Study On The Association Between Urinary Metal Exposure,genitourinary Infection And Semen Quality

[Objective] The purpose of this study was to investigate the relationship between genitourinary infection,urinary metal exposure and semen quality in men.[Methods] From September 2016 to September 2018,490 men who went to a Grade A hospital in Shenzhen for fertility consultation and semen examination were selected as the research subjects.A random urine sample and a semen sample were collected.Each subject must complete the collection of semen and urine samples and complete the questionnaire on semen quality factors.The process of filling out the questionnaire is under the quality control of public health professionals.Computer Assisted Semen Analysis(CASA)was used to measure the routine index of Semen.Ureaplasma urealyticum,Chlamydia trachomatis and Chlamydia genitalium were detected by real-time fluorescence quantitative PCR.Using Inductively Coupled Plasma Massspectrometry(ICP-MS)to detect the concentrations of magnesium,Ca,Cr,Mn,Fe,Co,Ni,Cu,Zn,As,Se,Mo,Cd,Sn,Sb,Hg,Thallium and Pb in urine.Epi-Data 3.1software was used to input and proofread the questionnaire,SPSS 25.0 and R 3.60 software was used for statistical description and statistical analysis,and PRISM8 was used for drawing the chart.The t-test or Mann-Whitney U test was used to analyze the differences between the infected group(subjects with at least one urinary infection index(Ureaplasma urealyticum,Chlamydia trachomatis,and Chlamydia genitalium)and the control group(subjects with negative urinary tract infections).Multiple linear regression model was used to analyze the relationship between urine metal exposure level and semen quality.The relationship between genitourinary infection and semen quality was further analyzed by stratified analysis.To analyze metal-to-metal or metal-to-infection interactions on semen quality.[Results] Between age,BMI,abstinence time,education level,smoking,drinking,sperm concentration,total number of sperm,forward motility rate of sperm,and total sperm motility rate between subjects with infection in the urogenital system and subjects without infection in the urinary system The difference was not statistically significant(P>0.05).After adjusting for factors that are clinically and biologically influential to semen quality,age,BMI,abstinence time,smoking,drinking,and infection,the results of the single metal model showed that the concentration of Zn,Se,Sn,Hg,and Tl in urine is related to certain There is a dose-response relationship in semen quality indicators.With the increase of Zn,Se,and Hg,the semen concentration and the total number of sperm showed an upward trend;compared with the low concentration,the second concentration of Sn was negatively correlated with Tl and semen concentration;with the increase of Hg concentration,the total sperm motility The rate is on the rise.The polymetallic model showed that only urine mercury was positively correlated with semen concentration and total sperm count.The results of stratified analysis showed that in people with genitourinary tract infections,urine manganese,urinary iron,and urinary mercury are associated with semen concentration,urinary manganese and urinary mercury are associated with the total number of sperm and the forward movement rate of sperm,and urine manganese is associated with the total sperm concentration.There is a correlation between motility rate;in people without infection in the genitourinary tract,urinary zinc is associated with the forward movement rate of sperm and the total sperm motility rate.The interaction showed that there was a significant interaction between urine Hg,urogenital infection and semen quality(P<0.05);[Conclusion]1.There were no significant differences in sperm concentration,sperm count,sperm forward motility rate and sperm motility rate between subjects with genitourinary system infection and subjects without genitourinary system infection.2.Urinary HG and urogenital tract infection had significant interaction with semen quality(P<0.05).3.Urine zinc and selenium concentrations are significantly positively correlated with semen quality;too high concentrations of mercury and thallium in urine will reduce semen quality.