膳食平衡指数与男性精液质量关系研究
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摘要
目的:应用调整的膳食平衡指数-07 (dietary balance index,DBI-07)评价男性精液质量,探讨膳食平衡指数水平与生殖门诊就诊男性精液质量的关系,为生育男性的营养宣教及干预提供科学依据。方法:选取2016—2017年合肥市某三甲医院生殖中心门诊部就诊男性,使用食物频率问卷(FFQ)调查其膳食情况,使用DBI-07评价其膳食质量,并分析DBI-07与男性精液质量的关系。结果:膳食质量情况处于摄入不足、摄入过量以及膳食总体不平衡的状态。男性精液质量异常率为54. 93%,BMI、体力活动锻炼与男性精液质量有关。Logistic回归分析DBI-07各指标与男性精液质量的关系,调整了年龄、吸烟、BMI、饮酒、体力活动等混杂因素之后,结果表明,DBI-07-HBS是精子总数以及前向运动精子活动度异常的风险因素,OR值分别为2. 40 (95%CI∶1. 06～5. 43),2. 32 (95%CI∶1. 13～4. 35),差异有统计学意义(P=0. 035,0. 020)。另外,DBI-07-DQD会增加精子形态异常的风险,OR值为0. 39 (95%CI∶0. 16～0. 91),差异有统计学意义(P=0. 030)。结论:该人群膳食摄入的总体不平衡较为严重,DBI-07与男性精液质量有关,膳食摄入的过量以及不平衡会增加精液质量异常的风险。生育期男性要加强营养均衡,提高膳食质量。
Objective The adjusted dietary balance index-07 (DBI-07) was applied to evaluate semen quality,and the relationship between dietary balance index and semen quality among men attempting fertility was discussed to provide scientific evidence for nutrition education and intervention in the future of male fertility. Method The study recruited males from the outpatient department of reproductive center of a third-grade first-class hospital in Hefei from 2016 to 2017. Food frequency questionnaire (FFQ) was used to investigate the dietary. The dietary quality was evaluated using the DBI-07 Scoring Method. And we analyzed the relationship between DBI-07 and semen quality.Result The quality of dietary intake was not balanced and with a low/high dietary intake in generally. The abnormal rate of semen quality was 54. 93%. BMI and physical activity exercise were related to semen quality in men. In the Logistic regression models,after additional adjusting for possible co-variables,such as age,BMI,smoking status,alcohol consumption and physical activity,DBI-07 was inversely related to semen quality. DBI-07-HBS was the risk factors for the decreased of sperm count and progressive motility. The odds ratio was 0. 92 (95% CI∶0. 18 ～0. 89),0. 82 (95% CI∶0. 23 ～0. 85), (P = 0. 026,0. 015). In addition,DBI-07-DQD could increased the risk of abnormal sperm morphology. The odds ratio was 1. 66 (95% CI∶0. 16 ～ 0. 84), (P = 0. 017). Conclusion The overall imbalance of dietary intake is relatively serious. DBI-07 is related to male semen quality. Excessive dietary intake and dietary imbalance will increase the risk of abnormal semen quality. Men should strengthen the balance of nutrition and improve the diet quality.
Objective The adjusted dietary balance index-07 (DBI-07) was applied to evaluate semen quality,and the relationship between dietary balance index and semen quality among men attempting fertility was discussed to provide scientific evidence for nutrition education and intervention in the future of male fertility. Method The study recruited males from the outpatient department of reproductive center of a third-grade first-class hospital in Hefei from 2016 to 2017. Food frequency questionnaire (FFQ) was used to investigate the dietary. The dietary quality was evaluated using the DBI-07 Scoring Method. And we analyzed the relationship between DBI-07 and semen quality.Result The quality of dietary intake was not balanced and with a low/high dietary intake in generally. The abnormal rate of semen quality was 54. 93%. BMI and physical activity exercise were related to semen quality in men. In the Logistic regression models,after additional adjusting for possible co-variables,such as age,BMI,smoking status,alcohol consumption and physical activity,DBI-07 was inversely related to semen quality. DBI-07-HBS was the risk factors for the decreased of sperm count and progressive motility. The odds ratio was 0. 92 (95% CI∶0. 18 ～0. 89),0. 82 (95% CI∶0. 23 ～0. 85), (P = 0. 026,0. 015). In addition,DBI-07-DQD could increased the risk of abnormal sperm morphology. The odds ratio was 1. 66 (95% CI∶0. 16 ～ 0. 84), (P = 0. 017). Conclusion The overall imbalance of dietary intake is relatively serious. DBI-07 is related to male semen quality. Excessive dietary intake and dietary imbalance will increase the risk of abnormal semen quality. Men should strengthen the balance of nutrition and improve the diet quality.
引文
[1]Eslamian G,Amirjannati N,Rashidkhani B,et al.Adherence to the western pattern is potentially an unfavorable indicator of asthenozoospermia risk:a case-control study[J].JAm Coll Nutr,2016(35):50-58.
[2]Cooper TG,Noonan E,von Eckardstein S,et al.World Health Organization reference values for human semen characteristics[J].Hum Reprod Update,2010,16(3):231-245.
[3]Pastuszak AW.Words of wisdom Re:Human semen quality in the new millennium:a prospective cross-sectional populationbased study of 4867 men[J].Eur urol,2012,62(6):1197-1198.
[4]Eslamian G,Amirjannati N,Rashidkhani B,et al.Intake of food groups and idiopathic asthenozoospermia:a case-control study[J].Hum Reprod,2012(27):3328-3336.
[5]Jensen T K,Heitmann B L,Jensen M B,et al.High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population[J].Am J Clin Nutr,2013,97(2):411-418.
[6]何宇纳,翟凤英,杨晓光,等.修订中国膳食平衡指数[J].营养学报,2009,31(6):532-536.
[7]Rimm EB,et al.Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals[J].Am J Epidemiol,1992,135(10):1114-1126.
[8]Cooper TG,Neuwinger J,Bahrs S.Internal quality control of semen analysis[J].Fertil and Steril,1992,58(1):172-178.
[9]World Health Organization.WHO laboratory manual for the examination and processing of human semen.5th ed.Geneva:World Health Organization,2010.
[10]罗盈怡.食物频率问卷及国际体力活动问卷的设计及其在不同人群中的应用[D].上海:同济大学,2007.
[11]程茅伟.中国成年居民膳食模式及与代谢综合征关系的研究(2006-2009)[D].北京:中国疾病预防控制中心,2017.
[12]Kant AK,Graubrard BI,et al.Eating out in America,1987-2000:trends and nutritional correlates[J].Prev Med,2004,38(2):243-249.
[13]Lachat C,et al.Eating out of home and its association with dietary intake:a systematic review of the evidence[J].Obes Rev,2012,13(2),329-346.
[14]Goverde HJ,et al.Semen quality and frequency of smoking and alcohol consumption-an explorative study[J].Int J Fertil Menopausal Stud,1995(40):135-138.
[15]刘美意,马春杰,唐立新,等.512例供精志愿者初次精液筛查结果分析[J].中华男科学杂志,2004(10):734-736.
[16]李娟.不育门诊男性精液质量和性功能与双酚A关系的研究[D].太原:山西医科大学,2016.
[17]莫金桦,赵瑰丽,李思慧,等.2005-2014年不孕不育门诊男性人群精液质量的单中心研究[J].生殖医学杂志,2018,27(4):368-371.
[18]Brahem S,Mehdi M,Elghezal H,et al.The effects of male aging on semen quality,sperm DNA fragmentation and chromosomal abnormalities in an infertile population[J].J of Assisted Reprod&Genetics,2011,28(5):425-432.
[19]Tsao C W,Liu C Y,Chou Y C,et al.Exploration of the association between obesity and semen quality in a 7630 male population[J].Plos One,2015,10(3):e0119458.
[20]Lalindeacevedo P C,et al.Physically active men show better semen parametersthan their sedentary counterparts[J].Int Jof Fertil&Steril,2017,11(3):156-165.
[21]Atkinson FS,Foster-Powell K.International tables of glycemic index and glycemic load values:2008[J].Diabetes Care,2008,31(12):2281-2283.
[22]Kristo A S,Matthan N R,Lichtenstein A H.Effect of diets differing in glycemic index and glycemic load on cardiovascular risk factors:review of randomized controlled-feeding trials[J].Nutr,2013,5(4):1071-1080.
[23]Chavarro J E,et al.Trans fatty acid intake is inversely related to total sperm count in young healthy men[J].Hum Reprod,2014,29(3):429-440.
[24]Eslamian G,Amirjannati N,Rashidkhani B,et al.Intake of food groups and idiopathic asthenozoospermia:a casecontrol study[J].Hum Reprod,2012,27(11):3328.
[25]Attaman J A,Toth T L,Furtado J,et al.Dietary fat and semen quality among men attending a fertility clinic[J].Fertil&Steril,2010,94(4):S49-S49.
[2]Cooper TG,Noonan E,von Eckardstein S,et al.World Health Organization reference values for human semen characteristics[J].Hum Reprod Update,2010,16(3):231-245.
[3]Pastuszak AW.Words of wisdom Re:Human semen quality in the new millennium:a prospective cross-sectional populationbased study of 4867 men[J].Eur urol,2012,62(6):1197-1198.
[4]Eslamian G,Amirjannati N,Rashidkhani B,et al.Intake of food groups and idiopathic asthenozoospermia:a case-control study[J].Hum Reprod,2012(27):3328-3336.
[5]Jensen T K,Heitmann B L,Jensen M B,et al.High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population[J].Am J Clin Nutr,2013,97(2):411-418.
[6]何宇纳,翟凤英,杨晓光,等.修订中国膳食平衡指数[J].营养学报,2009,31(6):532-536.
[7]Rimm EB,et al.Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals[J].Am J Epidemiol,1992,135(10):1114-1126.
[8]Cooper TG,Neuwinger J,Bahrs S.Internal quality control of semen analysis[J].Fertil and Steril,1992,58(1):172-178.
[9]World Health Organization.WHO laboratory manual for the examination and processing of human semen.5th ed.Geneva:World Health Organization,2010.
[10]罗盈怡.食物频率问卷及国际体力活动问卷的设计及其在不同人群中的应用[D].上海:同济大学,2007.
[11]程茅伟.中国成年居民膳食模式及与代谢综合征关系的研究(2006-2009)[D].北京:中国疾病预防控制中心,2017.
[12]Kant AK,Graubrard BI,et al.Eating out in America,1987-2000:trends and nutritional correlates[J].Prev Med,2004,38(2):243-249.
[13]Lachat C,et al.Eating out of home and its association with dietary intake:a systematic review of the evidence[J].Obes Rev,2012,13(2),329-346.
[14]Goverde HJ,et al.Semen quality and frequency of smoking and alcohol consumption-an explorative study[J].Int J Fertil Menopausal Stud,1995(40):135-138.
[15]刘美意,马春杰,唐立新,等.512例供精志愿者初次精液筛查结果分析[J].中华男科学杂志,2004(10):734-736.
[16]李娟.不育门诊男性精液质量和性功能与双酚A关系的研究[D].太原:山西医科大学,2016.
[17]莫金桦,赵瑰丽,李思慧,等.2005-2014年不孕不育门诊男性人群精液质量的单中心研究[J].生殖医学杂志,2018,27(4):368-371.
[18]Brahem S,Mehdi M,Elghezal H,et al.The effects of male aging on semen quality,sperm DNA fragmentation and chromosomal abnormalities in an infertile population[J].J of Assisted Reprod&Genetics,2011,28(5):425-432.
[19]Tsao C W,Liu C Y,Chou Y C,et al.Exploration of the association between obesity and semen quality in a 7630 male population[J].Plos One,2015,10(3):e0119458.
[20]Lalindeacevedo P C,et al.Physically active men show better semen parametersthan their sedentary counterparts[J].Int Jof Fertil&Steril,2017,11(3):156-165.
[21]Atkinson FS,Foster-Powell K.International tables of glycemic index and glycemic load values:2008[J].Diabetes Care,2008,31(12):2281-2283.
[22]Kristo A S,Matthan N R,Lichtenstein A H.Effect of diets differing in glycemic index and glycemic load on cardiovascular risk factors:review of randomized controlled-feeding trials[J].Nutr,2013,5(4):1071-1080.
[23]Chavarro J E,et al.Trans fatty acid intake is inversely related to total sperm count in young healthy men[J].Hum Reprod,2014,29(3):429-440.
[24]Eslamian G,Amirjannati N,Rashidkhani B,et al.Intake of food groups and idiopathic asthenozoospermia:a casecontrol study[J].Hum Reprod,2012,27(11):3328.
[25]Attaman J A,Toth T L,Furtado J,et al.Dietary fat and semen quality among men attending a fertility clinic[J].Fertil&Steril,2010,94(4):S49-S49.