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

Yıl 2019, Cilt: 12 Sayı: 1, 13 - 22, 18.01.2019

Cihan Kabukçu , Gülşen Vardar

https://doi.org/10.31362/patd.415288

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

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