Lifestyle and occupation risk factors for poor semen quality: a cross sectional study in Sri Lanka

Background: Infertility is a major problem all around the world. According to WHO, the rate of infertility is approximately 15% worldwide and it differ from geographical location, ethnicity and social status. Lifestyle habits, environmental and occupational hazards, physical parameters can be recognized as major risk factors which may affect male infertility. The objective of this study was to determine factors associated with male infertility in Sri Lankan context.Methods: A cross-sectional study was conducted on 299 individuals participated for an infertility clinic at Castle Street Teaching Hospital, Colombo, Sri Lanka. Socio-demographic, occupational and environmental characteristics were collected using interviewer administered questionnaire. Semen samples were collected from each participant for laboratory investigations. Sperm concentration and motility were measured.Results: Out of total participants, 30.1% of participants had a sperm concentration of <15×10⁶ and the sperm motility was <32% in 34.7% participants.  Older age, tobacco smokers, using tight under wears and individuals exposed to either heat or chemical hazards were identified as risk groups with low sperm concentration and low semen volume. In addition, older age, individuals using tight under wears and individuals exposed to either heat or chemical hazards were significantly associated with low or abnormal sperm mortality. Individuals having diabetes showed a significantly higher non-motility rate of sperms. Alcohol usage, betel chewing, mumps, special radiation exposure, body mass index and waist circumference were not significantly associated with semen parameters in study population.Conclusions: Older age, tobacco smoking, wearing tight underwear, occupational exposures, and diabetes mellitus has shown a risk for the generation of poor semen parameters, which can lead to male infertility. Furthermore, it is very important to carry out extended studies regarding this problem to establish the effect of above factors

Metals and Metallothionein Expression in Relation to Progression of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka

Chronic kidney disease of unknown etiology was investigated for metal relations in an endemic area by a cross-sectional study with CKD stages G1, G2, G3a, G3b, G4, G5 (ESRD), and endemic and nonendemic controls (EC and NEC) as groups. Subjects with the medical diagnosis were classified into groups by eGFR (SCr, CKD-EPI) and UACR of the study. It determined 24 metals/metalloids in plasma (ICPMS) and metallothionein (MT) mRNA in blood (RT-PCR). MT1A at G3b and MT2A throughout G2&ndash;G5 showed increased transcription compared to NEC (ANOVA, p &lt; 0.01). Both MT1A and MT2A remained metal-responsive as associations emerged between MT2A and human MT inducer Cr (in EC: r = 0.54, p &lt; 0.05, n = 14), and between MT1A and MT2A (in EC pooled with G1&ndash;G5: r = 0.58, p &lt; 0.001, n = 110). Human MT (hMT)-inducers, namely Zn, Cu, As, Pb, and Ni; &Sigma; hMT-inducers; 14 more non-inducer metals; and &Sigma; MT-binding metals remained higher (p &lt; 0.05) in EC as compared to NEC. Declining eGFR or CKD progression increased the burden of Be, Mg, Al, V, Co, Ni, Rb, Cs, Ba, Mn, Zn, Sr, &Sigma; hMT-inducers, and &Sigma; MT-binding metals in plasma, suggesting an MT role in the disease. MT1A/2A mRNA followed UACR (PCA, Dendrogram: similarity, 57.7%). The study provides evidence that proteinuric chronic renal failure may increase plasma metal levels where blood MT2A could be a marker