STUDY QUESTION Is intake of sugar-sweetened beverages (SSB) or artificially sweetened beverages (ASB) associated with testicular function in young men? SUMMARY ANSWER Among young men unaware of their semen quality and reproductive hormone levels, intake of SSBs was associated with lower sperm concentration, lower total sperm count, and a lower ratio of serum inhibin-B/FSH. WHAT IS KNOWN ALREADY SSBs may adversely impact testicular function, but results are not consistent across studies. Moreover, the associations of ASB, energy-drinks or fruit juices with testicular function are unclear. STUDY DESIGN, SIZE, DURATION Young healthy men and unselected for fertility status men enrolled in a cross-sectional study between 2008 and 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 2935 young (median age: 19 years) men enrolled in the study. Intake of SSBs, ASBs, fruit juices, and energy-drinks was assessed with a validated food frequency questionnaire. Testicular function was assessed through conventional semen quality parameters (semen volume, sperm concentration, total count, motility and morphology), testicular volume assessed with ultrasound, and serum reproductive hormone concentrations (total testosterone, free testosterone, E2, inhibin-B, LH, FSH, sex hormone-binding globulin) were measured. MAIN RESULTS AND THE ROLE OF CHANCE In multivariable-adjusted analyses, men in the highest category of SSB intake (median: 1.1 servings (∼220 ml)/day) had a 13.2 million/ml lower median sperm concentration (95% CI: –21.0, –5.5) than non-consumers. A similar pattern was observed with total sperm count (–28 million (95% CI: –48, –9)), serum inhibin-B (–12 pg/ml (95% CI: –21, –4)), and inhibin-B/FSH ratio (–9 (95% CI: –18, 0)). The adjusted median difference in sperm concentration and inhibin-B associated with increasing SSB intake by 1 serving (∼200ml)/day at the expense of water was –3.4 million sperm/ml (95% CI: –5.8, –1.0) and –7 pg/ml (95% CI: –11, –3), respectively. LIMITATIONS, REASONS FOR CAUTION Inferring causality is limited owing to the cross-sectional design. We adjusted for a number of potential confounders but cannot exclude that unmeasured lifestyle and behavior associated with soft drink intake is associated with testicular function in these young men. WIDER IMPLICATIONS OF THE FINDINGS In the largest study to date, intake of SSBs was associated with lower sperm concentration, total sperm count, and serum inhibin-B/FSH ratio, consistent with a direct suppressive effect of SSB intake on testicular function among otherwise healthy men, potentially affecting fertility. However, the observed association between higher SSB intake and lower semen quality does not necessarily imply a decrease in fertility. STUDY FUNDING/COMPETING INTEREST(S) Supported by research from the Danish Council for Strategic Research (2101-08-0058), Independent Research Fund Denmark (8020-00218B), European Union (212844), the Kirsten and Freddy Johansen’s Foundation (95-103-72087), the Research Fund of the Capital Region of Denmark (A6176), and the NIH (P30DK046200). The authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A.

中文翻译：

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年轻男性软饮料摄入量与睾丸功能的关系

研究问题 含糖饮料 (SSB) 或人工甜味饮料 (ASB) 的摄入是否与年轻男性的睾丸功能有关？总结答案 在不了解精液质量和生殖激素水平的年轻男性中，摄入 SSB 与较低的精子浓度、较低的总精子数量和较低的血清抑制素-B/FSH 比率有关。已知的 SSB 可能会对睾丸功能产生不利影响，但研究结果并不一致。此外，ASB、能量饮料或果汁与睾丸功能的关系尚不清楚。研究设学习。使用经过验证的食物频率问卷评估 SSB、ASB、果汁和能量饮料的摄入量。睾丸功能通过常规精液质量参数（精液体积、精子浓度、总计数、运动性和形态）、超声评估的睾丸体积和血清生殖激素浓度（总睾酮、游离睾酮、E2、抑制素-B、LH、 FSH，性激素结合球蛋白）进行了测量。主要结果和机会的作用 在多变量调整分析中，SSB 摄入量最高的男性（中位数：1.1 份（~220 毫升）/天）的精子浓度中位数低 1320 万/毫升（95% CI：- 21.0, –5.5) 高于非消费者。在总精子数 (–2800 万 (95% CI: –48, –9))、血清抑制素-B (–12 pg/ml (95% CI: –21, –4))、和抑制素-B/FSH 比率 (–9 (95% CI: –18, 0))。在消耗水的情况下，与每天增加 1 份（~200 毫升）SSB 摄入量相关的精子浓度和抑制素 B 的调整中位数差异为 –340 万精子/毫升（95% CI：–5.8，–1.0）和 –分别为 7 pg/ml (95% CI: –11, –3)。限制，谨慎的原因 由于横截面设计，推断因果关系是有限的。我们调整了一些潜在的混杂因素，但不能排除与软饮料摄入相关的未测量生活方式和行为与这些年轻男性的睾丸功能相关。研究结果的更广泛意义 与 SSB 摄入对其他健康男性睾丸功能的直接抑制作用一致，可能会影响生育能力。然而，较高的 SSB 摄入量和较低的精液质量之间观察到的关联并不一定意味着生育能力的下降。研究资金/竞争兴趣 由丹麦战略研究委员会 (2101-08-0058)、丹麦独立研究基金 (8020-00218B)、欧盟 (212844)、克尔斯滕和弗雷迪约翰森基金会 (95 -103-72087)、丹麦首都地区研究基金 (A6176) 和 NIH (P30DK046200)。作者报告没有利益冲突。试用注册号 不适用。较高的 SSB 摄入量和较低的精液质量之间观察到的关联并不一定意味着生育能力的下降。研究资金/竞争兴趣 由丹麦战略研究委员会 (2101-08-0058)、丹麦独立研究基金 (8020-00218B)、欧盟 (212844)、克尔斯滕和弗雷迪约翰森基金会 (95 -103-72087)、丹麦首都地区研究基金 (A6176) 和 NIH (P30DK046200)。作者报告没有利益冲突。试用注册号 不适用。较高的 SSB 摄入量和较低的精液质量之间观察到的关联并不一定意味着生育能力的下降。研究资金/竞争兴趣 由丹麦战略研究委员会 (2101-08-0058)、丹麦独立研究基金 (8020-00218B)、欧盟 (212844)、克尔斯滕和弗雷迪约翰森基金会 (95 -103-72087)、丹麦首都地区研究基金 (A6176) 和 NIH (P30DK046200)。作者报告没有利益冲突。试用注册号 不适用。丹麦首都地区研究基金（A6176）和美国国立卫生研究院（P30DK046200）。作者报告没有利益冲突。试用注册号 不适用。丹麦首都地区研究基金（A6176）和美国国立卫生研究院（P30DK046200）。作者报告没有利益冲突。试用注册号 不适用。