Objective: To explore the relationship between male sexual function and daily exposure to bisphenol A (BPA) at a reproductive center in Taiyuan. Methods: Male patients who were seeking treatment of infertility due to problems caused by either of the spouse were selected from the Shanxi reproductive center between September 2014 and April 2015. Information on general characteristics, sexual function and fasting venous blood samples were collected. Total scores of sexual function were evaluated by Delphi expert scoring method. Levels of serum BPA were measured by high-performance liquid chromatography. Data was analyzed by Spearman rank correlation, rank sum test, multivariate logistic regression analysis and χ(2) trend test. Relationship between BPA and sexual function was presented as OR and corresponding 95%CI. Results: Among the 353 participants, 45.0% was defined as sexual dysfunction with low sexual desire (47.3%) as the major reason. BPA was detected in all the 353 patients, with a range of concentration as 0.38-21.93 ng/ml and an average as 5.79 ng/ml. Results from the Spearman rank correlation analysis revealed significant negative correlations between serum BPA and sexual function, sexual desire, erectile ability and ejaculation intensity, while serum BPA was positively correlated with premature ejaculation. According to the four percentile of BPA concentration (ng/ml), the subjects were divided into four groups. Compared with the low concentration group (0.38-3.79 ng/ml), the risk of sexual dysfunction significantly increased in the groups with higher BPA levels. Particularly, in the highest BPA group (8.68-21.93 ng/ml), more obvious effects were seen on sexual dysfunction (OR=1.55, 95%CI:1.00-3.23), reduced sexual desire (OR=4.75, 95%CI: 2.44-9.22), reduced erection ability (OR=2.40, 95%CI: 1.18-4.88), reduced ejaculation intensity (OR=2.53, 95%CI: 1.25-5.16) and premature ejaculation (OR=1.95, 95%CI: 1.02-3.72). Conclusion: Low sexual desire appeared as the main type of male sexual dysfunction, the exposure to higher levels of BPA in daily life might lead to male sexual dysfunction.
目的： 探讨双酚A（BPA）日常生活暴露与男性性功能的关系。 方法： 选取2014年9月至2015年4月在山西省妇幼保健院生殖中心门诊部因不孕不育就诊的男性作为研究对象，收集其一般人口学特征、性功能状况资料和空腹静脉血标本。应用德尔菲专家评分法计算性功能总得分，采用高效液相色谱法测定研究对象血清BPA水平。采用Spearman秩相关、秩和检验，多因素logistic回归分析进行BPA水平、影响因素、性功能指标之间的关联性及趋势分析。 结果： 共纳入353名研究对象，总体性功能异常率为45.0%，性欲低下（47.3%）为性功能异常的主要类型。研究对象血清BPA浓度范围为0.38~21.93 ng/ml，中位数5.79 ng/ml。血清BPA水平与总体性功能、性欲、勃起能力、射精力度均呈负相关，与早泄呈正相关。按BPA水平的四分位数分组，以低浓度组（0.38~3.79 ng/ml）为参照进行关联性分析，发现BPA水平增高可增加性功能障碍的发生风险。 结论： 性欲低下是男性性功能障碍的主要类型，日常暴露于较高水平的BPA可能增加男性性功能障碍。.
Keywords: Bisphenol A; Male; Sexual dysfunction.