Objective

To explore the association between depression and semen quality and the mediating role of oxidative stress.

Design

Cross-sectional study with repeated measures of semen quality.

Setting

Human Sperm Bank of Hubei Province, People’s Republic of China.

Patient(s)

From April 2017 to July 2018, we recruited 1,000 potential sperm donors who completed the Beck Depression Inventory questionnaire and had measures of oxidative stress biomarkers.

Intervention(s)

None.

Main Outcome Measure(s)

Severity of depression was evaluated by the Beck Depression Inventory scores (0–4, no depression; 5–13, mild depression; 14–20, moderate depression; and 21 or greater, severe depression). The urinary concentrations of 8-hydroxy-2-deoxyguanosine, 4-hydroxy-2-nonenal-mercapturic acid, and 8-iso-prostaglandin F_2α (8-isoPGF_2α) were measured to reflect oxidative stress status. Repeated semen quality parameters (n = 5,880) were examined by trained professional technicians according to the World Health Organization laboratory manual. Associations between depression, oxidative stress, and repeated measures of semen quality parameters were evaluated using linear or mixed-effects models with adjustment for potential confounders. Mediation analysis was performed to test the potential mediating role of oxidative stress.

Result(s)

A total of 391 (39.1%) men were classified as mild depression, 67 (6.7%) as moderate depression, and 19 (1.9%) as severe depression. Inverse dose–response relationships between severity of depression and semen quality parameters were found. Compared with men without depression (n = 523), those with severe depression had a 25.26% (95% confidence interval, −38.65%, −8.93%) lower semen volume, 37.04% (−55.37%, −11.20%) lower total sperm count, 13.57% (−23.17%, −2.78%) lower total motility, and 15.08% (−25.09%, −3.72%) lower progressive motility; men with moderate depression also had a 12.28% (−21.16%, −2.40%) lower semen volume and 23.56% (−36.50%, −7.97%) lower total sperm count. We found a positive dose–response relationship between severity of depression and urinary 8-isoPGF_2α concentrations. However, we found no evidence that the associations between depression status and semen quality were mediated by oxidative stress markers.

Conclusion(s)

In the study of Chinese male sperm donors, men with depression had worse semen quality parameters, including semen volume, sperm concentration, total sperm count, total motility, and progressive motility. Although depression was positively associated with urinary 8-isoPGF_2α concentrations, depression–semen quality associations were not mediated by oxidative stress.

中文翻译：

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1000 名被筛选为潜在精子捐献者的健康男性的抑郁症、氧化应激和精液质量之间的关联

客观的

探讨抑郁与精液质量的关系以及氧化应激的中介作用。

设计

重复测量精液质量的横断面研究。

环境

中华人民共和国湖北省人类精子库。

患者）

从 2017 年 4 月到 2018 年 7 月，我们招募了 1000 名潜在的精子捐献者，他们完成了贝克抑郁量表问卷并测量了氧化应激生物标志物。

干预措施

没有任何。

主要观察指标）

通过贝克抑郁量表评分评估抑郁的严重程度（0-4，无抑郁；5-13，轻度抑郁；14-20，中度抑郁；21 或更高，重度抑郁）。尿中 8-羟基-2-脱氧鸟苷、4-羟基-2-壬烯醛-巯基酸和 8-异前列腺素 F _2α (8-isoPGF _2α) 测量以反映氧化应激状态。重复精液质量参数（n = 5,880）由训练有素的专业技术人员根据世界卫生组织实验室手册进行检查。使用线性或混合效应模型评估抑郁、氧化应激和重复测量精液质量参数之间的关联，并对潜在的混杂因素进行调整。进行中介分析以测试氧化应激的潜在中介作用。

结果）

共有 391 名（39.1%）男性被归类为轻度抑郁，67 名（6.7%）为中度抑郁，19 名（1.9%）为重度抑郁。发现抑郁症的严重程度与精液质量参数之间存在反向剂量反应关系。与没有抑郁症的男性（n = 523）相比，重度抑郁症患者的精液量降低 25.26%（95% 置信区间，-38.65%，-8.93%），总精液量降低 37.04%（-55.37%，-11.20%）精子数量，总运动性降低 13.57%（-23.17%，-2.78%），进行性运动性降低 15.08%（-25.09%，-3.72%）；患有中度抑郁症的男性精液量也降低了 12.28%（-21.16%，-2.40%），精子总数降低了 23.56%（-36.50%，-7.97%）。_{我们发现抑郁症的严重程度与尿 8-isoPGF 2α}呈正剂量反应关系浓度。然而，我们没有发现任何证据表明抑郁状态与精液质量之间的关联是由氧化应激标志物介导的。

结论

在对中国男性精子捐献者的研究中，抑郁症男性的精液质量参数较差，包括精液量、精子浓度、总精子数、总活力和进行性运动。_{尽管抑郁症与尿 8-isoPGF 2α}浓度呈正相关，但抑郁症与精液质量的关联并非由氧化应激介导。