A Meta-analysis Of Serum Inhibin B And Follicle Stimulating Hormone In Predicting Spermatogenesis In Non-obstructive Azoospermia Patients

Objective:Non-obstructive azoospermia(NOA): Azoospermia caused by abnormal testicular spermatogenesis.At present,the preferred method for predicting testicular spermatogenesis in patients with NOA is serum hormone testing.Among them,Inhibin B(INHB)and Follicle stimulating hormone(FSH)are widely used.Many scholars had reported the comparison of the predictive value of single and combined detection of INHB and FSH on testicular spermatogenesis in patients with NOA,but there was still controversy.The purpose of this article is to analyze the value of single or combined detection of INHB and FSH in predicting spermatogenic function of NOA patients by meta-analysis.Method:Electronically search the MEDLINE,Pub Med,CNKI and Wanfang databases to collect published Chinese and English full texts of related research on the predictive value of serum INHB test,FSH test and the combined test on testicular spermatogenesis of NOA patients And discharge criteria,and evaluate the quality of the literature.Use Stata SE 15.1 software to draw a forest map and a general receiver operator characteristic curve(SROC),and calculate the combined sensitivity(SEN),combined specificity(SPE),and positive likelihood ratio ratio(PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR),and area under the ROC curve(AUC).Meta-regression,sensitivity analysis,and subgroup analysis were used to explore sources of heterogeneity.Deek's funnel plots were used to evaluate publication bias.Fagan's nomograms were used to assess clinical potency.The t-test was performed on the relevant statistics of the three prediction methods.If P <0.05,the difference was statistically significant.Result:1.Including 14 related literatures on the predictive value of serum INHB on testicular spermatogenesis in NOA patients,the results were: Combined SEN: 0.71(95% CI: 0.63,0.79),Combined SPE: 0.80(95% CI: 0.69,0.88),PLR: 3.6(95% CI: 2.3,5.9),NLR: 0.36(95% CI: 0.27,0.47),DOR: 10(95% CI: 5,20),AUC: 0.81(95% CI: 0.77,0.84).2.Twelve relevant articles were included on the predictive value of serum FSH on testicular spermatogenesis in NOA patients.The results were: Combined SEN: 0.78(95% CI: 0.67,0.85),Combined SPE: 0.64(95% CI: 0.52,0.75),PLR: 2.2(95% CI: 1.5,3.1),NLR: 0.35(95% CI: 0.22,0.54),DOR: 6(95% CI: 3,13),AUC: 0.78(95% CI: 0.74,0.81).3.Five related literatures on the predictive value of combined testing of serum INHB and FSH on testicular spermatogenesis of NOA patients were included.The results were: Combined SEN: 0.78(95% CI: 0.64,0.87),Combined SPE: 0.85(95% CI: 0.72,0.92),PLR: 5.1(95% CI: 3.0,8.6),NLR: 0.26(95% CI: 0.17,0.41),DOR: 19(95% CI: 11,34),AUC: 0.88(95% CI: 0.85,0.91).4.The t-test was performed on the relevant statistics of the three methods for predicting spermatogenic function of NOA patients,and the P values were less than 0.05,suggesting statistical significance.Conclusion:1.Serum INHB and FSH have the best specificity.2.The combined detection of serum INHB and FSH has the same sensitivity as the single detection of FSH,but it is higher than the single detection of serum INHB.3.The combined detection of serum INHB and FSH has higher diagnostic value than the single test of both.