Objective To investigate the change of sperm mitochondrial membrane potential in obese male infertility patients,and to explore the re⁃lationship of sperm mitochondrial membrane potential with the reactive oxygen species and free fatty acids in seminal plasma. Methods According to the research conditions,samples were randomly selected by cluster sampling from outpatient,and divided into normal body mass index fertile men as control group(n=51),normal body mass index infertile group(n=36),overweight infertile group(n=44),and obesity infertile group(n=45). Semen routine analysis was performed. Free fatty acid and reactive oxygen species in the seminal plasma was determined by ELSA method,sperm mitochondrial membrane potential was determined by flow cytometry. Results The rate of normal sperm mitochondrial membrane potential in nor⁃mal weight infertility(27.34%±13.38%),overweight infertility(28.26%±9.76%),obesity infertility group(25.27%±7.51%)were lower than the control group(35.12%±15.90%),the difference was statistically significant(P<0.05). Although obesity infertility group normal rate of mitochon⁃drial membrane potential were lower than normal weight infertility group and the overweight infertility group,but there was no statistically significant difference. The rate of sperm normal mitochondrial membrane potential was positively correlated with the rate of sperm progressive motility(r=0.29, P<0.01). Free fatty acid was positively correlated with reactive oxygen species in seminal plasma(r=0.30,P<0.01),reactive oxygen species in seminal plasma was negatively correlated with sperm normal mitochondrial membrane potential(r=-0.24,P<0.01). Conclusion Free fatty acid was elevated in the seminal plasma of overweight and obese patients with male infertility,which causes increased reactive oxygen species,reduced mitochondrial membrane potential,and eventually lead to the decline of sperm movement ability. Patients undergoing the treatment should be ad⁃vised to reduce the high fat diet and perform proper exercise.%目的：探讨肥胖男性不育患者精子线粒体膜电位的改变，以及线粒体膜电位与精浆中游离脂肪酸、活性氧之间的关系。方法按照研究条件，随机整群选取正常生育男性51人（对照组）、正常体重指数不育男性36人（正常体重不育组）、超重不育男性44人（超重不育组）、肥胖不育男性45人（肥胖不育组）。精液常规分析，ELSA法检测精浆中游离脂肪酸、活性氧，流式细胞仪检测精子线粒体膜电位。结果线粒体膜电位正常率的比较中正常体重不育组（27.34%±13.38%）、超重不育组（28.26%±9.76%）、肥胖不育组（25.27%±7.51%）均低于对照组（35.12%±15.90%），差异有统计学意义（P<0.01）。肥胖不育组中线粒体膜电位正常率虽然低于正常体重不育组及超重不育组，但差异无统计学意义。精子线粒体膜电位正常率与精子前向运动率呈明显正相关（r=0.29，P<0.01）。精浆中游离脂肪酸与精浆中活性氧呈明显正相关（r=0.30，P<0.01），精浆中活性氧与精子正常线粒体膜电位呈明显负相关（r=-0.24，P<0.01）。结论超重及肥胖男性不育患者精浆中游离脂肪酸增高，引起活性氧增加，活性氧使得线粒体膜电位下降，最终可能导致精子运动能力下降。治疗时应考虑建议患者减少高脂餐、适当运动。
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