Semen quality and reproductive endocrine function with regard to blood cadmium in Croatian male subjects

In 123 Croatian men with no occupational exposure to metals, the influence of cadmium on reproductive parameters was examined after adjusting for age, smoking, alcohol, and biomarkers of lead, copper, zinc, and selenium. The following variables were measured: blood cadmium (BCd), blood lead (BPb), activity of -aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin, serum copper (SCu), serum zinc (SZn), serum selenium (SSe), activity of glutathione peroxidase (GPx) in blood, testis size, semen quality (including sperm concentration, motility, viability, and morphology), indicators in seminal fluid (the lactate dehydrogenase isoenzyme LDH-C₄, fructose, zinc, acid phosphatase, and citric acid), and hormones in serum (follicle-stimulating hormone – FSH, luteinizing hormone, prolactin, testosterone, and estradiol). The median and range BCd values were 2.94 (0.49-11.93) g/L in 61 smokers and 0.59 (0.20-3.71) g/L in 62 nonsmokers (p<0.0001). Smoking habits (cigarettes/day) highly significantly correlated with BCd (p<0.0001). After adjusting for potential confounding variables by multiple regression, BCd was significantly associated with a decrease in testis size (p<0.03) and an increase in serum estradiol (p<0.005), FSH (p<0.03), and testosterone (p<0.04). Smoking was significantly associated with a decrease in serum prolactin (p<0.006) and LDH-C₄ in seminal fluid (p<0.03). Several reproductive parameters were significantly associated with BPb and ALAD, biomarkers of lead, and/or with SCu, SZn, SSe, and GPx. The necessity of controlling for various metals, and other potential confounders when assessing the influence of a particular metal on reproductive function in men, is emphasized.