PDF(Pubmed)
Abstract：
OBJECTIVE: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta-analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele.
METHODS: A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (×106), sperm vitality (%), total sperm motility (%), and sperm DNA fragmentation (SDF) (%). Standardized mean difference (SMD) (95% confidence interval [CI]) was chosen to express the effect size. The quality of the included studies was evaluated using the Cambridge Quality Checklist.
RESULTS: Out of 76 identified articles, 6 studies on rats were included in the meta-analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high.
CONCLUSIONS: This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.
METHODS: A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (×106), sperm vitality (%), total sperm motility (%), and sperm DNA fragmentation (SDF) (%). Standardized mean difference (SMD) (95% confidence interval [CI]) was chosen to express the effect size. The quality of the included studies was evaluated using the Cambridge Quality Checklist.
RESULTS: Out of 76 identified articles, 6 studies on rats were included in the meta-analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high.
CONCLUSIONS: This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.
摘要：
目的：精索静脉曲张与高精液氧化应激（OS）有关，精液质量受损，降低了男性的生育潜力。然而,精索静脉曲张介导的不孕症发展的确切机制以及精索静脉曲张与睾丸功能障碍之间的因果关系尚不完全清楚.本系统综述和荟萃分析（SRMA）的目的是研究与无精索静脉曲张的动物相比，精索静脉曲张对精索静脉曲张实验动物的睾丸OS标记和精子参数的影响。
方法：使用Scopus和PubMed数据库对研究精索静脉曲张动物睾丸OS标记和精子参数的研究进行了文献检索。主要结局包括丙二醛（MDA）（nmol/mg）水平，而次要结局包括精子总数（×106），精子活力（%），精子总活动力(%)，和精子DNA片段(SDF)(%)。选择标准化平均差(SMD)(95%置信区间[CI])来表达效应大小。使用剑桥质量检查表评估纳入研究的质量。
结果：在76篇确定的文章中，在荟萃分析中包括6项关于大鼠的研究。分析显示精索静脉曲张大鼠的MDA显着增加（SMD：15.61[1.93，29.29]；p=0.03）controls.我们还观察到精子总数显着下降（SMD：-17.45[-28.97，-5.93];p<0.01），精子活力（SMD：-16.41[-26.30，-6.52]；p<0.01），精子总活动力(SMD:-17.67[-24.90,-10.44];p<0.01),SDF显著增加(SMD：7.41[1.23，13.59]；p=0.02)，精索静脉曲张大鼠与controls.纳入研究的质量排名较高。
结论：该SRMA表明精索静脉曲张实验动物的睾丸MDA和SDF水平显着增加，精子质量降低。这些发现支持睾丸OS在精索静脉曲张引起的睾丸损伤发展中的潜在作用。
方法：使用Scopus和PubMed数据库对研究精索静脉曲张动物睾丸OS标记和精子参数的研究进行了文献检索。主要结局包括丙二醛（MDA）（nmol/mg）水平，而次要结局包括精子总数（×106），精子活力（%），精子总活动力(%)，和精子DNA片段(SDF)(%)。选择标准化平均差(SMD)(95%置信区间[CI])来表达效应大小。使用剑桥质量检查表评估纳入研究的质量。
结果：在76篇确定的文章中，在荟萃分析中包括6项关于大鼠的研究。分析显示精索静脉曲张大鼠的MDA显着增加（SMD：15.61[1.93，29.29]；p=0.03）controls.我们还观察到精子总数显着下降（SMD：-17.45[-28.97，-5.93];p<0.01），精子活力（SMD：-16.41[-26.30，-6.52]；p<0.01），精子总活动力(SMD:-17.67[-24.90,-10.44];p<0.01),SDF显著增加(SMD：7.41[1.23，13.59]；p=0.02)，精索静脉曲张大鼠与controls.纳入研究的质量排名较高。
结论：该SRMA表明精索静脉曲张实验动物的睾丸MDA和SDF水平显着增加，精子质量降低。这些发现支持睾丸OS在精索静脉曲张引起的睾丸损伤发展中的潜在作用。
