Polycystic Ovary Syndrome is Affected and Protected by DD and DI Genotypes of Angiotensin Converting Enzyme, Respectively: An Update of a Meta-Analysis

Abstract

IntroductionAngiotensin 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 metaanalysis 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 MethodsWe 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 had bee...

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