title: Anogenital distance is associated with serum reproductive hormones, but not with semen quality in young men.
abstract: OBJECTIVE
  Is anogenital distance associated with semen parameters and serum reproductive hormone levels in males?
  
  
  CONCLUSIONS
  Anogenital distance is associated with serum reproductive hormones, but not with semen quality.
  
  
  BACKGROUND
  Epidemiological studies have suggested that anogenital distance (AGD) may be associated with testicular dysfunction in adult men. However, the role of AGD in estimating male reproductive function remains unclear.
  
  
  METHODS
  We examined the associations between AGD and semen parameters and reproductive hormones levels in 656 young college students in a Male Reproductive Health in Chongqing College Students (MARHCSs) cohort study in June of 2014.
  
  
  METHODS
  In this study, two variants of AGD (AGDAP and AGDAS) were measured in 656 university students. Serum levels of testosterone (T), estradiol (E2), progesterone (P), prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG) and inhibin-B; and semen quality outcomes, including semen volume, sperm concentration, total sperm number, sperm progressive motility, total motility and morphology, were assessed. The associations between AGD and semen parameters/reproductive hormones levels were analyzed using multiple regression analysis.
  
  
  RESULTS
  Both AGDAS and AGDAP were not associated with any semen parameters. In the non-parametric correlation analysis, AGDAP were correlated with sperm progressive motility and reproductive hormones of E2, testosterone, SHBG and the testosterone/LH ratio. However, body mass index (BMI) also significantly correlated with serum testosterone ( ITALIC! r = -0.216, ITALIC! P = <0.0001) and SHBG ( ITALIC! r = -0.229, ITALIC! P = <0.001). In the multiple regression models, AGDAP was negatively associated with the serum E2 level (95% CI, -0.198 to -0.043; ITALIC! P = 0.002) and positively associated with the ratio of T/E2 (95% CI, 0.004-0.011; ITALIC! P = 0.001) after an adjustment for BMI and other confounders.
  
  
  CONCLUSIONS
  Using only a single semen sample to predict male reproductive function over a longer period is a potential limitation of the present study. The other limitation is the cross-sectional nature of the study design. Longitudinal data from an extended follow-up on a large cohort would be more definitive.
  
  
  CONCLUSIONS
  Our results do not support previous studies where AGD is associated with male semen quality. The utility of AGD in predicting reproductive outcomes in adult males should thus be considered prudently.
  
  
  BACKGROUND
  This study was supported by the Key Program of Natural Science Funding of China (no. 81130051), Young Scientist Program of NSFC (no. 81502788) and the National Scientific and Technological Support Program of China (no. 2013BAI12B02). None of authors had any competing interests to declare.
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Niya
authors.initials: N
authors.lastname: Zhou
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Sun
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Huan
authors.initials: H
authors.lastname: Yang
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Chongqing Institute of Science and Technology for Population and Family Planning, Chongqing, PR China.
authors.forename: Hao
authors.initials: H
authors.lastname: Yang
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Lu
authors.initials: L
authors.lastname: Tan
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Hongqiang
authors.initials: H
authors.lastname: Chen
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Guowei
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Xi
authors.initials: X
authors.lastname: Ling
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Linping
authors.initials: L
authors.lastname: Huang
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zou
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Kaige
authors.initials: K
authors.lastname: Peng
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Taixiu
authors.initials: T
authors.lastname: Liu
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Jinyi
authors.initials: J
authors.lastname: Liu
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ao
authors.affiliation: Department of Environmental Health, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China.
authors.forename: Ziyuan
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China caojia1962@126.com zhihongcui_4@126.com.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Cui
authors.affiliation: Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, PR China caojia1962@126.com zhihongcui_4@126.com.
authors.forename: Jia
authors.initials: J
authors.lastname: Cao
mesh_terms: D000328:Adult; D001003:Anal Canal; D001699:Biometry; D004958:Estradiol / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D010413:Penis / Q000033:anatomy & histology; D010502:Perineum / Q000033:anatomy & histology*; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D055101:Semen Analysis; D013739:Testosterone / Q000097:blood
chemical_list: D012739:Gonadal Steroid Hormones; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: MARHCS study; anogenital distance; reproductive hormones; semen quality; testicular dysgenesis syndrome