The association of vitamin D, semen parameters, and reproductive hormones with male infertility: A cross-sectional study.

Background: The prevalence of vitamin D deficiency and male infertility is high in Iran. Objective: The present research aimed to examine the association between serum vitamin D [25(OH)D], parameters of semen including semen volume, sperm count, motility and morphology, and reproductive hormones in infertile Iranian men. Materials and Methods: This was a cross-sectional study on 119 infertile men conducted between September 2018 and May 2019. Subjects were divided into 3 groups based on serum vitamin D levels: deficient ( < 10 ng/mL), insufficient (10 ng/mL ≤ 25(OH)D ≤ 30 ng/mL), and sufficient ( > 30 ng/mL). Body mass index and waist circumference were measured. 25(OH)D, testosterone, sex hormone-binding globulin, luteinizing hormone (LH), follicle-stimulating hormone and estradiol levels, and semen parameters were assessed. Results: The semen volume, sperm counts, total and progressively motile sperm, normal sperm morphology, testosterone levels, and testosterone/estradiol ratio were substantially higher in the sufficient group compared to the other groups (p < 0.001). Also, in the sufficient group, serum LH (p < 0.001) and estradiol (p < 0.001, p = 0.01) were notably lower and serum sex hormone-binding globulin (p < 0.001) and the testosterone/LH ratio (p < 0.001) were considerably higher compared to the insufficient and deficient groups. Conclusion: Our study showed a positive relationship between serum vitamin D levels, and seminal parameters and sex hormones in Iranian infertile males.

Vitamin D3 Supplementation Effects on Spermatogram and Oxidative Stress Biomarkers in Asthenozoospermia Infertile Men: a Randomized, Triple-Blind, Placebo-Controlled Clinical Trial.

The objective is to evaluate the effects of vitamin D3 (VD3) on sperm parameters and seminal and serum oxidative stress (OS) biomarkers in asthenozoospermia infertile men. This randomized, triple-masking, placebo-controlled clinical trial conducted on 86 asthenozoospermia infertile men with serum 25 hydroxy vitamin D3 (25-OH-D3) < 30 ng/ml in the infertility clinic of Ahvaz Jahad Daneshgahi, Iran. Patients were randomly allocated to groups A and B, who received daily 4000 IU vitamin D3 (VD3) and matching placebo respectively for 3 months. Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum and seminal levels of MDA (Malondialdehyde), 8-hydroxy-2- Dioxy Guanosine (8-OHDG), total antioxidant capacity (TAC) and calcium, sperm DNA fragmentation index (DFI), serum 25-OH-D3, parathyroid hormone (PTH), phosphorus, and sperm parameters were assessed. VD3 supplementation had no significant effects on body weight, body mass index (BMI), waist circumference (WC), body fat (BF), 8-OHDG, DFI, semen volume, sperm count, and normal sperm morphology, but increased post-intervention mean and mean change of serum 25-OH-D3 (P < 0.001, P < 0.001), PTH (P < 0.001, P < 0.001) and phosphorus (P = 0.009, P = 0.049) and seminal calcium (P = 0.035, P = 0.038) and serum calcium (P = 0.008, P = 0.009), seminal TAC (P < 0.001, P < 0.001), and serum TAC (P = 0.007, P = 005), total sperm motility (P < 0.001, P < 0.001) and progressive sperm motility (P < 0.001, P < 0.001) and decreased seminal MDA (P = 0.017, P = 0.004) and serum MDA (P = 006, P = 0.005) significantly compared to the baseline and placebo group respectively. VD3 supplementation may modulate OS and affect sperm motility in men with asthenozoospermia and serum 25-OH-D3 < 30 ng/ml. Iran Clinical Trials Registry, ID: IRCT20151128025274N4, registered on 28 March 2018, URL of trial registry record: https://www.irct.ir/trial/29983.

The effects of Vitamin D3 supplementation on Spermatogram and endocrine factors in asthenozoospermia infertile men: a randomized, triple blind, placebo-controlled clinical trial.

OBJECTIVE: Evaluate the effects of vitamin D3 (VD3) on sperm parameters and endocrine markers in infertile men with asthenozoospermia. MATERIALS AND METHODS: This randomized, triple-masking, placebo-controlled clinical trial conducted on 86 asthenozoospermia infertile men with serum 25 hydroxy vitamin D3 (25(OH)VD3) < 30 ng/ml in the infertility clinic of Ahvaz Jahad daneshgahi, Iran. Patients were randomly allocated to groups A and B, who received daily 4000 IU VD3 and matching placebo respectively for 3 months. Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum 25(OH)VD3, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), estradiol (E2),, sex hormone-binding globulin (SHBG), free androgen index (FAI = T/SHBG. 100), T/LH and T/E2 ratios, prolactin (PRO), parathyroid hormone (PTH), osteocalcin (OCN), phosphorus and sperm parameters were assessed. RESULTS: Three months VD3 supplementation with 4000 IU/day had no significant effects body weight, body mass index (BMI), waist circumference (WC), body fat (BF), serum, OCN, LH, FSH, T, E2, SHBG, PRO, T/E2 ratio, FAI, semen volume, sperm count and normal sperm morphology. It increases serum 25(OH)VD3, PTH and phosphorus and seminal and serum calcium, T/LH ratio and total and progressive sperm motility and decreased significantly compared to the baseline and placebo group. CONCLUSION: VD3 supplementation may affect sperm motility in men with asthenozoospermia and serum 25(OH)VD3 < 30 ng/ml. TRIAL REGISTRATION: Iran Clinical Trials Registry, ID: IRCT20151128025274N4, registered on 28 March 2018, URL of trial registry record: https://www.irct.ir/trial/29983.

Evaluation of the effect of vitamin D supplementation on spermatogram, seminal and serum levels of oxidative stress indices in asthenospermia infertile men: a study protocol for a triple-blind, randomized controlled trial.

BACKGROUND: It is suggested that vitamin D may have a beneficial role in male reproduction. The male reproductive system is a target tissue for vitamin D. This study will aim to evaluate the effects of vitamin D supplementation on sperm parameters, seminal and serum levels of oxidative stress and serum endocrine factors in asthenospermia infertile men. METHODS/DESIGN: This randomized, triple-blind, placebo-controlled clinical trial will be conducted on 86 infertile men with idiopathic asthenozoospermia (the mobility of sperm < 40% and rapid progressive sperm motility < 32%), with serum levels of vitamin D less than 30 ng / ml in the "Infertility Clinic of Ahvaz Jahad daneshgahi", Iran. MAIN OUTCOMES MEASURE (S): Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum and seminal levels of MDA (Malondialdehyde), 8-hydroxy-2- Dioxy Guanosine (8-OHDG), Total Antioxidant Capacity (TAC) and calcium, sperm DNA fragmentation index (DFI), serum 25-OHD, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), estradiol (E2), sex hormone-binding globulin (SHBG), free androgen index (FAI = T/SHBG. 100), T/LH and T/E2 ratios, prolactin (PRO), parathyroid hormone (PTH), osteocalcin (OCN), phosphorus and sperm parameters. DISCUSSION: The deficiency of vitamin D as an antioxidant is common all over the world. Numerous observational studies have shown a positive association between vitamin D levels and semen quality. However, few clinical studies have been conducted in this area. So considering with the high prevalence of this antioxidant deficiency specifically in infertile men, it seems that the supplementation of vitamin D in infertile men with insufficient levels or deficiency may improve the status of oxidative stress and thereby may affect sperm parameters and endocrine factors involved in male fertility. TRIAL REGISTRATION: Iran Clinical Trials Registry, ID: IRCT20151128025274N4 , registered on 28 March 2018.

Male adiposity, sperm parameters and reproductive hormones: An updated systematic review and collaborative meta-analysis.

The present updated systematic review and meta-analysis aims to summarize the evidence from published studies with low risk for any important bias (based on methodological quality assessment) investigating the potential associations of adiposity with sperm quality and reproductive hormones. We conducted a systematic search of the literature published in MEDLINE-PubMed and EMBASE through June 2019. Based on the criteria in our review, 169 eligible publications were used for data abstraction. Finally, 60 articles were included in the qualitative analysis and 28 in the quantitative analysis. Our systematic review results indicated that overweight and/or obesity were associated with low semen quality parameters (i.e., semen volume, sperm count and concentration, sperm vitality and normal morphology) and some specific reproductive hormones (e.g., inhibin B, total testosterone and sex hormone-binding globulin). Overweight and/or obesity were also positively associated with high estradiol concentrations. Meta-analysis indicated that overweight and/or obesity categories were associated with lower sperm quality (i.e., semen volume, sperm count and concentration, sperm vitality, total motility and normal morphology), and underweight category was likewise associated with low sperm normal morphology. In conclusion, our results suggest that maintaining a healthy body weight is important for increasing sperm quality parameters and potentially male fertility.

Effects of Concurrent Omega-3 and Cranberry Juice Consumption Along with Standard Antibiotic Therapy on the Eradication of Helicobacter pylori, Gastrointestinal Symptoms, Some Serum Inflammatory and Oxidative Stress Markers in Adults with Helicobacter pylori Infection: A Study Protocol for a Randomized Controlled Trial.

BACKGROUND: It seems alternative treatments such as antioxidant intervention and anti-inflammatory intervention adjuvant to antibiotic regimens may enhance cancer prevention approaches and decrease adverse side effects related to therapeutic antibiotic regimens. So, we will evaluate the effects of concurrent omega-3 and cranberry juice supplementation along with standard antibiotic therapy on the eradication of Helicobacter pylori, gastrointestinal symptoms, some serum inflammatory and oxidative stress markers in adults with HP infection. METHODS: We will conduct a 4-week double-blinded randomized clinical trial. The subjects will be randomly stratified according to sex and BMI using a permuted block randomization procedure by Random Allocation Software (RAS). They will be assigned to one of the four study groups: (1) cranberry juice fortified with omega-3 Intervention (n=23), (2) cranberry juice intervention group (n=23), (3) placebo beverage fortified with omega-3 intervention group (n=23), and (4) placebo beverage intervention (control group) (n=23). All statistical analyses will be performed using IBM SPSS Statistics software. DISCUSSION: A combination of alternative therapies may have a synergistic effect compared to a single approach. It could potentially be more effective in promoting the efficacy of standard antibiotic therapy in eradicating HP infection. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT20151128025274N3, www.irct.ir/trial/28997). TRIAL STATUS: This study is in the early stages of sampling.

The Impact of Obesity on Various Semen Parameters and Sex Hormones in Iranian Men with Infertility: A Cross-Sectional Study.

OBJECTIVE: The aim of this study was to examine the correlations between body mass index (BMI) and waist circumference (WC) and semen parameters (semen volume, sperm count, motility, and morphology) and sex hormones in Iranian men with infertility. MATERIALS AND METHODS: In this cross-sectional study, a total of 119 male patients who had lived as a partner in an infertile couple for at least 1 year, after regular unprotected sexual intercourse in their married life were investigated. BMI and WC were assessed, and a morning blood sample was taken assessing serum levels of testosterone (T), sex hormone-binding globulin (SHBG), prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2) and leptin. Semen-analysis parameters were also measured. RESULTS: Based on BMI and WC, the sperm count, total motility and progressive sperm were significantly lower in overweight and obese infertile males compared to that in normal weight infertile males and those with WC<102 cm. In addition, the fraction of sperm with abnormal morphology was significantly higher in infertile men with WC>102 cm compared to that in those with WC<102 cm. Moreover serum levels of LH, FSH, and leptin were significantly higher in overweight and obese infertile males compared to that in normal weight infertile males and those with WC<102 cm. Moreover serum level of E2 was significantly higher in obese infertile males compared to the normal weight infertile males and in those with WC>102 cm compared to the WC<102 cm. Furthermore, serum level of T was significantly lower in obese infertile males compared to the overweight infertile males and in those with WC>102 cm compared to the WC<102 cm. The mean of T/E2 ratio also was significantly lower in obese infertile males vs overweight and normal weight infertile males and in those with WC>102 cm compared to the WC<102 cm. CONCLUSION: We concluded that overweight and obesity in infertile men compared to those with normal weight may worsen the infertility situation.

The Impacts of Synbiotic Supplementation on Periodontal Indices and Biomarkers of Oxidative Stress in Type 2 Diabetes Mellitus Patients with Chronic Periodontitis Under Non-Surgical Periodontal Therapy. A Double-Blind, Placebo-Controlled Trial.

AIM: The aim of the current study was to investigate that combination of the synbiotic supplementation in adjunct with non-surgical periodontal therapy (NSPT) is useful in treating periodontitis and biomarkers of oxidative stress in type 2 diabetes mellitus (T2DM) patients. METHODS: In this study, 47 patients suffering from DM and CP were recruited and randomly assigned to two groups. The intervention (n= 23) and control (n=24) groups received either multispecies probiotic supplement plus 100 mg fructo-oligosaccharide (500 mg in each capsule) or placebo capsule containing 500 mg wheat flour, respectively, every day for 8 weeks. All subjects were treated with NSPT during the intervention period. Serum levels of interleukin-1ß (IL-1ß), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and periodontal indices including clinical attachment loss (CAL), pocket depth (PD) (main outcome), BOP, and plaque index were measured before and after the intervention. RESULTS: Supplementation with the synbiotic with NSPT led to a significant decrease in the levels of IL-1ß, MDA, plaque index, PD, and CAL in the intervention group post-intervention (p < 0.05). The serum levels of TAC, SOD, and GPx were significantly increased in the intervention group compared with the baseline (p < 0.05). Consumption of synbiotic with NSPT, compared to the control, resulted in a significant decrease in the mean changes of IL-1ß, MDA, and CAL (p < 0.05). Also, the mean changes of TAC and GPx were significantly higher in the intervention group compared with the control group (p < 0.05). Also, in the intervention group was seen a significant reduction in plaque index (p = 0.035) and BOP (p = 0.04) compared with the control group. CONCLUSION: It was observed that synbiotic supplementation with NSPT may be beneficial in improving inflammatory, antioxidant, and periodontal status in T2DM patients with CP.

Effects of the Consumption of Probiotic Yogurt Containing Bifidobacterium lactis Bb12 on the Levels of Streptococcus mutans and Lactobacilli in Saliva of Students with Initial Stages of Dental Caries: A Double-Blind Randomized Controlled Trial.

Dental caries, caused by oral microbiota, is one of the most common human diseases. The present study aimed to investigate the effect of consumption of probiotic yogurt containing Bifidobacterium lactis Bb12 on salivary Streptococcus mutans and lactobacilli in students with initial stages of dental caries. In this double-blind randomized placebo-controlled clinical trial, 66 students (18-30 years) with initial stages of dental caries were selected and randomly assigned into 2 groups: the intervention group received 300 g/day of probiotic yogurt and the control group received 300 g/day of conventional yogurt for 2 weeks. An unstimulated fasting saliva sample was collected pre- and post-intervention. Bacterial counting was performed for salivary S. mutans and lactobacilli. A significant reduction in salivary S. mutans and lactobacillus counts was observed in the intervention group compared to their baseline and compared to the control group. In conclusion, it is suggested that the consumption of probiotic yogurt containing B. lactis Bb12 may modify the oral biofilm.

Distribution of genes encoding resistance to macrolides, lincosamides, and streptogramins among methicillin-resistant Staphylococcus aureus strains isolated from burn patients.

The increasing resistance to macrolide, lincosamide, and streptogramin B agents among methicillin-resistant Staphylococcus aureus (MRSA) is a worldwide problem for the health community. This study aimed to investigate the prevalence of ermA, ermB, ermC, and msrA in MRSA strains isolated from burn patients in Ahvaz, southwest of Iran. A total of 76 isolates of S. aureus were collected from January to May 2017 from Taleghani Burn Hospital in Ahvaz. Among 76 S. aureus strains collected, 60 (78.9%) isolates were MRSA. The antimicrobial susceptibility testing for MRSA showed extreme high resistance rate to clarithromycin (100%) and azithromycin (100%), followed by erythromycin (98.3%). The PCR assay revealed that the frequency rates of msrA, ermA, and ermC genes were 23 (38.3%), 28 (46.7%), and 22 (36.7%), respectively. In addition, none of the MRSA isolates had the ermB gene. Because of the high prevalence of macrolide and lincosamide resistance found in MRSA isolates from infections of burn patients in Ahvaz, southwest of Iran, it is recommended that local periodic survey be performed for controlling the dissemination of antimicrobial resistance.

Effects of Chicory Leaf Extract on Serum Oxidative Stress Markers, Lipid Profile and Periodontal Status in Patients With Chronic Periodontitis.

AIM: The aim of present study was to evaluate the effects of chicory leaf extract on serum oxidative stress markers, lipid profile, and periodontal status in patients with chronic periodontitis. METHODS: In this double-blind, randomized controlled clinical trial 40 patients with chronic periodontitis were allocated to intervention and control groups. The intervention group received a 1-gram chicory leaf methanolic extract capsule twice daily for 8 weeks. In the control group, participants received a placebo capsule (containing 1 gram wheat flour) twice daily for 8 weeks. All participants had nonsurgical periodontal therapy during the study. Anthropometric measurements, dietary intake, total antioxidant capacity (TAC), malondialdehyde (MDA), uric acid, lipid profile (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]), and pocket depth (PD) were assessed before and after intervention. RESULTS: The results showed that mean serum TAC, uric acid, and HDL-C increased and mean serum MDA, TG, LDL-C, and TC decreased significantly in the intervention group compared to their baseline and the control group post-intervention. A significant difference was observed in mean PD between the two groups. CONCLUSION: Chicory leaf extract as an adjunct nutritional approach with nonsurgical periodontal therapy may be helpful in controlling periodontal status.

Impact of Cranberry Juice Enriched with Omega-3 Fatty Acids Adjunct with Nonsurgical Periodontal Treatment on Metabolic Control and Periodontal Status in Type 2 Patients with Diabetes with Periodontal Disease.

OBJECTIVES: Cranberries, high in polyphenols, have been associated with a favorable glycemic response in patients with type 2 diabetes and also are beneficial for oral health. Because type 2 diabetes mellitus and periodontal disease have a physiological relationship, this study aimed to evaluate the hypothesis that cranberry juice enriched with omega-3 will improve glycemic and lipid profiles and periodontal status in patients with diabetes with periodontal disease. MATERIALS AND METHODS: In this randomized clinical trial, 41 patients with diabetes (age 35-67 years) with periodontal disease were recruited and randomly assigned to 4 groups: control (C; n = 12), receiving omega-3 (I1; n = 10, 1 g/ twice daily), cranberry juice (I2; n = 9, 200 ml, twice daily), and cranberry juice enriched with omega-3 (I3; n = 10, 200 ml, containing 1 g omega-3) twice daily for 8 weeks. Nonsurgical periodontal therapy was provided for all patients during the study. Fasting blood glucose and glycated hemoglobin, lipid profile, probing depth, anthropometric indices, and 3-day 24-hour dietary recalls were measured pre- and postintervention. RESULTS: Glycated hemoglobin was decreased significantly in I1 and I3 groups. Serum high-density lipoprotein cholesterol (HDL-C) levels increased significantly in the I3 group compared to baseline and compared to I1 and I2 groups. Probing depth was significantly reduced in all groups postintervention. CONCLUSION: Consumption of cranberry juice enriched with omega-3 can be beneficial as adjuvant therapy with nonsurgical periodontal therapy in decreasing glycated hemoglobin, increasing HDL-C, and improving periodontal status in patients with diabetes with periodontal disease.

Effects of omega-3 fatty acids on the frequency, severity, and duration of migraine attacks: A systematic review and meta-analysis of randomized controlled trials.

The present systematic review with meta-analysis of randomized controlled trials (RCTs) aimed to analyze the effectiveness of omega-3 fatty acids on the frequency, severity, and duration of migraine. This systematic review was performed by searching several databases for controlled clinical trials. Of the 13 trials, five, two, and three RCTs met the eligibility criteria to evaluate the efficacy of omega-3 on the frequency, duration, and severity of migraine attacks, respectively. The Jadad scale was used to evaluate the risk of bias analysis. Overall estimates of the intervention effect were obtained from random-effect meta-analysis. The studies' heterogeneity was evaluated using the chi-squared test (χ2) (Cochran's test (Q test)) and I2 Index. Potential sources of heterogeneity among the trials were investigated by meta-regression analyses. The results showed that omega-3 intake had no effect on frequency (WMD = -0.20; 95%CI -0.67, 0.27; P = 0.401, and I2 = 4.6%; P = 0.380) and severity (SMD = -0.59; 95%CI -1.85, 0.66; P = 0.35, and I2 = 88.8%; P = 0.000) of migraine but had a reduction effect on the duration of migraine attacks (WMD = -3.44; 95%CI -5.70, -1.19; P = 0.003, and I2 = 0.0%; P = 0.926). In conclusion, omega-3 intake leads to a significant reduction of approximately 3.44 hours in the duration of migraine. Further randomized controlled trials of high methodological quality with adequate sample sizes are required to confirm the results of the meta-analyses.

Effects of Arctium lappa L. (Burdock) root tea on inflammatory status and oxidative stress in patients with knee osteoarthritis.

AIM: This study was designed to examine the effect of Burdock root tea on inflammatory markers and oxidative stress indicators in patients with knee osteoarthritis (OA). METHODS: Thirty-six patients (10 men and 26 women) aged 50-70 years old with knee osteoarthritis referred to the Physical Medicine and Rehabilitation Department of the Tabriz University of Medical Sciences Hospitals, were selected for the study and randomly divided into two groups. Anthropometric measurements, including height, weight and body mass index (BMI) were measured. For all individuals along the 42 days of study period, the same drug treatments, including two lots of 500 mg acetaminophen twice a day and one glucosamine 500 mg once a day,were considered. The intervention group received daily three cups of Burdock root tea (each cup containing 2 g/150 mL boiled water) half-hour after the meal. The control group received three cups containing 150 cc boiled water daily. We assessed inflammatory markers such as high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) and oxidative stress indicators such as total antioxidants capacity (TAC), glutathione peroxidase (GPX), superoxide dismutase (SOD) and thiobarbituric acid reactive substances before and after the intervention. RESULTS: The results showed that burdock root tea significantly decreased the levels of serum IL-6 (P = 0.002), hs-CRP (P = 0.003) and malondialdehyde (P < 0.001), while the levels of serum TAC (P < 0.001) and activities of SOD (P = 0.009) were significantly increased. GPX activities increased but not significantly. CONCLUSIONS: The results suggested that Arctium lappa L. root tea improves inflammatory status and oxidative stress in patients with knee osteoarthritis.