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Renin-Angiotensin System overactivation in polycystic ovary syndrome, a risk for SARS-CoV-2 infection?

Abu Saleh Md Moin1, Thozhukat Sathyapalan2, Stephen L Atkin3

  • 1Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), PO Box 34110, Doha, Qatar.

Metabolism Open
|August 25, 2020
PubMed
Abstract

Insights

Polycystic ovary syndrome (PCOS) is linked to Renin-Angiotensin System (RAS) overactivity, with altered RAS protein levels observed in women with PCOS. This may increase their risk for severe COVID-19 due to insulin resistance.

Area of Science:

  • Endocrinology
  • Cardiovascular Science
  • Reproductive Medicine

Background:

  • Polycystic Ovary Syndrome (PCOS) shares metabolic and cardiovascular risk factors with conditions linked to Renin-Angiotensin System (RAS) overactivity.
  • SARS-CoV-2 utilizes the ACE2 receptor for cell entry, a component of the RAS.
  • RAS overactivity is implicated in metabolic syndrome, type 2 diabetes (T2D), and obesity.

Purpose of the Study:

  • To investigate potential Renin-Angiotensin System (RAS) overactivity in women with Polycystic Ovary Syndrome (PCOS).
  • To compare plasma levels of key RAS-related proteins between women with and without PCOS.

Main Methods:

  • Plasma levels of Angiotensin-Converting Enzyme 2 (ACE2), Renin, and Angiotensinogen (AGT) were measured using SOMA-scan technology.
  • A cohort of 146 women with PCOS and 97 age-matched control women were analyzed.
  • Clinical and biochemical parameters including BMI, blood pressure, and hormone levels were assessed.

Main Results:

  • Women with PCOS exhibited higher BMI, blood pressure, waist circumference, testosterone, and CRP levels.
  • Elevated Renin and lower Angiotensinogen levels in PCOS women indicate Renin-Angiotensin System (RAS) overactivity.
  • Lower ACE2 levels in PCOS women suggest an increased risk for hypertension development.

Conclusions:

  • Plasma levels of RAS proteins differ significantly between women with and without PCOS.
  • Insulin resistance associated with PCOS may predispose women to more severe COVID-19 outcomes.
  • Findings suggest a potential link between PCOS, RAS dysregulation, and infectious disease susceptibility.
Keywords:
ACE2 proteinAngiotensinogenPolycystic ovary syndromeRenin

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