Association of ACE2, Insulin Resistance, and Other Parameters in Obese Polycystic Ovary Syndrome Patients Infected with COVID-19

Main Article Content

Shaimaa Imad Ali
Fayhaa M. Khaleel
Ali Majeed Ali Almukram

Abstract

        Polycystic ovary syndrome (PCOS) has a high predisposition to many cardiometabolic risk factors that increase susceptibility to severe complications of COVID-19 and also exhibit an increased likelihood of subfertility. Therefore, women with polycystic ovary syndrome may be disproportionately affected by this epidemic and its related consequences. The accumulation of extra body fat that has the possibility of affecting health is referred to as obesity, which is the outcome of an imbalance between energy intake and expenditure, whereby more calories are consumed than are expended through exercise. This study investigated the relationship between angiotensin-converting enzyme 2 and insulin resistance and other parameters in PCOS patients with COVID-19 infection. The study groups comprised 120 sample ladies, involving 80 PCOS patients with and without COVID-19 and 40 control ladies. The leading group of patients was divided into subgroups based on BMI. Blood samples were taken from Kamal-Al-Samarai Hospital between December 2021 and June 2022. Some biochemical parameters were measured for all study groups, which included serum ACE2, D-dimer, lipid profile, GST activity, FBS, and hormones. PCOS women had a higher BMI, FBS, lipid profile (except high-density lipoprotein), D-dimer, waist/hip ratio, testosterone, insulin, and HOMA-IR (p < 0.0001). While GST-activity and ACE2 levels were lower in PCOS (p < 0.001), suggesting that PCOS women are at risk for cardiovascular diseases, In the current research, we found there is a probable relationship between ACE2 and HOMA IR in PCOS patients who have a coronavirus infection. 

Article Details

How to Cite
[1]
Ali, S.I. et al. 2024. Association of ACE2, Insulin Resistance, and Other Parameters in Obese Polycystic Ovary Syndrome Patients Infected with COVID-19. Ibn AL-Haitham Journal For Pure and Applied Sciences. 37, 3 (Jul. 2024), 287–295. DOI:https://doi.org/10.30526/37.3.3351.
Section
Chemistry

How to Cite

[1]
Ali, S.I. et al. 2024. Association of ACE2, Insulin Resistance, and Other Parameters in Obese Polycystic Ovary Syndrome Patients Infected with COVID-19. Ibn AL-Haitham Journal For Pure and Applied Sciences. 37, 3 (Jul. 2024), 287–295. DOI:https://doi.org/10.30526/37.3.3351.

Publication Dates

Received

2023-03-19

Accepted

0023-05-03

Published Online First

2024-07-20

References

Ali, S.E.; Khaleel, F.M.; Ali, F.E. A Study of Apelin-36 and GST Levels with Their Relationship to Lipid and Other Biochemical Parameters in The Prediction of Heart Diseases in PCOS Women Patients. Baghdad Science Journal. 2020, 17(3), 0924. http://dx.doi.org/10.21123/bsj.2020.17.3(Suppl.).0924.

Ali, L.; Khaleel, F.M.; Ali, F.E. Role of Apelin-13 and Its Relationship with Hormones levels and other Parameters in Iraqi Polycystic Ovary Syndrome patients. Annals of the Romanian Society for Cell Biology. 2021, 25(6), 8018-24. http://annalsofrscb.ro/index.php/journal/article/view/6994.

Ali, S.E.; Khaleel, F.M.; Ali, F.E. Estimation of Renin and D-Dimer Levels in Women with Polycystic Ovary Disease With or Without Coronavirus Infection. BJ-BABS. 2022, 3(4), 286-98. https://doi.org/10.47419/ bjbabs.v3i04.151.

Ali, S.E.; Khaleel, F.M.; Ali, F.E. Effect of Apelin-36 on Cardiovascular Disease and Its Relationship with other Parameters in Patients with PCOS. Journal of the College of Basic Education (وقائع المؤتمر العلمي الدولي الثاني/نقابة الاكاديميين العراققيين). 2020.

Christ, J.P.; Cedars, M.I. Current Guidelines for Diagnosing PCOS. Diagnostics 2023, 13(6), 1113. https://doi.org/10.3390/diagnostics13061113.

Ollila, M.M.; Arffman, R.K; Korhonen, E.; Morin-Papunen, L.; Franks, S.; Junttila, J.; Piltonen, T.T. Women With PCOS Have an Increased Risk for Cardiovascular Disease Regardless of Diagnostic Criteria a Prospective Population-Based Cohort Study. European Journal of Endocrinology. 2023, 189(1),96-105. https://doi.org/10.1093/ejendo/lvad077.

Barrea, L.; Verde, L.; Camajani, E.; Cernea, S.; Frias-Toral, E.; Lamabadusuriya, D.; Ceriani, F.; Savastano, S.; Colao, A.; Muscogiuri, G. Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS). Current Nutrition Reports. 2023, 12(1), 56-64. https://doi.org/10.1007/s13668-023-00456-1.

Eng, P.C.; Phylactou, M.; Qayum, A.; Woods, C.; Lee, H.; Aziz, S.; Moore, B.; Miras, A.D.; Comninos, A.N.; Tan, T.; Franks, S. Obesity-Related Hypogonadism in Women. Endocrine Reviews. 2024, 45(2), 171-89. https://doi.org/10.1210/endrev/bnad027.

Ibáñez L, de Zegher F. Adolescent PCOS: A Postpubertal Central Obesity Syndrome. Trends in Molecular Medicine. 2023, 29(5), 354-63. https://doi.org/10.1016/j.molmed.2023.02.006.

Barber, T.M.; Franks, S. Obesity and Polycystic Ovary Syndrome. Clinical endocrinology. 2021, 95(4), 531-41. https://doi.org/10.1111/cen.14421.

Saleh, B.O.; Al-Naddawi, A.M. Association between Serum Fructose Level and Insulin Resistance in Women with Polycystic Ovary Syndrome: The effect of obesity. Journal of the Faculty of Medicine Baghdad. 2022, 64(2), 91-5. https://doi.org/10.32007/jfacmedbagdad.6421926.

Ali, S.E.; Khaleel, F.M. Effect of COVID-19 on the Role of Renin Enzyme and ACE2 and Hormones in PCOS Females. Baghdad Science Journal. 2023, 20(6), 2249-2255.

https://dx.doi.org/10.21123/bsj.2023.7746.

Ali, S.E.; Khaleel, F.M. Assessing the Activity of Renin and GST in the Serum of Ladies Suffering from Polycystic Ovary Syndrome and COVID-19 to Predict the Danger of Cardiac Disease. Baghdad Science Journal. 2023, 20(3), 0986. https://dx.doi.org/10.21123/bsj.2023.7879.

Basavaraju, S.V.; Patton, M.E.; Grimm, K.; Rasheed, M.A.; Lester, S.; Mills, L.; Stump, f.M.; Freeman, B.; Tamin, A.; Harcourt, J.; Schiffer, J. Serologic Testing of US Blood Donations To Identify Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2)–Reactive Antibodies. Clinical Infectious Diseases. 2021, 72(12), e1004-1009. https://doi.org/10.1093/cid/ciaa1785.

Dilbaz, B. Are Women With Polycystic Ovary Syndrome More Vulnerable To COVID-19 Infection. Turkish journal of obstetrics and gynecology. 2021, 18(3), 221. https://doi.org/10.4274/tjod.galenos.2021.05014.

de Medeiros, S.F.; Yamamoto, M.M.; de Medeiros, M.A.; Yamamoto, A.K.; Barbosa, B.B. Polycystic Ovary Syndrome and Risks for COVID-19 Infection: A Comprehensive Review: PCOS and COVID-19 Relationship. Reviews in Endocrine and Metabolic Disorders. 2022, 23(2), 251-64. https://doi.org/10.1007/s11154-022-09715-y.

Subramanian, A.; Anand, A.; Adderley, N.J.; Okoth, K.; Toulis, K.A.; Gokhale, K.; Sainsbury, C.; O'Reilly, M.W.; Arlt, W.; Nirantharakumar, K. Increased COVID-19 Infections In Women With Polycystic Ovary Syndrome: A Population-Based Study. European journal of endocrinology. 2021, 184(5), 637-45. https://doi.org/10.1530/EJE-20-1163.

Han, H.; Xu, Z.; Cheng, X.; Zhong, Y.;Yuan, L.; Wang, F.; Li, Y.; Liu, F.; Jiang, Y.; Zhu, C.; Xia, Y. Descriptive, Retrospective Study of the Clinical Characteristics of Asymptomatic COVID-19 Patients. MSphere 2020, 5(5), e00922-20. https://doi.org/10.1128/msphere.00922-20.

Goren, A.V.; Vano-Galvan, S.; Wambier, C.G.; McCoy, J.; Gomez-Zubiaur, A.; Moreno-Arrones, O.M.; Shapiro, J.; Sinclair, R.D.; Gold, M.H.; Kovacevic, M.; Mesinkovska, N.A. A Preliminary Observation: Male Pattern Hair Loss among Hospitalized COVID-19 Patients in Spain-A Potential Clue To the Role of Androgens in COVID-19 Severity. J Cosmet Dermatol. 2020, 19(7), 1545-7. https://doi:10.1111/JOCD.13443.

Tahapary, D.L.; Pratisthita, L.B.; Fitri, N.A.; Marcella, C.; Wafa, S.; Kurniawan, F.; Rizka, A.; Tarigan, T.J.; Harbuwono, D.S.; Purnamasari, D.; Soewondo, P. Challenges in the Diagnosis of Insulin Resistance: Focusing on the Role Of HOMA-IR and Tryglyceride/Glucose Index. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2022, 16(8), 102581. https://doi.org/10.1016/j.dsx.2022.102581.

Zhang, X.; Li, S.; Niu, S. ACE2 And COVID-19 and the Resulting ARDS. Postgraduate medical journal. 2020, 96(1137), 403-7. https://doi.org/10.1136/postgradmedj-2020-137935.

Ni, W.; Yang, X.; Yang, D.; Bao, J.; Li, R.; Xiao, Y.; Hou, C.; Wang, H.; Liu, J.; Yang, D.; Xu, Y. Role of Angiotensin-Converting Enzyme 2 (ACE2) in COVID-19. Critical Care 2020, 24(12), 1-0. https://doi.org/10.1186/s13054-020-03120-0.

Scialo, F.; Daniele, A.; Amato, F.; Pastore, L.; Matera, M.G.; Cazzola, M.; Castaldo, G.; Bianco, A. ACE2: The Major Cell Entry Receptor For SARS-Cov-2. Lung 2020, 198:867-77. https://doi.org/10.1007/s00408-020-00408-4.

Lan, J.; Ge, J.; Yu, J.; Shan, S.; Zhou, H.; Fan, S.; Zhang, Q.; Shi, X.; Wang, Q.; Zhang, L.; Wang, X. Structure Of The SARS-Cov-2 Spike Receptor-Binding Domain Bound To The ACE2 Receptor. Nature 2020, 581(7807), 215-20. https://doi.org/10.1038/s41586-020-2180-5.

Huffman, A.M.; Rezq, S.; Basnet, J.; Yanes Cardozo, L.L.; Romero, D.G. SARS-CoV-2 Viral Entry Proteins in Hyperandrogenemic Female Mice: Implications for Women with PCOS And COVID-19. International Journal of Molecular Sciences. 2021, 22(9),4472. https://doi.org/10.3390/ijms22094472.

Moin, A.S.; Sathyapalan, T.; Atkin, S.L.; Butler, A.E. Renin-Angiotensin System Overactivation in Polycystic Ovary Syndrome, a Risk For SARS-Cov-2 Infection. Metabolism Open 2020, 7(15),100052. https://doi.org/10.1016/j.metop.2020.100052.

Sun, X.; Wu, X.; Zhou, Y.; Yu, X.; Zhang, W. Evaluation of Apelin And Insulin Resistance In Patients with PCOS and Therapeutic Effect of Drospirenone Ethinyl Estradiol Plus Metformin. Medical science monitor: International Medical Journal of Experimental and Clinical Research. 2015, 21 (14), 2547. https://doi: 10.12659/MSM.894926.

Moti, M.; Amini, L.; Ardakani, S.S.; Kamalzadeh, S.; Masoomikarimi, M. Oxidative Stress and Anti-Oxidant Defense System in Iranian Women with Polycystic Ovary Syndrome. Iranian journal of reproductive medicine. 2015, 13(6),373. PMCID: PMC4555058.

Kebapcilar, L.; Taner, C.E.; Kebapcilar, A.G.; Sari, I. High Mean Platelet Volume, Low-Grade Systemic Coagulation and Fibrinolytic Activation are Associated with Androgen and Insulin Levels in Polycystic Ovary Syndrome. Archives of gynecology and obstetrics. 2009, 280(56),187-93. https://doi.org/10.1007/s00404-008-0884-0.

Lehmann, A.; Prosch, H.; Zehetmayer, S.; Gysan, M.R.; Bernitzky, D.; Vonbank, K.; Idzko, M.; Gompelmann, D. Impact of Persistent D-Dimer Elevation Following Recovery from COVID-19. PLOS One. 2021, 16(10), e0258351.https://doi.org/10.1371/journal.pone.0258351.

Bannigida, D.M.; Nayak, B.S.; Vijayaraghavan, R. Insulin Resistance and Oxidative Marker in Women with PCOS. Archives of physiology and biochemistry. 2020, 126(2), 183.

https://doi.org/10.1080/13813455.2018.1499120.