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. 2025 Jul 17;23(1):101.
doi: 10.1186/s12958-025-01438-4.

Association between serum Vitamin D levels and sperm DNA fragmentation index in varicocele patients: a retrospective cohort study

Tianhong Cai  1 , Rong Zhang  1 , Kai Chen  1 , Jianfeng He  1 , Tenghui Zhan  2   3
Affiliations

Association between serum Vitamin D levels and sperm DNA fragmentation index in varicocele patients: a retrospective cohort study

Tianhong Cai et al. Reprod Biol Endocrinol. .

Abstract

Objective: While varicocele is a major cause of male infertility, the role of vitamin D in sperm DNA integrity remains unclear. This study aimed to investigate the association between serum vitamin D levels and sperm DNA fragmentation index (DFI) in varicocele patients.

Methods: This retrospective cohort study conducted at Fujian Maternity and Child Health Hospital included 355 varicocele patients aged 18-45 years (June 2021-June 2024). The primary exposure was serum 25-hydroxyvitamin D level, and the primary outcome was DFI. Multiple linear regression models were used to analyze the association between vitamin D and DFI, adjusting for age, BMI, smoking, alcohol consumption, and other confounders.

Results: A significant inverse association was found between vitamin D levels and DFI (β = -0.24, 95% CI: -0.28 to -0.19, P < 0.0001). Piecewise linear regression identified a threshold at 25.9 nmol/L, below which the inverse association was more pronounced (β = -1.0, 95% CI: -1.2 to -0.8, P < 0.001).

Conclusion: Serum vitamin D levels have been demonstrated to be significantly associated with the rate of sperm DNA fragmentation index in patients with varicocele, particularly at levels below 25.9 nmol/l.

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Conflict of interest statement

Declarations. Ethical approval: This study was approved by the Ethics Committee of Fujian Maternity and Child Health Hospital and strictly adhered to the tenets of the Declaration of Helsinki (IRB: No. 2025KY008). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Smooth curve fitting analysis of the relationship between serum vitamin D levels and DFI
Fig. 2
Fig. 2
Association between serum vitamin D and DNA fragmentation index
See this image and copyright information in PMC

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