State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Gynecol Obstet Invest. 2023;88(3):174-184. doi: 10.1159/000530089. Epub 2023 Mar 24.
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).
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.
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).
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.
本研究旨在阐明血管紧张素转换酶（ACE）I/D 多态性对胰岛素抵抗和多囊卵巢综合征（PCOS）风险的影响。
采用 6 种基因型模型和均数差（MD）/标准化均数差（SMD）评估 ACE I/D 多态性对胰岛素抵抗和 PCOS 风险的影响。
共纳入 13 项研究，包含 3212 例 PCOS 患者和 2314 例对照。荟萃分析和白种人群亚组结果显示，ACE I/D 多态性与 PCOS 风险显著相关，即使去除非 Hardy-Weinberg 平衡（HWE）研究也是如此。此外，ACE I/D 多态性在 PCOS 中的阳性作用主要见于白种人（去除非 HWE，DD+DI 与 II 相比：比值比[OR] = 2.15，p = 0.017；DD 与 DI+II 相比：OR = 2.64，p = 0.007；DD 与 DI 相比：OR = 2.48，p = 0.014；DD 与 II 相比：OR = 3.31，p = 0.005；D 与 I 相比：OR = 2.02，p = 0.005）。有趣的是，仅在亚洲人群中，ACE I/D 多态性与胰岛素水平（DI 与 II 相比：SMD = 0.19，95%CI =（0.03，0.35），p = 0.023）和 HOMA-IR（DI 与 II 相比：MD = 0.50，95%CI =（0.05，0.95），p = 0.031）显著相关。
ACE I/D 多态性的 D 等位基因促进 PCOS 的发生。此外，ACE I/D 多态性也与胰岛素抵抗型 PCOS 相关，尤其是在亚洲人群中。
