Association of angiotensin-converting enzyme gene insertion/deletion polymorphism with polycystic ovary syndrome: a meta-analysis

Abstract

Introduction Angiotensin converting enzyme (ACE) is a renal enzyme catalyzing the conversion of angiotensin 1 to angiotensin 2. This, results in production of the aldosterone resulting in natrium retention and potassium excretion. ACE gene has 3 polymorphic genotypes of II, DI and DD. It has been observed in several studies and meta-analyses that patients with DD genotype are more at risk of renal and cardiovascular diseases. It seems that these effects could be due to hyperactivity of ACE gene in such patients (1,2). In addition to kidneys, ovaries have renin angiotensin system (RAS). The role of this system in ovulation and reproduction is not completely understood (3). Different histopathologic and angiogenic abnormal conditions result in pregnancy complications (4). Polycystic ovary syndrome (PCOS) is one of such conditions resulting in infertility and other complications of women's reproductive system (5). Based on a meta-analysis conducted by Jalilian et al, prevalence of PCOS in Iran was 6.8%, 4.41% and 19.5% based on NIH, ultrasound and Rotterdam criteria, respectively (6). Type 2 diabetes, obesity, metabolic syndrome, hypertension and so on are considered as risk factors of PCOS (7-9). Also metformin is used for the treatment, because of insulin resistance in such patients (10). All of these evidences give us clues that hypertension related genes like ACE my play roles in pathogenesis of PCOS. Of course it is not clear whether this role is associated with renal RAS, ovarian RAS or both. On the occasion of the clues and findings above, we intend to update the only meta-analysis conducted by Jia et al in 2013 on the association of ACE gene polymorphism and risk of PCOS (11). The reason of our attempt to update this meta-analysis was that Jia et al did not find any significant relation in their random-effect model meta-analysis. Materials and Methods We searched in databases for relevant keywords in the titles of the articles (Figure 1). Finally we found 8 relevant papers based on our inclusion criteria (similar protocols including similar criteria for their PCOS and control groups). In order to perform this meta-analysis, we used comprehensive meta-analysis version 2 software (Biostat, US). The analysis was done through the P value and sample size of each study using fixed-effect model. Analyses were performed in 5 different groups of allele and genotype comparisons (Table 1). This meta-analysis Abstract Objectives: Angiotensin converting enzyme (ACE) is an important enzyme involved in the physiopathology of renal, cardiovascular and ovarian systems. One of these ACE related diseases is polycystic ovary syndrome (PCOS). Materials and Methods: We intend to update the only meta-analysis written by Jia et al in 2013 on the association of ACE gene polymorphism and risk of PCOS. The reason of our attempt to update this meta-analysis was that they found no significant relation in their meta-analysis. For this aim, we searched in databases for relevant documents. Results: We found 8 relevant papers, 6 of which h...

Do ACE I/D gene polymorphism serve as a predictive marker for age at onset in PCOS?

“…Several studies reported no contribution of this polymorphism in susceptibility to PCOS, however, few studies did find a relationship with insulin resistance, hyperandrogenism and aggravated clinical manifestations of PCOS [16][17][18]. A recent meta-analysis by Jia Hongxia et al (2012) reported a significant relation between this polymorphism and PCOS risk in Caucasians but produced a null result for Asians [15]. Since no studies were reported from India, the present study was carried out in South Indian women in order to establish the role of ACE I/D polymorphism in susceptibility to PCOS.…”

“…To date, most of the studies conducted on PCOS patients from various ethnic groups differ in their reports [15]. Controversial reports of this polymorphism with the clinical manifestations such as insulin resistance and testosterone levels among the PCOS patients were also reported [16][17][18].…”

Angiotensin-Converting Enzymes Play a Dominant Role in Fertility

“…Genetic studies further demonstrate that polymorphisms in Ace1 are related to the risk factors for PCOS. Jia and his team proposed that Ace1 insertion/deletion (I/D) polymorphisms are associated with an increased risk for PCOS [81]. The D allele, which is found in approximately 55% of the population, is associated with increased ACE1 activity [82].…”

Polycystic ovarian syndrome: rs1799752 polymorphism of ACE gene

“…The meta-analysis performed by Jia et al 13 in 2013 showed no association of polymorphisms with PCOS in the general population. Only after stratification in ethnicities, it was concluded that the polymorphism is associated with the disease in Caucasian women, but it is not related in Asian women.…”

“…A meta-analysis involving six studies with 1,451 patients and 773 controls suggested that the polymorphism is associated with the risk of developing PCOS in Caucasian women. 13 In addition, there are no studies on this polymorphism and PCOS in Brazilian women. In view of the above, this study aimed to determine the frequency of the insertion (I)/deletion (D) polymorphism of the ACE gene (rs1799752) in patients with PCOS and to compare it with a control population in order to verify the association of this polymorphism with the syndrome.…”