Insertion / deletion polymorphism of angiotensin-converting enzyme gene in ovarian hyperstimulation syndrome patients

Öz

Purpose: Previous studies have shown that ovary contains all the components of renin-angiotensin system. Renin-angiotensin system may play a primary role in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). In this study our purpose was to investigate the relationship between the angiotensin-converting enzyme (ACE) gene polymorphism and OHSS in high risk patients for the syndrome.

Materials and methods:  47 patients who have undergone controlled ovarian hyperstimulation cycle (control n: 25; OHSS n: 22) were recruited in the study. Estradiol levels of all patients in both group were higher than 3000 pg/ml . Age, duration of infertility, total gonadotropin dose, induction time, total follicular number, endometrial thickness and cause of infertility were recorded. DNA was extracted, and the insertion/deletion polymorphism of ACE gene was detected by polymerase chain reaction (PCR).

Results: There were no statistically difference in age, duration of infertility, total gonadotropin dose, induction time and endometrial thickness between control and OHSS group. Follicle number was higher in OHSS group (p<0,001). There were no difference in the ACE  II – ID – DD  genotypes between OHHS and control group patients (p>0,05). Homozygotes for the deletion polymorphism (DD genotype) were found 1,47 times higher in OHSS group (OR: 1,47 %95 confidence interval, 0,44 - 4,86) but this was statistically insignificant.

Conclusion: These data indicate that ACE gene I/D polymorphism is not associated with OHSS. ACE gene polymorphism doesn’t play a major role in the pathogenesis of OHSS.

Anahtar Kelimeler

• Ovarian hyperstimulation syndrome,angiotensin converting enzyme,polymorphism

Ovaryan hipersimulasyon sendromlu hastalarda anjiotensin dönüştürücü enzim geni insersiyon / delesyon polimorfizmi

Öz

Amaç: Ovaryan hiperstimulasyon sendromu (OHSS) riski altındaki hastalarda, anjiotensin dönüştürücü enzim (ACE) gen insersiyon / delesyon (I/D) polimorfiziminin ovaryan hiperstimulasyon sendromu gelişiminde etkisinin olup olmadığının belirlenmesidir.

Gereç ve yöntem: Yardımcı üreme teknikleri tedavisi için ovulasyon indüksiyon programına alınan, ve human koryonik gonadotropin yapıldığı gün estradiol seviyesi 3000 pg/ml’den fazla olan, OHSS gelişimi için yüksek risk altında bulunan 47 infertil hasta dahil edildi. Hastaların yaşı, infertilite süresi, kullanılan total gonadotropin dozu, indüksiyon süresi, elde edilen folikül sayısı, endometriyum kalınlığı ve infertilite nedeni kaydedildi. Kontrol (n:25) ve OHSS (n:22) grubu hastalarının ACE genine ait insersiyon/delesyon polimorfizmi, PCR yöntemiyle çalışılarak tesbit edildi.

Bulgular: Yaş, infertilite süresi, gonadotropin dozu, indüksiyon süresi, endometriyum kalınlık ölçümleri iki grup arasında anlamlı farklılık göstermedi. Folikül sayısı kontrol grubunda 17,1 ± 4,2 OHSS grubunda 25,4 ± 6,8 olarak bulundu. Her iki grup arasında bulunan fark anlamlıdır (p<0,001). OHSS grubunda ACE geni D allel frekansı %56,8 kontrol grubunda %54,0 ve toplam 47 hastadaki D allel frekansı %55,3 olarak bulundu. OHSS ve kontrol grubu ACE genotipi için karşılaştırıldığında iki grup arasında II – ID – DD genotipleri bakımından anlamlı fark bulunmamıştır(p>0,05). OHSS grubunda genotipin DD olma olasılığı, kontrol grubuna gore 1,47 kat daha yüksektir (OR: 1,47 %95 Güven Sınırı, 0,44-4,86) fakat istatistiksel olarak anlamlı değildir.

Sonuç: Çalışmada OHSS için yüksek riskli hastalarda ACE gen insersiyon/delesyon polimorfizmi çalışılmıştır. DD genotipinin oranı OHSS ve kontrol grubunda farklı değildir. ACE gen insersiyon/delesyon polimorfizminin, OHSS gelişiminde etken faktör olarak değerlendirilmemiştir.

Anahtar Kelimeler

• ovaryan hiperstimulasyon sendromu,anjiotensin-dönüştürücü enzim,polimorfizm

Kaynakça

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