DNA 断裂与人类精子形态异常强度之间的关系

Mercedes González-Martínez, P. Sánchez-Martín, C. López‐Fernández, Stephen D Johnston, J. Gosálvez
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摘要

目的:确定畸形精子症与人类射精中精子DNA碎片(SDF)之间的关系。 根据世界卫生组织的定义,这项回顾性研究纳入了100名正常无精症男性作为对照组(精子异常率>14%)、210名精子异常率较高(≤4%)的患者和65名精子异常率中等(>4%至≤14%)的患者。精子形态通过明视野显微镜进行评估。精子染色质分散试验对精子DNA碎片进行评估。对精子形态异常与精子DNA碎片之间的关系进行了非参数分析;对这种关系的敏感性和特异性进行了接收器操作特征(ROC)分析。 相关分析表明,射精中异常精子比例越高,SDF水平越高(Spearman's Rho = -0.230;P<0.001)。在对所有组群进行比较时,发现 SDF 的比例存在显著差异(P<0.001);在对不同组群进行配对比较时,这些显著差异也得以保留。ROC分析显示,SDF在区分不同程度的畸形胎儿血症患者方面具有中等但显著的预测价值。 尽管对更连续的畸形精子症数值范围进行分析有助于进一步澄清与 SDF 的任何因果关系,但这些变量之间显然存在协同或重合关系,临床医生在解释精子图时需要认识到这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The relationship between DNA fragmentation and the intensity of morphologically abnormal human spermatozoa
To determine the relationship between teratozoospermia and sperm DNA fragmentation (SDF) in the human ejaculate. This retrospective study included 100 normozoospermic men as a control cohort (abnormal forms >14%), 210 patients with a high level of abnormal forms (≤4%) and 65 patients presenting with a moderate level of abnormal forms (>4% to ≤14%) based on the World Health Organization definitions. Sperm morphology was assessed using bright field microscopy. Sperm DNA fragmentation was assessed using the sperm chromatin dispersion assay. Non-parametric analyses were conducted to examine the relationship between abnormal sperm morphology and sperm DNA fragmentation; receiver operating characteristic (ROC) analyses were conducted to assess sensitivity and specificity of this relationship. A correlation analysis revealed that the higher the proportion of abnormal spermatozoa in the ejaculate, the higher the level of SDF (Spearman's Rho = -0.230; P<0.001). Significant differences in the proportion of SDF were found when all cohorts were compared (P<0.001); these significant differences were also retained when the different cohorts were compared pairwise. ROC analysis showed a moderate but significant predictive value for SDF to differentiate patients with different levels of teratozoospemia. Although analysis of a more continuous range of values for teratozoospermia would help further clarify any causal relationship with SDF, there is clearly a synergistic or coincident affiliation between these variables that needs to be acknowledged by the clinician when interpreting the spermiogram.
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