正常生育力與低生育力男性血液中鉛、鎘、硒、鋅、銅和鎂濃度之比較分析

A study of blood lead, cadmium, selenium, zinc, copper, and magnesium levels in fertile and infertile men

陳俞璇(Yu-Hsuan Chen)

指導教授 ： 葉錦瑩

臺北醫學大學/公共衛生暨營養學院/公共衛生學研究所/碩士(2004年)

摘要

近年來，不孕問題日益受到重視。許多研究指出，男性在生殖系統異常之盛行率有增加的趨勢。而過去50年來，世界男性族群精液濃度則呈現下降的趨勢，其可能的原因包括：年齡、環境因素和營養因素。環境因素中的生活型態例如抽菸、喝酒、壓力和高溫均會影響精子品質。環境荷爾蒙亦可能造成泌尿道異常和影響精液品質，例如重金屬、農藥、戴奧辛等。隨著環境的變遷，現在暴露於毒性物質的機會越來越多，而暴露於重金屬物質的狀況即可能會影響到男性生殖功能。已知對於男性生育力有影響的金屬物質有鉛、鎘、硒、鉻、鋅、銅、鎂等。本研究主要的目的是想要膫解各種金屬在正常生育力男性以及低生育力男性血液中、精液中分佈情形，及其對於男性生育力之影響。 本研究採病例對照研究，從台北醫學大學附設醫院和萬芳醫院的媽媽教室和泌尿科門診分別選取正常生育力男性和低生育力男性個案。收集血液、精液檢體，並利用結構式問卷調查研究對象之生活習慣，以精蟲計數盤和電腦分析精蟲儀 (Computer-aided sperm analysis；CASA)分析男性精液品質，並以原子吸收光譜測定血液中和精液中各種金屬元素的濃度。 結果顯示，在正常生育力男性賀爾蒙檢驗中促使濾泡刺激素(Follicle-stimulating hormone；FSH)、黃體激素 (Luteinizing hormone；LH)、泌乳激素 (Prolactin；PRL)皆低於低生育力男性，睪固酮 (Testosterone)則較高。鉛、硒、鋅和鎂在正常生育力男性和低生育力男性血液中分佈濃度有統計上的差異存在，但是精液中各金屬濃度則無。精液品質檢驗的結果顯示，精蟲濃度、具活動力精蟲比例、正常精蟲型態比例在兩組別間有差異性存在；在模式分析中，發現男性抽菸、血鉛值對於精液品質參數為危害因子，而血硒、血鎂對於男性精液品質參數則是保護因子。而精液中之金屬無顯著之發現。由於金屬影響男性生育力之機轉仍未清楚，希望未來能進一步探討。

關鍵字

低生育力 ； 鉛 ； 硒 ； 鎂

並列摘要

Recently, infertility issue is more important to be discussed. In the past 50 years, the trend of the semen quality in globe males is descending. The situation is caused by possible reason including age, environmental factors and lifestyles. In developed countries, environmental factors, lifestyles, smoke habits, alcohol consumption and stress have suggested to play a role in human subfertility. The environmental toxicant which adverse effects on male reproductive function have been extensively studied. As a matter of fact, many metals have been investigated in vivo or vitro, such as lead, zinc, cadmium, magnesium and copper. However, the metals effect upon the male semen qualities is still controversial. The aim of the study is to explore the association between the distribution of metals and male fertility. The study is perormed by case-control study. The subjects are selected from a local medicine university in Taipei. Subfertile men are diagnosed in the division of urology in the hospital. Volunteers are searched from the division of Obstetrics and Gynecology whose wife are pregnancy at the study period. All subjects’ socioeconomic state, habits, job, and history of medicine are collected by questionnaire. The semen samples are processed and examined to determine the sperm count and motility using a Markler Counting Chambers and Computer-aided sperm analysis. The metals concentrations in blood and semen are detected by Atomic Absorption Spectrometry. The results show that the concentration of follicle-stimulating hormone , luteinizing hormone , and prolactin in the fertile males are lower than the subfertile males, but the concentration of testosterone is reverse. The concentrations of blood lead, selenium, magnesium and semen count, motility, normal morphology percentage among the fertile males and the subfertile males are statistically different. But no correlation could be demonostrated between the concentrations of metals in semen and the male fertility. The multiple logistic regression model displays that amount of smoking habit and lead are hazards for semen quality, but selenium and magnesium are protective factors for male semen quality.

並列關鍵字

subfertility ； lead ； selenium ； magnesium

參考文獻

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