The role of plasma renin activity in distinguishing patients with polycystic ovary syndrome (PCOS) from oligomenorrheic patients without PCOS

Abstract

All the components of the renin-angiotensin system have been identified in the human ovary. Renin plays a major role in folliculogenesis, and possibly in follicular atresia. Polycystic ovary syndrome (PCOS)is characterized by early follicular atresia. We studied whether assessment of plasma renin activity would be useful for diagnosing PCOS and distinguishing PCOS and non-PCOS in oligomenorrheic patients.Patients were divided into three groups: PCOS group (group 1, n = 40), non-PCOS oligomenorrheic group (group 2, n = 30) and ovulatory control group (group 3, n = 30). Plasma renin activity was determinedin the early follicular phase of the menstrual cycle. Baseline serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, insulin, aldosterone and androgens (total testosterone,free testosterone, androstenedione, dehydroepiandrosterone sulfate and 17α hydroxyprogesterone) were determined in all groups. The mean LH level was lower (4.94 ± 4.65 mIU/ml) in control patientsthan in PCOS patients (12.9 ± 1.75 mIU/ml) and non-PCOS oligomenorrheic patients (10.8 ± 1.65 mIU/ml). There was no statistically significant difference between the groups regarding FSH levels.The mean plasma renin activity was 3.47 ± 0.29 ng/ml in the PCOS group. The mean plasma renin activity was 1.59 ± 0.21 ng/ml the non-PCOS oligomenorrheic group (statistically significiantdifferrence). There was no statistically significant difference between the non-PCOS oligomenorrheic (1.59 ± 0.21 ng/ml) and control groups (1.2 ± 0.16 ng/ml). Use of plasma renin activityalone as a diagnostic marker in PCOS is not useful, because the clinical findings of PCOS are heterogeneous and the pathogenesis is unclear. However, it can be used together with other variables to diagnosewomen with PCOS and to distinguish non-PCOS oligomenorrheic women from those with PCOS.