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Published in: Journal of Assisted Reproduction and Genetics 3/2014

01-03-2014 | Gonadal Physiology and Disease

Plasminogen Activator Inhibitor-1 -675 4G/5G Polymorphism and Polycystic Ovary Syndrome Risk: A Meta Analysis

Authors: Ying Liu, Mei-Guo Sun, Rong Jiang, Rui Ding, Zhen Che, Yan-Yan Chen, Ci-Jiang Yao, Xiao-Xia Zhu, Ji-Yu Cao

Published in: Journal of Assisted Reproduction and Genetics | Issue 3/2014

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Abstract

Purpose

Several studies have reported that excessive amounts of plasminogen activator inhibitor-1(PAI-1) might increase the incidence of polycystic ovary syndrome(PCOS), but so far the published results were inconsistent. The aim of this study was to further investigate the association between PAI-1 gene polymorphism and the susceptibility to PCOS by performing a meta-analysis.

Methods

A comprehensive literature search for relevant studies was conducted on google scholar, PubMed, the Chinese National Knowledge Infrastructure (CNKI) and the Chinese Biomedical Literature Database (CBM). This meta-analysis was performed using the STATA 11.0 software and the pooled odds ratio (OR) with 95 % confidence interval (CI) was calculated.

Results

Ten case–control studies were included in this meta-analysis with a total of 2,079 cases and 1,556 controls. The results showed that PAI-1 -675 4G/5G polymorphism may increase the risk of PCOS, especially among Asian populations. However, there was no statistically significant association between the polymorphism and PCOS risk in Caucasians.

Conclusion

Our meta-analysis suggests that PAI-1 -675 4G/5G polymorphism may contribute to increasing susceptibility to PCOS in Asians. Detection of the PAI-1 gene polymorphism might be a promising biomarker for the susceptibility of PCOS.
Literature
1.
go back to reference Urbanek M, Nampiaparampil G, D’Souza J, Sefton E, Ackerman C, Legro RS, et al. The role of genetic variation in the lamin a/c gene in the etiology of polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:2665–9.PubMedCentralPubMedCrossRef Urbanek M, Nampiaparampil G, D’Souza J, Sefton E, Ackerman C, Legro RS, et al. The role of genetic variation in the lamin a/c gene in the etiology of polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:2665–9.PubMedCentralPubMedCrossRef
2.
go back to reference Asuncion M, Calvo RM, San MJL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434–8.PubMed Asuncion M, Calvo RM, San MJL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434–8.PubMed
3.
go back to reference March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010;25:544–51.PubMedCrossRef March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010;25:544–51.PubMedCrossRef
4.
go back to reference Li R, Zhang Q, Yang D, Li S, Lu S, Wu X, et al. Prevalence of polycystic ovary syndrome in women in China: a large community-based study. Hum Reprod. 2013;28:2562–9.PubMedCrossRef Li R, Zhang Q, Yang D, Li S, Lu S, Wu X, et al. Prevalence of polycystic ovary syndrome in women in China: a large community-based study. Hum Reprod. 2013;28:2562–9.PubMedCrossRef
5.
go back to reference Motta AB. The role of obesity in the development of polycystic ovary syndrome. Curr Pharm Des. 2012;18:2482–91.PubMedCrossRef Motta AB. The role of obesity in the development of polycystic ovary syndrome. Curr Pharm Des. 2012;18:2482–91.PubMedCrossRef
6.
go back to reference Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Rev Mol Med. 2008;10:e3.PubMedCrossRef Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Rev Mol Med. 2008;10:e3.PubMedCrossRef
7.
go back to reference Diamanti-Kandarakis E, Economou F. Stress in women: metabolic syndrome and polycystic ovary syndrome. Ann N Y Acad Sci. 2006;1083:54–62.PubMedCrossRef Diamanti-Kandarakis E, Economou F. Stress in women: metabolic syndrome and polycystic ovary syndrome. Ann N Y Acad Sci. 2006;1083:54–62.PubMedCrossRef
8.
go back to reference Dokras A. Cardiovascular disease risk factors in polycystic ovary syndrome. Semin Reprod Med. 2008;26:39–44.PubMedCrossRef Dokras A. Cardiovascular disease risk factors in polycystic ovary syndrome. Semin Reprod Med. 2008;26:39–44.PubMedCrossRef
9.
go back to reference Shan Y, Wang A, Sun Y, Jiang W, Pang B, An Z, et al. Coagulation and fibrinolytic indices during the first trimester of pregnancy in women with polycystic ovary syndrome: a preliminary study. Reproductive sciences (Thousand Oaks, Calif). 2013;20:1390–7.CrossRef Shan Y, Wang A, Sun Y, Jiang W, Pang B, An Z, et al. Coagulation and fibrinolytic indices during the first trimester of pregnancy in women with polycystic ovary syndrome: a preliminary study. Reproductive sciences (Thousand Oaks, Calif). 2013;20:1390–7.CrossRef
10.
go back to reference Becker RC. Thrombogenesis in atrial fibrillation: contributing mechanisms and natural history. J Thromb Thrombolysis. 2008;26:262–4.PubMedCrossRef Becker RC. Thrombogenesis in atrial fibrillation: contributing mechanisms and natural history. J Thromb Thrombolysis. 2008;26:262–4.PubMedCrossRef
11.
go back to reference Diamanti-Kandarakis E, Spina G, Kouli C, Migdalis I. Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J Clin Endocrinol Metab. 2001;86:4666–73.PubMedCrossRef Diamanti-Kandarakis E, Spina G, Kouli C, Migdalis I. Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J Clin Endocrinol Metab. 2001;86:4666–73.PubMedCrossRef
12.
go back to reference DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials. 2007;28:105–14.PubMedCrossRef DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials. 2007;28:105–14.PubMedCrossRef
13.
go back to reference MANTEL N, HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719–48.PubMed MANTEL N, HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719–48.PubMed
14.
go back to reference Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.PubMedCrossRef Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.PubMedCrossRef
15.
go back to reference Glueck CJ, Wang P, Fontaine RN, Sieve-Smith L, Tracy T, Moore SK. Plasminogen activator inhibitor activity: an independent risk factor for the high miscarriage rate during pregnancy in women with polycystic ovary syndrome. Metabolism. 1999;48:1589–95.PubMedCrossRef Glueck CJ, Wang P, Fontaine RN, Sieve-Smith L, Tracy T, Moore SK. Plasminogen activator inhibitor activity: an independent risk factor for the high miscarriage rate during pregnancy in women with polycystic ovary syndrome. Metabolism. 1999;48:1589–95.PubMedCrossRef
16.
go back to reference San MJL, Corton M, Villuendas G, Sancho J, Peral B, Escobar-Morreale HF. Association of the polycystic ovary syndrome with genomic variants related to insulin resistance, type 2 diabetes mellitus, and obesity. J Clin Endocrinol Metab. 2004;89:2640–6.CrossRef San MJL, Corton M, Villuendas G, Sancho J, Peral B, Escobar-Morreale HF. Association of the polycystic ovary syndrome with genomic variants related to insulin resistance, type 2 diabetes mellitus, and obesity. J Clin Endocrinol Metab. 2004;89:2640–6.CrossRef
17.
go back to reference Zhao JL, Chen ZJ, Zhao YR, Zhao LX, Wang LC, Tang R, et al. Correlation between 4G and 5G genetypes distribution of plasminogen activator inhibitor-1 gene polymorphism in its promoter region with polycystic ovarian syndrome. Zhonghua Fu Chan Ke Za Zhi. 2005;40:528–31.PubMed Zhao JL, Chen ZJ, Zhao YR, Zhao LX, Wang LC, Tang R, et al. Correlation between 4G and 5G genetypes distribution of plasminogen activator inhibitor-1 gene polymorphism in its promoter region with polycystic ovarian syndrome. Zhonghua Fu Chan Ke Za Zhi. 2005;40:528–31.PubMed
18.
go back to reference Walch K, Grimm C, Huber JC, Nagele F, Kolbus A, Hefler LA. A polymorphism of the plasminogen activator inhibitor-1 gene promoter and the polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2005;123:77–81.PubMedCrossRef Walch K, Grimm C, Huber JC, Nagele F, Kolbus A, Hefler LA. A polymorphism of the plasminogen activator inhibitor-1 gene promoter and the polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2005;123:77–81.PubMedCrossRef
19.
go back to reference Glueck CJ, Sieve L, Zhu B, Wang P. Plasminogen activator inhibitor activity, 4G5G polymorphism of the plasminogen activator inhibitor 1 gene, and first-trimester miscarriage in women with polycystic ovary syndrome. Metabolism. 2006;55:345–52.PubMedCrossRef Glueck CJ, Sieve L, Zhu B, Wang P. Plasminogen activator inhibitor activity, 4G5G polymorphism of the plasminogen activator inhibitor 1 gene, and first-trimester miscarriage in women with polycystic ovary syndrome. Metabolism. 2006;55:345–52.PubMedCrossRef
20.
go back to reference Karadeniz M, Erdogan M, Berdeli A, Saygili F, Yilmaz C. 4G/5G polymorphism of PAI-1 gene and Alu-repeat I/D polymorphism of TPA gene in Turkish patients with polycystic ovary syndrome. J Assist Reprod Genet. 2007;24:412–8.PubMedCentralPubMedCrossRef Karadeniz M, Erdogan M, Berdeli A, Saygili F, Yilmaz C. 4G/5G polymorphism of PAI-1 gene and Alu-repeat I/D polymorphism of TPA gene in Turkish patients with polycystic ovary syndrome. J Assist Reprod Genet. 2007;24:412–8.PubMedCentralPubMedCrossRef
21.
go back to reference Zhang Z, YAng J, Tian Y, Liang H. A study on relationship between PAI-1gene polymorphism and PCOS. Chinese Journal of Women and Child Health Research. 2008;19:541–3. Zhang Z, YAng J, Tian Y, Liang H. A study on relationship between PAI-1gene polymorphism and PCOS. Chinese Journal of Women and Child Health Research. 2008;19:541–3.
22.
go back to reference Sun L, Lv H, Wei W, Zhang D, Guan Y. Angiotensin-converting enzyme D/I and plasminogen activator inhibitor-1 4G/5G gene polymorphisms are associated with increased risk of spontaneous abortions in polycystic ovarian syndrome. J Endocrinol Invest. 2010;33:77–82.PubMed Sun L, Lv H, Wei W, Zhang D, Guan Y. Angiotensin-converting enzyme D/I and plasminogen activator inhibitor-1 4G/5G gene polymorphisms are associated with increased risk of spontaneous abortions in polycystic ovarian syndrome. J Endocrinol Invest. 2010;33:77–82.PubMed
23.
go back to reference Lin S, Huiya Z, Bo L, Wei W, Yongmei G. The plasminogen activator inhibitor-1 (PAI-1) gene -844 A/G and -675 4G/5G promoter polymorphism significantly influences plasma PAI-1 levels in women with polycystic ovary syndrome. Endocrine. 2009;36:503–9.PubMedCrossRef Lin S, Huiya Z, Bo L, Wei W, Yongmei G. The plasminogen activator inhibitor-1 (PAI-1) gene -844 A/G and -675 4G/5G promoter polymorphism significantly influences plasma PAI-1 levels in women with polycystic ovary syndrome. Endocrine. 2009;36:503–9.PubMedCrossRef
24.
go back to reference Sales M, Soter M, Candido A, Fernandes A, Oliveira F, Ferreira A, et al. Correlation between plasminogen activator inhibitor-1 (PAI-1) promoter 4G/5G polymorphism and metabolic/proinflammatory factors in polycystic ovary syndrome. Gynecol Endocrinol. 2013;29:936–9.PubMedCrossRef Sales M, Soter M, Candido A, Fernandes A, Oliveira F, Ferreira A, et al. Correlation between plasminogen activator inhibitor-1 (PAI-1) promoter 4G/5G polymorphism and metabolic/proinflammatory factors in polycystic ovary syndrome. Gynecol Endocrinol. 2013;29:936–9.PubMedCrossRef
25.
go back to reference Glueck CJ, Wang P, Fontaine R, Tracy T, Sieve-Smith L. Metformin-induced resumption of normal menses in 39 of 43 (91%) previously amenorrheic women with the polycystic ovary syndrome. Metabolism. 1999;48:511–9.PubMedCrossRef Glueck CJ, Wang P, Fontaine R, Tracy T, Sieve-Smith L. Metformin-induced resumption of normal menses in 39 of 43 (91%) previously amenorrheic women with the polycystic ovary syndrome. Metabolism. 1999;48:511–9.PubMedCrossRef
26.
go back to reference Diamanti-Kandarakis E, Palioniko G, Alexandraki K, Bergiele A, Koutsouba T, Bartzis M. The prevalence of 4G5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene in polycystic ovarian syndrome and its association with plasma PAI-1 levels. Eur J Endocrinol. 2004;150:793–8.PubMedCrossRef Diamanti-Kandarakis E, Palioniko G, Alexandraki K, Bergiele A, Koutsouba T, Bartzis M. The prevalence of 4G5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene in polycystic ovarian syndrome and its association with plasma PAI-1 levels. Eur J Endocrinol. 2004;150:793–8.PubMedCrossRef
27.
go back to reference Zhuang Z, Shen Z, Huang Y, Xu W. Polymorphism in plasminogen activator inhibitor-1 (PAI-1) gene and obese polycystic ovarian syndrome. Medical Innovation of China. 2013;10:1–3. Zhuang Z, Shen Z, Huang Y, Xu W. Polymorphism in plasminogen activator inhibitor-1 (PAI-1) gene and obese polycystic ovarian syndrome. Medical Innovation of China. 2013;10:1–3.
28.
go back to reference Attia J, Thakkinstian A, D’Este C. Meta-analyses of molecular association studies: methodologic lessons for genetic epidemiology. J Clin Epidemiol. 2003;56:297–303.PubMedCrossRef Attia J, Thakkinstian A, D’Este C. Meta-analyses of molecular association studies: methodologic lessons for genetic epidemiology. J Clin Epidemiol. 2003;56:297–303.PubMedCrossRef
29.
go back to reference Midgette AS, Wong JB, Beshansky JR, Porath A, Fleming C, Pauker SG. Cost-effectiveness of streptokinase for acute myocardial infarction: A combined meta-analysis and decision analysis of the effects of infarct location and of likelihood of infarction. Med Decis Making. 1994;14:108–17.PubMedCrossRef Midgette AS, Wong JB, Beshansky JR, Porath A, Fleming C, Pauker SG. Cost-effectiveness of streptokinase for acute myocardial infarction: A combined meta-analysis and decision analysis of the effects of infarct location and of likelihood of infarction. Med Decis Making. 1994;14:108–17.PubMedCrossRef
30.
go back to reference Diamanti-Kandarakis E, Piperi C. Genetics of polycystic ovary syndrome: searching for the way out of the labyrinth. Hum Reprod Update. 2005;11:631–43.PubMedCrossRef Diamanti-Kandarakis E, Piperi C. Genetics of polycystic ovary syndrome: searching for the way out of the labyrinth. Hum Reprod Update. 2005;11:631–43.PubMedCrossRef
31.
go back to reference Abbott DH, Bacha F. Ontogeny of polycystic ovary syndrome and insulin resistance in utero and early childhood. Fertil Steril. 2013;100:2–11.PubMedCrossRef Abbott DH, Bacha F. Ontogeny of polycystic ovary syndrome and insulin resistance in utero and early childhood. Fertil Steril. 2013;100:2–11.PubMedCrossRef
32.
go back to reference Dumesic DA, Richards JS. Ontogeny of the ovary in polycystic ovary syndrome. Fertil Steril. 2013;100:23–38.PubMedCrossRef Dumesic DA, Richards JS. Ontogeny of the ovary in polycystic ovary syndrome. Fertil Steril. 2013;100:23–38.PubMedCrossRef
33.
go back to reference Atiomo WU, Bates SA, Condon JE, Shaw S, West JH, Prentice AG. The plasminogen activator system in women with polycystic ovary syndrome. Fertil Steril. 1998;69:236–41.PubMedCrossRef Atiomo WU, Bates SA, Condon JE, Shaw S, West JH, Prentice AG. The plasminogen activator system in women with polycystic ovary syndrome. Fertil Steril. 1998;69:236–41.PubMedCrossRef
34.
go back to reference Cui L, Zhao H, Zhang B, Qu Z, Liu J, Liang X, et al. Genotype-phenotype correlations of PCOS susceptibility SNPs identified by GWAS in a large cohort of Han Chinese women. Hum Reprod. 2013;28:538–44.PubMedCrossRef Cui L, Zhao H, Zhang B, Qu Z, Liu J, Liang X, et al. Genotype-phenotype correlations of PCOS susceptibility SNPs identified by GWAS in a large cohort of Han Chinese women. Hum Reprod. 2013;28:538–44.PubMedCrossRef
35.
go back to reference Morgan JA, Bombell S, McGuire W. Association of plasminogen activator inhibitor-type 1 (-675 4G/5G) polymorphism with pre-eclampsia: systematic review. PLOS ONE. 2013;8:e56907.PubMedCentralPubMedCrossRef Morgan JA, Bombell S, McGuire W. Association of plasminogen activator inhibitor-type 1 (-675 4G/5G) polymorphism with pre-eclampsia: systematic review. PLOS ONE. 2013;8:e56907.PubMedCentralPubMedCrossRef
36.
go back to reference Zhang T, Pang C, Li N, Zhou E, Zhao K. Plasminogen activator inhibitor-1 4G/5G polymorphism and retinopathy risk in type 2 diabetes: a meta-analysis. BMC Med. 2013;11:1.PubMedCentralPubMedCrossRef Zhang T, Pang C, Li N, Zhou E, Zhao K. Plasminogen activator inhibitor-1 4G/5G polymorphism and retinopathy risk in type 2 diabetes: a meta-analysis. BMC Med. 2013;11:1.PubMedCentralPubMedCrossRef
37.
go back to reference Su MT, Lin SH, Chen YC, Kuo PL. Genetic association studies of ACE and PAI-1 genes in women with recurrent pregnancy loss: a systematic review and meta-analysis. Thromb Haemost. 2013;109:8–15.PubMedCrossRef Su MT, Lin SH, Chen YC, Kuo PL. Genetic association studies of ACE and PAI-1 genes in women with recurrent pregnancy loss: a systematic review and meta-analysis. Thromb Haemost. 2013;109:8–15.PubMedCrossRef
Metadata
Title
Plasminogen Activator Inhibitor-1 -675 4G/5G Polymorphism and Polycystic Ovary Syndrome Risk: A Meta Analysis
Authors
Ying Liu
Mei-Guo Sun
Rong Jiang
Rui Ding
Zhen Che
Yan-Yan Chen
Ci-Jiang Yao
Xiao-Xia Zhu
Ji-Yu Cao
Publication date
01-03-2014
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 3/2014
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-013-0171-2

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