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中华肥胖与代谢病电子杂志 ›› 2021, Vol. 07 ›› Issue (02) : 108 -115. doi: 10.3877/cma.j.issn.2095-9605.2021.02.008

循证医学

减重手术对男性精子质量影响的Meta分析
高志光1,(), 张涛1, 梁煜芝2   
  1. 1. 523326 东莞;东莞市松山湖中心医院普通外科
    2. 523326 东莞;东莞市松山湖中心医院医学影像科
  • 收稿日期:2021-04-08 出版日期:2021-05-30
  • 通信作者: 高志光
  • 基金资助:
    东莞市社会发展科技重点项目(20211800902451)

Effect of bariatric surgery on male’s semen quality: a meta-analysis.

Zhiguang Gao1,(), Tao Zhang1, Yuzhi Liang2   

  1. 1. Department of General Surgery, the Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan 523326, China
    2. Department of Medical Imaging, the Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan 523326, China
  • Received:2021-04-08 Published:2021-05-30
  • Corresponding author: Zhiguang Gao
引用本文:

高志光, 张涛, 梁煜芝. 减重手术对男性精子质量影响的Meta分析[J/OL]. 中华肥胖与代谢病电子杂志, 2021, 07(02): 108-115.

Zhiguang Gao, Tao Zhang, Yuzhi Liang. Effect of bariatric surgery on male’s semen quality: a meta-analysis.[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(02): 108-115.

目的

系统评价减重手术对男性精子质量的影响。

方法

计算机检索医学文献数据库,包括EMBASE、PubMed、Cochrane Library、万方、中国知网等,检索时间均从建库开始至2020年12月。搜集关于男性肥胖患者减重手术前后精子质量变化的文献,并对纳入文献进行质量评估,提取数据后采用Review Manager 5.3统计软件分析。

结果

共纳入6项队列研究。Meta分析结果示:减重手术对男性肥胖患者射精量、精子浓度、运动精子(%)、向前运动精子(%)及正常形态精子(%)无明显影响,甚至可引起患者的精子总数下降(MD=43.29,95%CI: 3.24~83.34,P<0.03)。

结论

减重手术不能改善精子质量,这需要更大样本及更长随访时间的随机前瞻性研究来证实。

Objective

To systematically review the effect of bariatric surgery for male’s semen quality.

Methods

Computer retrieval of medical literature databases, including EMBASE, PubMed, Cochrane Library, Wanfang, CNKI and so on, was conducted from the establishment of the database to December 2020. To collect the literatures about the effect of bariatric surgery on obesity with semen quality, and evaluate the quality of the included literatures. After extracting the data, the Review Manager 5.3 statistical software was used to analyze.

Results

A total of 6 before-after studies were included. The results of meta-analysis showed that there was no significant difference in semen volume, sperm concentration, total motility (%), progressive motility (%), normal morphology (%). In addition, bariatric surgery could reduce sperm number (MD = 43.29, 95%CI: 3.24 to 83.34, P<0.03).

Conclusions

Bariatric surgery did not improve semen quality in obese male patients. Randomized prospective studies with larger samples and longer follow-up are needed to confirm these findings.

图1 文献筛选流程与结果
表1 纳入文献基本资料
表2 减重手术前后精液参数变化情况
表3 纳入研究的MINORS条目文献质量评分
图2 减重手术对射精量的影响
图3 减重手术对精子浓度的影响
图4 减重手术对精子总数的影响
图5 减重手术对运动精子(%)的影响
图6 减重手术对向前运动精子(%)的影响
图7 减重手术对正常形态精子(%)的影响
[1]
Zarotsky V, Huang MY, Carman W, et al. Systematic literature review of the risk factors, comorbidities, and consequences of hypogonadism in men [J]. Andrology, 2014, 2(6): 819-834.
[2]
Salas-Huetos A, Maghsoumi-Norouzabad L, James ER, et al. Male adiposity, sperm parameters and reproductive hormones: An updated systematic review and collaborative meta-analysis [J]. Obes Rev, 2021, 22(1): e13082.
[3]
Glina F, de Freitas Barboza JW, Nunes VM, et al. What Is the Impact of Bariatric Surgery on Erectile Function? A Systematic Review and Meta-Analysis [J]. Sex Med Rev, 2017, 5(3): 393-402.
[4]
Sallmén M, Sandler DP, Hoppin JA, et al. Reduced fertility among overweight and obese men [J]. Epidemiology, 2006, 17(5): 520-523.
[5]
Wood G, Tiseo BC, Paluello DV, et al. Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study [J]. Obes Surg, 2020, 30(12): 4840-4851.
[6]
Arolfo S, Scozzari G, Di Benedetto G, et al. Surgically induced weight loss effects on sexual quality of life of obese men: a prospective evaluation [J]. Surg Endosc, 2020, 34(12): 5558-5565.
[7]
Reis LO, Zani EL, Saad RD, et al. Bariatric surgery does not interfere with sperm quality—a preliminary long-term study [J]. Reproductive Sciences, 2012, 19(10):1057-1062.
[8]
Samavat J, Cantini G, Lotti F, et al. Massive Weight Loss Obtained by Bariatric Surgery Affects Semen Quality in Morbid Male Obesity: a Preliminary Prospective Double-Armed Study [J]. Obes Surg, 2018, 28(1): 69-76.
[9]
Scotto DFA, Brian D, Di ML, et al. Secondary male factor infertility after Roux-en-Y gastric bypass for morbid obesity: Case report [J]. Human Reproduction, 2005(4):997-998.
[10]
Sermondade N, Massin N, Boitrelle F, et al. Sperm parameters and male fertility after bariatric surgery: three case series [J]. Reprod Biomed Online. 2012. 24(2): 206-210.
[11]
Lazaros L, Hatzi E, Markoula S, et al. Dramatic reduction in sperm parameters following bariatric surgery: report of two cases [J]. Andrologia, 2012, 44(6): 428-432.
[12]
Wei Y, Chen Q, Qian W. Effect of Bariatric Surgery on Semen Parameters: A Systematic Review and Meta-Analysis [J]. Med Sci Monit Basic Res. 2018. 24: 188-197.
[13]
Lee Y, Dang JT, Switzer N, et al. Impact of Bariatric Surgery on Male Sex Hormones and Sperm Quality: a Systematic Review and Meta-Analysis [J]. Obes Surg, 2019, 29(1): 334-346.
[14]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration [J]. PLoS Med, 2009, 6(7): e1000100.
[15]
Calderón B, Huerta L, Galindo J, et al. Lack of Improvement of Sperm Characteristics in Obese Males After Obesity Surgery Despite the Beneficial Changes Observed in Reproductive Hormones [J]. Obes Surg, 2019, 29(7): 2045-2050.
[16]
Carette C, Levy R, Eustache F, et al. Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study [J]. Surg Obes Relat Dis, 2019, 15(8): 1271-1279.
[17]
El Bardisi H, Majzoub A, Arafa M, et al. Effect of bariatric surgery on semen parameters and sex hormone concentrations: a prospective study [J]. Reprod Biomed Online, 2016, 33(5): 606-611.
[18]
Legro RS, Kunselman AR, Meadows JW, et al. Time-related increase in urinary testosterone levels and stable semen analysis parameters after bariatric surgery in men [J]. Reprod Biomed Online, 2015, 30(2): 150-156.
[19]
Carrageta DF, Oliveira PF, Alves MG, et al. Obesity and male hypogonadism: Tales of a vicious cycle [J]. Obes Rev, 2019, 20(8): 1148-1158.
[20]
Verderame M, Migliaccio V, Scudiero R. Role of estrogen receptors, P450 aromatase, PCNA and p53 in high-fat-induced impairment of spermatogenesis in rats [J]. C R Biol, 2018, 341(7-8): 371-379.
[21]
Palmer NO, Bakos HW, Fullston T, et al. Impact of obesity on male fertility, sperm function and molecular composition [J]. Spermatogenesis, 2012, 2(4): 253-263.
[22]
Vincenzo AD, Busetto L, Vettor R, et al. Obesity, male reproductive function and bariatric surgery [J]. Frontiers in Endocrinology, 2018, 9.
[23]
Isidori AM, Caprio M, Strollo F, et al. Leptin and androgens in male obesity: evidence for leptin contribution to reduced androgen levels [J]. J Clin Endocrinol Metab, 1999, 84(10): 3673-3680.
[24]
Fariello RM, Pariz JR, Spaine DM, et al. Association between obesity and alteration of sperm DNA integrity and mitochondrial activity [J]. Bju International, 2012, 92(6):S28-S29.
[25]
[1] Bondia-Pons I, Ryan L, Martinez JA. Oxidative stress and inflammation interactions in human obesity [J]. Journal of Physiology and Biochemistry, 2012, 68(4):701-711.
[26]
Fan W, Xu Y, Yue L, et al. Obesity or overweight, a chronic inflammatory status in male reproductive system, leads to mice and human subfertility [J]. Frontiers in Physiology, 2017, 8:1117.
[27]
Ding GL, Liu Y, Liu ME, et al. The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis [J]. Asian J Androl, 2015, 17(6):948-953.
[28]
Mingrone G, Panunzi S, De Gaetano A, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial [J]. Lancet, 2021, 397(10271):293-304.
[29]
Askarpour M, Khani D, Sheikhi A, et al. Effect of Bariatric Surgery on Serum Inflammatory Factors of Obese Patients: a Systematic Review and Meta-Analysi [J]. Obes Surg, 2019, 29(8):2631-2647.
[30]
Horn RC, Gelatti GT, Mori NC, et al. Obesity, bariatric surgery and oxidative stress [J]. Rev Assoc Med Bras (1992), 2017, 63(3):229-235.
[31]
Terra X, Auguet T, Guiu-Jurado E, et al. Long-term Changes in Leptin, Chemerin and Ghrelin Levels Following Different Bariatric Surgery Procedures: Roux-en-Y Gastric Bypass and Sleeve Gastrectomy [J]. Obesity Surgery, 2013, 23(11):1790-1798.
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