0.002); PC O- 16: 1/16:0 lipid (β-coefficient 1.96; 95% CI -4.12 to 0.27; OR: 0.14; OR CI: 0.02 to 0.76; Wald's test: -2.05; p = 0.04). 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引用次数: 3

摘要

介绍。梗阻性和非梗阻性无精子症伴精子成熟阻滞的区别对于治疗策略的选择和已婚夫妇的适当咨询是重要的。研究目的:该研究旨在评估精子成熟停止患者的精液脂质谱。材料和方法。本文对24例无精子症患者和64例无精子症患者的精浆脂质组成进行了研究。无精子症患者行显微解剖睾丸活检，并进行睾丸组织病理检查。脂质提取物采用液相色谱-质谱法进行分析。脂质数据与病理形态学研究结果进行比较。两组比较，正离子模式下检测到的脂质有22种，负离子模式下检测到的脂质有11种，差异有统计学意义。这些脂质主要属于己糖神经酰胺类、鞘磷脂类和磷脂酰胆碱类、简单醚类和氧化类脂质。在多变量分析中，以下脂质被发现是具有统计学意义的精子成熟阻滞的预测因子:pc16:0 _22:6脂质(β-系数:-0.73;95%置信区间(95% CI): -1.42 ~ -0.27;优势比(OR): 0.48;OR CI: 0.24 ~ 0.76;沃尔德检验:-2.58;p = 0.01)， SM d20: 1/22:2脂质(β-系数4.96;95% CI 2.29 - 9.13;OR: 142.31;OR CI: 9.90 ~ 9.22^103;沃尔德检验:2.93;P = 0.003);PG 20:3_22: 6脂质(β-系数2.52;95% CI 1.13 - 4.49;OR: 12.37;OR CI: 3.10 ~ 89.27;Wald检验:3.02;P = 0.002);PC 0 - 16:0: 1/16:0脂质(β-系数1.96;95% CI -4.12至0.27;OR: 0.14;OR CI: 0.02 ~ 0.76;沃尔德检验:-2.05;P = 0.04)。阳性模式下交叉验证得到的精子成熟阻滞预测模型特征为:灵敏度91%，特异性85%;负离子模式:灵敏度75%;.conclusions特异性81%。尽管精子发生的早期阶段在有生育能力的男性和同质精子成熟受阻的男性中都得到了同样的保存，但研究组患者的精液在脂质谱上存在差异。与减数分裂停止相关的非阻塞性无精子症患者可能具有独特的精浆脂质组学特征，这将使将来使用非侵入性方法区分严重男性不育症的各种变体成为可能。

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Lipidomic profile of seminal plasma in non-obstructive azoospermia with sperm maturation arrest

Introduction. The difference between obstructive and non-obstructive azoospermia with sperm maturation arrest is important for the choice of treatment tactics and adequate counseling of a married couple.Purpose of the study. The study aimed to assess the semen lipid profile in patients with sperm maturation arrest. Materials and methods. Samples of seminal plasma for lipid composition of 24 men with normozoospermia and 64 men with azoospermia were studied. Patients with azoospermia underwent microdissection testicular biopsy followed by the detection of testicular tissue pathology. Lipid extracts were analyzed by liquid chromatography with mass spectrometry. Lipid data were compared with the results of pathomorphological studies.Results. Comparison of two groups revealed a statistically significant concentration differences for 22 lipids detected in positive-ion mode and 11 lipids detected in negative-ion mode. Those lipids mainly belong to the classes hexosylceramides, sphingomyelins and phosphatidylcholines — simple ethers and oxidized lipids. In multivariate analysis, the following lipids were found to be statistically significant predictors of sperm maturation arrest: PC 16: 0_22: 6 lipid (β-coefficient: -0.73; 95% confidence interval (95% CI): -1.42 to -0.27; odds ratio (OR): 0.48; OR CI: 0.24 to 0.76; Wald's test: -2.58; p = 0.01), SM d20: 1/22:2 lipid (β-coefficient 4.96; 95% CI 2.29 to 9.13; OR: 142.31; OR CI: 9.90 to 9.22^103; Wald's test: 2.93; p = 0.003); PG 20:3_22: 6 lipid (β-coefficient 2.52; 95% CI 1.13 to 4.49; OR: 12.37; OR CI: 3.10 to 89.27; Wald's test: 3.02; p = 0.002); PC O- 16: 1/16:0 lipid (β-coefficient 1.96; 95% CI -4.12 to 0.27; OR: 0.14; OR CI: 0.02 to 0.76; Wald's test: -2.05; p = 0.04). The prediction model characteristics of sperm maturation arrest, obtained during cross-validation in the positiveion mode composed: sensitivity 91%, specificity 85%; in negative-ion mode: sensitivity 75%; specificity 81%.Conclusions. Even though early stages of spermatogenesis are equally preserved in both fertile men and men with homogeneous sperm maturation arrest, the semen in the studied group of patients differed in its lipid profile. Patients with non-obstructive azoospermia, associated with meiosis arrest, may have unique lipidomic characteristics of seminal plasma, which in the future will make it possible to differentiate various variants of severe male infertility using non-invasive methods.

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Vestnik Urologii

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