The Prevalence and Components of Metabolic Syndrome in Men from Infertile Couples and Its Relation on Semen Analysis

Figures & data

Table 1 Distribution of General Characteristics of the Study Population with and without Metabolic Syndrome

Factors	Total (n=534)	Metabolic Syndrome		P-value*
		MetS (n=125)	Non-MetS (n=409)
Age (years)	34.7 ± 6.3	36.1 ± 6.6	34.3 ± 6.1	0.006
< 35	291 (54.5%)	54 (10.1%)	237 (44.4%)	0.004
≥ 35	243 (45.5%)	71 (13.3%)	172 (32.2%)
BMI (kg/m2)	23.2 ± 2.9	25.1 ± 2.6	22.6 ± 2.8	< 0.001
< 23	310 (58.1%)	35 (6.6%)	275 (51.5%)	< 0.001
≥ 23	224 (41.9%)	90 (16.9%)	134 (25.1%)
WC (cm)	83.6 ± 8.4	90.1 ± 7.2	81.6 ± 7.7	< 0.001
< 90	386 (72.3%)	37 (6.9%)	349 (65.4%)	< 0.001
≥ 90	148 (27.7%)	88 (16.5%)	60 (11.2%)
HC (cm)	95.5 ± 6.3	99.9 ± 5.6	94.2 ± 5.9	< 0.001
WHR	0.88 ± 0.06	0.90 ± 0.05	0.87 ± 0.07	< 0.001
< 0.9	350 (65.5%)	44 (8.2%)	306 (57.3%)	< 0.001
≥ 0.9	184 (34.5%)	81 (15.2%)	103 (19.3%)
WHtR	0.50 ± 0.05	0.54 ± 0.04	0.49 ± 0.05	< 0.001
Hepatitis B virus
Positive	38 (7.1%)	2 (0.4%)	36 (6.7%)	0.005
Negative	496 (92.9%)	123 (23.0%)	373 (69.9%)
Blood pressure				< 0.001
SBP (mmHg)	115.4 ± 10.2	120.4 ± 13.0	113.9 ± 8.6
< 130	476 (89.1%)	90 (16.8%)	386 (72.3%)	< 0.001
≥ 130	58 (10.9%)	35 (6.6%)	23 (4.3%)
DBP (mmHg)	73.3 ± 7.4	77.5 ± 8.9	72.1 ± 6.3	< 0.001
< 85	507 (95.0%)	104 (19.5%)	403 (75.0%)	< 0.001
≥ 85	27 (5.0%)	21 (3.9%)	6 (1.1%)
Smoking
No	348 (65.2%)	81 (15.2%)	267 (50.0%)	0.92
Yes	186 (34.8%)	44 (8.2%)	142 (26.6%)
Alcohol consumption
No	245 (45.9%)	55 (10.3%)	190 (35.6%)	0.63
Yes	289 (54.1%)	70 (13.1%)	219 (41.0%)
Lipidemia
Total cholesterol (nmol/L)	4.89 ± 0.98	5.27 ± 1.03	4.77 ± 0.93	< 0.001
Triglyceride (nmol/L)	2.27 ±1.53	3.65 ± 1.78	1.85 ± 1.15	< 0.001
LDL – Cholesterol (nmol/L)	1.26 ± 0.39	3.45 ± 0.94	3.27 ± 0.90	0.059
HDL – Cholesterol (nmol/L)	3.31 ± 0.91	1.02 ± 0.22	1.33 ± 0.40	< 0.001
Fasting glucose (nmol/L)	5.53 ± 1.00	6.08 ± 1.18	5.36 ± 0.87	< 0.001

Notes: Data are presented as mean ± SD or number (%). *Comparison was performed between men with and without MetS using the independent-samples t-test and Chi-square test or Fisher exact test with so small sample (under 5) in one cell.

Abbreviations: BMI, body mass index; DBP, diastolic blood pressure; HC, hip circumference; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; MetS, metabolic syndrome; SBP, systolic blood pressure; WC, waist circumference; WHR, waist-to-hip ratio; WHtR, waist-to-height ratio.

Table 2 Predictors of MetS in Men from Infertile Couples Using Univariate Analysis

Factors	AUC	J-Value	Se (%)	Sp (%)	P-value
Weight	0.76	67.50	69.6	72.6	<0.001
HC	0.77	95.50	84.0	60.6	<0.001
BMI	0.75	23.67	72.0	67.2	<0.001
WHR	0.71	0.90	64.8	74.6	<0.001
WHtR	0.78	0.52	72.0	76.5	<0.001

Note: Data are presented as percentage (%).

Abbreviations: AUC, area under curve; BMI, body mass index; HC, hips circumference; Se, sensitivity; Sp, specificity; WHR, waist-to-hip ratio; WHtR, waist-to-height ratio.

Table 3 Predictors of MetS in Men from Infertile Couples Using Logistic Regression Analysis

Factors	OR	CI 95%		P-value
		Lower	Upper
Age	1.055	1.018	1.093	0.004
Weight	1.023	0.968	1.081	0.426
HC	1.140	1.077	1.207	< 0.001
BMI	1.149	0.984	1.341	0.079

Note: P-value was age-adjusted p value by using logistic regression.

Abbreviations: BMI, body mass index; HC, hips circumference; CI, confidence interval; OR, odds ratio.

Figure 1 Comparison of ROC curves between weight, height, hips circumference, BMI, WHR and WHtR, in prediction of MetS in men from infertile couples using univariate analysis. Diagonal segments are produced by ties.

Abbreviations: ROC, receiver operating characteristic; BMI, body mass index; WHR, waist-to-hip ratio; WHtR, waist-to-height ratio; MetS, metabolic syndrome.

Table 4 The Relation of Anthropometric Factors, Metabolic Components and Semen Analysis Results

Factors	Total (n=534)	Semen Analysis		P-value*
		Abnormal (n=348)	Normal (n=96)
Age (years)		34.8 ± 6.4	34.6 ± 5.6	0.82
< 35	291 (54.5%)	239 (44.8%)	52 (9.7%)	0.94
≥ 35	243 (45.5%)	199 (37.3%)	44 (8.2%)
WC (cm)		83.5 ± 8.6	84.2 ± 7.7	0.45
< 90	386 (72.3%)	317 (59.4%)	69 (12.9%)	0.92
≥ 90	148 (27.7%)	121 (22.7%)	27 (5.0%)
WHR		0.87 ± 0.07	0.88 ± 0.05	0.68
< 0.9	350 (65.5%)	287 (53.7%)	63 (11.8%)	0.99
≥ 0.9	184 (34.5%)	151 (28.3%)	33 (6.2%)
WHtR		0.50 ± 0.05	0.50 ± 0.05	0.41
Blood pressure
SBP (mmHg)		115.2 ± 10.3	116.5 ± 9.7	0.26
DPB (mmHg)		73.2 ± 7.6	73.85 ± 6.4	0.45
Lipidemia tests
Total cholesterol (nmol/L)		4.88 ± 1.00	4.95 ± 0.86	0.52
Triglyceride (nmol/L)		2.25 ± 1.56	2.37 ± 1.40	0.46
LDL-Cholesterol (nmol/L)		3.30 ± 0.92	3.36 ± 0.86	0.55
HDL- Cholesterol (nmol/L)		1.25 ± 0.39	1.29 ± 0.40	0.34
Fasting glucose (nmol/L)		5.53 ± 1.02	5.55 ± 0.89	0.85
Hepatitis B virus
Positive	38 (7.1%)	30 (5.6%)	8 (1.5%)	0.65
Negative	496 (92.9%)	408 (76.4%)	88 (16.5%)
Smoking
Yes	186 (34.8%)	161 (30.1%)	25 (4.7%)	0.046
No	348 (65.2%)	277 (51.9%)	71 (13.3%)
Alcohol consumption
Yes	289 (54.1%)	230 (43.1%)	59 (11.0%)	0.11
No	245 (45.9%)	208 (39.0%)	37 (6.9%)
MetS	125 (23.4%)	99 (18.5%)	26 (4.9%)	0.35
Non-MetS	409 (76.6%)	339 (63.5%)	70 (13.1%)

Notes: Data are presented as mean ± SD or number (%). *Comparison was performed between men with and without MetS using the independent-samples t-test and Chi-square test.

Abbreviations: BMI, body mass index; DBP, diastolic blood pressure; HC, Hip circumference; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; MetS, metabolic syndrome; SBP, systolic blood pressure; WC, waist circumference; WHR, waist-to-hip ratio; WHtR, waist-to-height ratio.

Table 5 The Relationship Between Semen Parameters and Metabolic Syndrome

Semen Parameters	Total (n = 534)	Metabolic Syndrome		P-value*	P1-value
		MetS	Non-MetS
Azoospermia	33 (6.2%)	7 (1.3%)	26 (4.9%)	0.76	0.784
Volume (mL)		1.9 ± 1.0	2.0 ± 1.0	0.21	0.146
< 1.5	163 (32.5%)	44 (8.8%)	119 (23.7%)	0.21
≥ 1.5	338 (67.5%)	74 (14.8%)	264 (52.7%)
Sperm concentration (x10^6/mL)		34.1 ± 15.0	31.4 ± 15.4	0.09	0.105
< 15	60 (12.0%)	9 (1.8%)	51 (10.2%)	0.09
≥ 15	441 (88.0%)	109 (21.7%)	332 (66.3%)
Total sperm count (x10^6)		62.5 ± 47.2	61.7 ± 44.7	0.87	0.803
PR motility (%)		31.4 ± 12.4	29.7 ± 11.7	0.19	0.114
< 32	279 (55.7%)	57 (11.4%)	222 (44.3%)	0.07
≥ 32	222 (44.3%)	61 (12.2%)	161 (32.1%)
Total PR motility (x10^6)		21.9 ± 23.2	20.1 ± 17.7	0.37	0.295
Vitality (%)		78.9 ± 11.8	79.4 ± 10.5	0.71	0.891
< 58%	14 (2.8%)	6 (1.2%)	8 (1.6%)	0.08
≥ 58%	487 (97.2%)	112 (22.4%)	375 (74.8%)
Normal morphology (%)		3.7 ± 2.1	3.7 ± 2.2	0.94	0.778
< 4%	287 (57.3%)	63 (12.6%)	224 (44.7%)	0.33
≥ 4%	214 (42.7%)	55 (11.0%)	159 (31.7%)
Abnormal head (%)		86.9 ± 5.7	87.5 ± 7.5	0.34	0.397
Abnormal neck-tail (%)		57.7 ± 11.1	57.1 ± 12.6	0.64	0.758
Sperm DFI (%)		25.8 ± 18.6	25.9 ± 18.2	0.95	0.864

Notes: Data are presented as mean ± SD or number (%). *Comparison was performed between men with and without MetS using the independent-samples t-test and Chi-square test. P1 was age-adjusted p value by using logistic regression. Percentage of semen parameters were calculated in total of 501 after deducting 33 cases with azoospermia.

Abbreviations: DFI, DNA fragmentation index; PR, progressive; MetS, metabolic syndrome.

Table 6 The Correlation Between Sperm Morphology and DFI with Anthropometry

Factors	Abnormal Sperm Head		Sperm DFI
	Rho	P-value	Rho	P-value
WC (cm)	0.067	0.14	0.094	0.04
WHR	0.095	0.03	0.095	0.03
WHtR	0.061	0.18	0.101	0.03
SBP (mmHg)	0.115	0.01	−0.037	0.41

Note: Pearson’s bivariate correlations was used to find the negative or positive relationship.

Abbreviations: DFI, DNA fragmentation index; SBP, systolic blood pressure; WC, waist circumference; WHR, waist-to-hip ratio; WHtR, waist-to-height ratio.