Renin-angiotensin system: involvement in polycystic ovarian syndrome

Objective: To investigate the relationship between renin-angiotensin system (RAS) and polycystic ovarian syndrome (PCOS)

Methods: A pituitary-stimulating test with luteinizing hormone releasing hormone (LRH, 100 micrograms) was performed in two PCOS groups with similar mean testosteron (T) levels of luteinizing hormone/follicular stimulating hormone (LH/FSH) (LH/FSH > or = 3, group 1, n = 15; LH/FSH < 3, group 2, n = 15) and the controls (n = 20) of matched body mass index with group 1. The basal level and LRH-evoked responses of LH, plasma renin activity (PRA), angiotensin II (AT II ) and aldosterone (ALD) were measured by RIA with commercially available kits. In the basal state, a positive correlation was found between T and AT II levels (r = 0. 49, P < 0.05) in all PCOS subjects. After LRH administration, susceptible individuals, especially of group 1 had exaggerated responses of LH, PRA, AT II and ALD as compared with the controls, and a positive correlation was also found between peak levels of LH and AT II (r = 0.54, P < 0.01).

Conclusions: There is enhanced RAS function in PCOS especially in group 1. This may contribute to the excess androgen production and high incidence of ovarian hyperstimulation syndrome in this disorder.