应用贝叶斯和加权回归评价特发性少雄异精子症与精浆金属混合物的关系

Using Bayesian and weighted regression to evaluate the association of idiopathic oligoastenoteratozoospermia and seminal plasma metal mixtures

 应用贝叶斯和加权回归评价特发性少雄异精子症与精浆金属混合物的关系

Authors：Yin T, Ji D, Su X, Zhou X, Wang X, He S, Jiang T, Yue X, Zhang H, Zhang Y, Peng J, Zou W, Liang D, Liu Y, Du Y, Zhang Z, Liang C, Cao Y.

Source：Chemosphere

DOI:10.1016/j.chemosphere.2024.141202

Abstract

Idiopathic oligoastenoteratozoospermia (OAT) affects 30% of infertile men of reproductive age. However, the associations between Cr, Fe, Cu, Se or Co levels and OAT risk have not been determined. This research aimed to assess the associations between Cr, Fe, Cu, Se and Co levels as well as their mixtures in seminal plasma and the risk and severity of OAT. Therefore, a case‒control study including 823 participants (416 OAT patients and 407 controls) recruited from October 2021 to August 2022 at the reproductive centre of the First Affiliated Hospital of Anhui Medical University was conducted in Anhui, China. The concentrations of Cr, Fe, Cu, Se and Co in the seminal plasma were detected via inductively coupled plasma‒mass spectrometry. Binary logistic regression models were used to assess the associations between the levels of Cr, Fe, Cu, Se and Co and the risk of OAT and severe OAT; additionally, Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regressions were performed to evaluate the joint effect of seminal plasma levels of Cr, Fe, Cu, Se and Co on the risk of OAT and explore which elements contributed most to the relationship. We found significant associations between the concentrations of Fe, Cu and Se in seminal plasma and OAT risk after adjusting for covariates (Fe, lowest tertile vs. second tertile: aOR = 1.86, 95% CI = 1.31, 2.64; Cu, lowest tertile vs. second tertile: aOR = 1.95, 95% CI = 1.37, 2.76; Se, lowest tertile vs. second tertile: aOR = 1.65, 95% CI = 1.17, 2.35). A lower Se concentration in seminal plasma (lowest tertile vs. second tertile: aOR = 1.84, 95% CI = 1.10, 3.10) was positively associated with the severity of OAT risk. According to the BKMR analyses, the risk of OAT increased when the overall concentrations were less than the 25th percentile. The results from the WQS regression indicated that a negative WQS index was significantly associated with the OAT risk, while a positive WQS index was not. Se and Fe had significant weights in the negative direction. In conclusion, lower Cu, Fe and Se levels in seminal plasma were positively associated with OAT risk, while higher Cr levels in seminal plasma were positively associated with OAT risk according to the single element model, and lower levels of Se were related to a greater risk of severe OAT; when comprehensively considering all the results from BKMR and WQS regression, Fe, Se and Cr levels contributed most to this relationship.

摘要

特发性少胚头动物精子症 （OAT） 影响 30% 的育龄不育男性。然而，Cr、Fe、Cu、Se 或 Co 水平与 OAT 风险之间的关联尚未确定。本研究旨在评估精浆中Cr、Fe、Cu、Se和Co水平及其混合物与OAT的风险和严重程度之间的关联。因此，2021 年 10 月至 2022 年 8 月在中国安徽医科大学附属第一医院生殖中心招募了 823 名受试者（416 名 OAT 患者和 407 名对照组）的病例对照研究。采用电感耦合等离子体质谱法检测精浆中Cr、Fe、Cu、Se和Co的浓度。采用二元logistic回归模型评估Cr、Fe、Cu、Se和Co水平与OAT和重症OAT风险的相关性;此外，还采用贝叶斯核机回归（BKMR）和加权分位数和（WQS）回归 ，评估 精浆Cr、Fe、Cu、Se和Co水平对OAT风险的共同影响，并探讨哪些因素对OAT风险的贡献最大关系。我们发现精浆中Fe、Cu和Se的浓度与调整协变量后的OAT风险之间存在显着关联（Fe，最低三分位数与第二三分位数：aOR=1.86,95%CI=1.31,2.64;Cu，最低三分位数与第二三分位数：aOR = 1.95,95% CI = 1.37,2.76;Se，最低三分位数与第二三分位数：aOR = 1.65,95% CI = 1.17,2.35）。精浆中较低的 Se 浓度（最低三分位数与第二三分位数：aOR = 1.84,95% CI = 1.10,3.10）与 OAT 风险的严重程度呈正相关。根据BKMR分析，当总浓度低于第25个百分位数时，OAT的风险增加。WQS 回归结果表明，WQS指数为负与OAT风险显著相关，而WQS指数为正与OAT风险无关。Se 和 Fe 在负方向上具有显著的权重。综上所述，根据单因素模型，精浆中较低的Cu、Fe和Se水平与OAT风险呈正相关，而精浆中Cr水平较高与OAT风险呈正相关，Se水平较低 与重症OAT风险较高相关;当综合考虑BKMR和WQS回归的所有结果时，Fe、Se和Cr水平对这种关系的贡献最大。