Muthusami, K R (2005) Effect of Chronic Alcoholism and Smoking in Male Reproductive Function. Doctoral thesis, The Tamilnadu Dr. M.G.R. Medical University, Chennai.
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Abstract
The effect of chronic alcoholism, chronic smoking and chronic alcoholism with smoking on pituitary, testicular hormones and semen pertaining to male reproductive functions were studied in human beings. The male population who were included in the study were categorized into four groups: Group I. Control (non alcoholics and non smokers), Group II. Alcoholics, Group III. Smokers and Group IV. Alcoholics with smoking. The Questionnaire specially prepared for this study were carefully analyzed. Subjects falling under the age group of 20 to 50 years, married, who are free from chronic diseases were selected. Based on the questionnaire, the inclusion and exclusion criteria were fixed and the eligible subjects were included in the present study. All the investigations planned in the study were done before alcohol deaddiction treatment. Alcohol and smoking are two different pleasure-seeking habits. Initially people start these for fun but slowly most of the people become addicted to these habits. Controls and smokers were selected from 6000 people registered in Health registry. About 1700 de-addiction center alcoholic persons were screened and selected for alcoholics and alcoholics with smoking groups. In all the subjects, haematological parameters such as haemoglobin, total WBC count, differential WBC count, platelet count, total RBC count, MCV, MCH, MCHC, PCV were estimated. Biochemical parameters such as glucose, creatinine, total bilirubin, total protein, albumin, globulin, albumin / globulin ratio, SGPT, alkaline phosphatase, gamma GT, cholesterol, triglycerides, HDLcholesterol, LDL – cholesterol, VLDL-cholesterol and phospholipids were estimated in blood. Functions of liver and kidneys, lipid profile, glucose and haematological parameters were found statistically normal. Along with above results clinical examination was carried out by a physician showed that all the subjects were free from diseases. The inclusion criteria such as age limit, volume of alcohol consumption, duration of alcohol consumed in a week, number of years of consumption of alcohol in a row and number of cigarettes smoked in a day, libido, potency and fertility status data were tabulated and statistically analyzed. Fertility hormones FSH, LH, testosterone, progesterone, estradiol and prolactin were estimated in blood. Volume of semen, sperm count, sperm motility (sperm rapid progressive motility, slow or sluggish motility, non progressive motility and immotility), viability (alive sperm and dead sperm) and sperm morphology (normal morphology, head defective morphology, neck defective morphology and tail defective morphology) were analysed. The semen viscosity, pH, color, appearance and fructose were also analysed. The testosterone and progesterone levels in the blood were found to be significantly decreased in alcoholics and alcoholics with smoking. The levels of FSH, LH, and estrodiol in the blood were significantly increased in alcoholics and alcoholics with smoking. Prolactin level in the blood was not significantly altered in alcoholics and alcoholics with smoking. Smoking alone did not alter the levels of the above hormones in blood. The volume of semen, sperm count, motility, viability and morphology were decreased in alcoholics and alcoholics with smoki ng. In smokers, the volume of semen and the morphology of sperm were not affected, but the sperm count, motility and viability were decreased. Seminal pH, viscosity, appearance, color and fructose were found to be normal in all the groups studied. In the present study, on alcoholics, the testicular hormonal and seminal impairments were observed. Alcohol affected both testicular Leydig cells and seminiferous tubule functions. In Leydig cells, alcohol decreased the synthesis of testosterone, progesterone hormones and increased the synthesis of estradiol, which might be by way of altering the functions of steroidogenesis enzymes. Because of the suppression of testosterone, the pituitary feedback regulation was affected and by the compensatory mechanism, the pituitary LH was increased. At seminiferous tubular level, the toxicity of alcohol might acted on Sertoli cells, germ cells, accessory sex organs and decreased the process of spermatogenesis and spermiogenesis, which might have led to decreased semen volume, sperm count, motility, viability and morphology. This variation was due to decreased testosterone level in blood and the entry of alcohol directly to seminiferous tubules. Due to the loss of seminiferous tubular function, the pituitary FSH level was increased. This elevated FSH levels in alcoholics demonstrated that the alcohol was having direct toxic effects at seminiferous tubule Sertoli cells and germ cells. The increased level of estradiol revealed that the metabolic clearance (aromatization) rate of testosterone was accelerated in alcoholics. Along with low sperm count, decreased testosterone level and increased estradiol level in blood, alcohol decreased the libido, potency and led to male infertility. In the present study, chronic cigarette smoking, did not produce any alteration in the levels of testosterone, progesterone, estradiol, FSH, LH and prolactin in the blood. Smoking reduced the semen quality to a certain extent. Smoking might have acted on germ cells and accessory sex organs directly and decreased the process of spermatogenesis, spermiogenesis and led to decreased total sperm concentration, viability and motility. The semen volume and morphology of the sperm were not affected by smoking. An unaltered levels of testosterone in smokers suggested that the smoking acted only at seminiferous tubules and it was not at Leydig cells. Chronic smoking was having a definite toxic effect on male reproduction by altering the sperm count, motility, and viability. Because of this, male infertility was possible to a certain limit. Sexual functions, libido and potency were not affected much by smoking alone because testosterone, the male reproductive hormone was not affected. In this study, it is found that chronic alcoholism together with chronic smoking increased the severity of the reproductive illnesses compared to alcoholism or smoking alone. Due to the toxicity of alcohol together with smoke on the steroidogenesis pathway, the synthesis of testosterone and progesterone decreased and estradiol was found to be elevated significantly. The toxicity of alcohol together with smoking acted at the level of testicular Leydig cell steroidogenic enzymes, StAR protein, autocrine and paracrine regulations and decreased the progesterone and testosterone levels in blood. Elevated levels of FSH and LH were noted in alcoholics with smoking. These elevations were due to the decreased negative feedback regulations on pituitary. The toxicity of alcohol together with smoking acted at seminiferous tubular Sertoli cells, germ cells and accessory sex organs, decreased the semen quality severely along with decreased testosterone. Semen sperm count was significantly suppressed, the progressive motile sperms were significantly reduced, sluggish motile, non-progressive motile and immotile sperms were significantly increased in alcoholics with smoking. In the viability study, alcoholics with smoking have a significant negative effect on alive sperms. Dead sperms were found to be significantly increased. Morphology of sperms was significantly altered by alcohol with smoking. Percentage of normal sperm morphology decreased and abnormal forms like defective head, neck and tail were increased in alcoholics with smoking. In the libido and potency study, smoking did not alter the libido and potency significantly. Alcohol and alcohol with smoking decreased the libido and potency significantly. This may be due to the decreased level of testosterone in blood. In the fertility status, smoking had less effect, followed by alcohol, which was having more effect and alcohol together with smoking the effect was very severe. Decreased blood testosterone and seminal parameters, decreased libido and potency might be the reason for the decreased fertility in alcoholics and alcoholics with smoking. In smokers the decreased sperm quality alone decreased the male fertility to a certain extent. It is concluded that cigarette smoking decreased the male reproductive function in unique direction by acting at testicular germ cells, accessory sex organs and decreased the semen quality alone. Alcohol has decreased the reproductive function bidirectionally, one by acting at testicular Leydig cells, decreasing the male reproductive hormone testosterone and the other by acting at seminiferous tubular Sertoli cells, germ cells and accessory sex organs and decreasing the semen quality. Consumption of alcohol and smoking together have severely suppressed the male reproductive function by further decreasing testosterone and semen quality. Therefore, by reviewing the effects of alcohol, smoking and alcohol with smoking, it is concluded that smoking has less toxic effect by impairing only the semen quality and alcohol abuse is having more toxic effect than smoking is evidenced by decrease in blood testosterone level and semen quality. Alcohol together with smoking the toxicity on male reproductive function is increased further. All the possible toxic actions of alcohol and smoke are at testicular level than at the central pituitary level. Further to know about the molecular mechanisms involved in the present study of decreased levels of testosterone, progesterone, increased levels of LH, FSH, estradiol in blood, decreased semen quality in alcoholics and alcoholics with smoking and the decreased semen quality alone in smokers, additional molecular level study needs to be carried out. To know the status of restoration of testosterone, progesterone, estradiol, LH, FSH levels in blood and the quality of semen in alcoholics, smokers and alcoholics with smoking, a further study on the withdrawal of the habits of chronic alcoholism, chronic smoking and chronic alcoholism with smoking can be carried out. This research has proved beyond doubt that chronic alcohol consumption and chronic smoking have a detrimental effect on the male reproductive hormones and also on the quality of semen, which, in turn, will make people impotent and sterile. Hence, men are advised to refrain from these addictions if they want to procreate and also to lead a normal sexual life.
| Item Type: | Thesis (Doctoral) |
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| Uncontrolled Keywords: | Chronic Alcoholism, Smoking, Male, Reproductive Function. |
| Subjects: | Respiratory Medicine > Biochemistry > Respiratory Medicine > Biochemistry |
| Depositing User: | Devi S |
| Date Deposited: | 16 Jun 2017 07:07 |
| Last Modified: | 11 Sep 2022 11:47 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5 |
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