Correlation study and full management of metabolic syndrome and sperm DNA fragmentation index, a regional multicentre prospective long term follow-up study from Anhui, China

Dongsheng Ma¹Jianhong Xi^2*

• ¹Department of Reproductive Medicine, The People''s Hospital Bozhou, Bozhou, China
• ²Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

Objective:To investigate the correlation between Metabolic syndrome (Mets) and Sperm DNA fragmentation index (DFI) in men of reproductive age, and to summarise the Mets and metabolic component health management model in men.Results:Intergroup comparison between the observation and control groups in this study showed no statistical difference between the two groups in terms of baseline information and fertility assessment (P>0.05).However, there was statistical difference between the two groups in MetS and metabolic scores (P<0.001).One-way ANOVA showed a statistically significant difference between DFI and MetS scores (P=0.021), and two-way comparisons showed a statistically significant difference between the groups with 0-4 points (P<0.05).There was a moderate-strength positive correlation between metabolic score and DFI by Spearman's correlation analysis (r=0.475, P<0.001).Overall, DFI and MetS were positively associated [OR (95%CI):1.09 (1.07-1.11)] when DFI< 32.26 [OR (95%CI): 1.15(1.12-1.19)].In the overall analysis, the association between MetS and adverse maternity outcomes was statistically significant (OR=1.50, 95% CI: 1.01-2.22, P=0.045).In the sperm DFI subgroup, the association of MetS with adverse maternity outcomes was significant in both DFI≤15 and DFI >30 (15: OR=2.51, 95%CI: 1.01-6.22, P=0.047;>30:OR=2.94, 95%CI: 1.19-7.22, P=0.019), and subgroup analyses of age showed significant association between MetS and adverse maternity outcomes in age > 30 years (OR=1.94, 95% CI: 1.13-3.33, P=0.016).The results of the mediated analysis pathway showed that obesity and hyperlipidaemia lead to sperm DFI abnormalities, which indirectly contribute to adverse maternity outcomes, but it has not been proven that sperm DFI abnormalities contribute to the occurrence of adverse maternity outcomes.The results of multifactorial logistic regression analysis showed that varicocele (OR=1.975), obesity (OR=2.296), hyperlipidaemia (OR=2.422), and Low-HDL (OR=3.654) were the independent risk factors for abnormal sperm DFI.And effective interventions for the group with abnormal sperm DFI could significantly reduce sperm DFI values and metabolic scores (P<0.001). The predictive model has been validated to show positive predictive efficacy and clinical benefit.Conclusion:MetS may lead to abnormal sperm DNA fragmentation indices, which in turn suggests that abnormal sperm DFI due to MetS may be a risk factor for male infertility and spousal dyspareunia, and that effective interventions to reduce sperm DFI values and metabolic scores are necessary and urgent.