Key result
The D allele of the ACE I/D polymorphism was significantly associated with increased PCOS risk in Caucasians (OR 2.02, p=0.005) and correlated with insulin resistance in Asians.
Why the study?
The study was conducted to clarify the effects of angiotensin converting enzyme (ACE) I/D polymorphism on the risk of insulin resistance and polycystic ovary syndrome.
Is the ACE I/D polymorphism associated with the risk of insulin resistance and polycystic ovary syndrome?
Meta-Analysis (n=5,526)
Is the ACE I/D polymorphism associated with the risk of insulin resistance and polycystic ovary syndrome?
Odds Ratio: 2.02
p-value: p=0.005
The D allele of the ACE I/D polymorphism is associated with an increased risk of PCOS development and insulin resistance, with ethnic differences in presentation.
INTRODUCTION: This study was performed to clarify the effects of angiotensin converting enzyme (ACE) I/D polymorphism on the risk of insulin resistance and polycystic ovary syndrome (PCOS). METHODS: Six genotype models and the mean difference (MD)/standardized mean difference (SMD) were applied to evaluate the effects of ACE I/D polymorphism on insulin resistance and PCOS risk. RESULTS: Thirteen studies with 3,212 PCOS patients and 2,314 controls were collected. In the pooled analysis and Caucasian subgroup, the ACE I/D polymorphism was significantly associated with PCOS risk, even after removing the non-Hardy-Weinberg equilibrium (HWE) studies. Moreover, the positive effect of ACE I/D polymorphism in PCOS was mainly presented in Caucasians (removing non-HWE, DD + DI vs. II: odds ratio [OR] = 2.15, p = 0.017; DD vs. DI + II: OR = 2.64, p = 0.007; DD vs. DI: OR = 2.48, p = 0.014; DD vs. II: OR = 3.31, p = 0.005; D vs. I: OR = 2.02, p = 0.005) compared to Asians. Interestingly, only in Asians was the ACE I/D polymorphism significantly correlated to insulin levels (DI vs. II: SMD = 0.19, 95% CI = (0.03, 0.35), p = 0.023) and HOMA-IR (DI vs. II: MD = 0.50, 95% CI = (0.05, 0.95), p = 0.031). CONCLUSIONS: The D allele of the ACE I/D polymorphism promotes PCOS development. Moreover, the ACE I/D polymorphism was also associated with insulin-resistant PCOS, especially among Asians.
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Li et al. (2023) conducted a meta-analysis in Insulin Resistance and Polycystic Ovary Syndrome (n=5,526). ACE I/D polymorphism (D allele) vs. I allele / Controls was evaluated on PCOS risk (D vs. I allele in Caucasians) (OR 2.02, p=0.005). The D allele of the ACE I/D polymorphism was significantly associated with increased PCOS risk in Caucasians (OR 2.02, p=0.005) and correlated with insulin resistance in Asians.
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