Skip to main content
Log in

Lack of association of INS VNTR polymorphism with polycystic ovary syndrome: a meta-analysis

  • Genetics
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

An association between the INS VNTR polymorphisms and polycystic ovary syndrome (PCOS) susceptibility has been reported in previous studies, but the results were inconsistent. This study was conducted to explore this association using meta-analysis.

Methods

PubMed, Embase, and China National Knowledge Infrastructure (CNKI) were searched according to predefined criteria for all relevant studies published up to August 2013. Four genetic models, together with odds ratios (ORs) and 95 % confidence intervals (CI), were calculated. Subgroup analyses were performed by ethnicity, anovulatory PCOS, and Hardy–Weinberg equilibrium (HWE) in the controls.

Results

In total, 13 case–control studies, including 1,767 cases and 4,108 controls, were included. No significant association was detected in overall population in all models (III/III vs. I/I: OR = 1.200, 95%CI = 0.866–1.664, P = 0.277; I/III vs. I/I: OR = 1.041, 95%CI = 0.880–1.232, P = 0.637; III/III + I/III vs. I/I: OR = 1.191, 95%CI = 0.912–1.554, P = 0.199; III/III vs. I/III + I/I: OR = 1.100, 95%CI = 0.816–1.484, P = 0.531), the same as in Caucasian and Asian populations. When the studies were limited to conform to HWE, the results remained persistent and robust. The anovulation subgroup showed significantly elevated risk in the I/III vs. I/I (OR = 1.460, 95%CI = 1.017–2.095, P = 0.040).

Conclusions

This meta-analysis revealed no significant association between INS VNTR polymorphisms and the risk of PCOS in the overall population, while it supported that variance may be associated with susceptibility to PCOS with anovulation. Further confirmation is needed from more well-designed and larger studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, et al. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89:2745–9.

    Article  CAS  PubMed  Google Scholar 

  2. Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: etiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 2011;7:219–31.

    Article  CAS  PubMed  Google Scholar 

  3. Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, et al. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113:1210–7.

    Article  CAS  PubMed  Google Scholar 

  4. DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005;83:1454–60.

    Article  CAS  PubMed  Google Scholar 

  5. de Paula Martins W, Santana LF, Nastri CO, Ferriani FA, de Sa MF, et al. Agreement among insulin sensitivity indexes on the diagnosis of insulin resistance in polycystic ovary syndrome and ovulatory women. Eur J Obstet Gynecol Reprod Biol. 2007;133:203–7.

    Article  PubMed  Google Scholar 

  6. Tosi F, Negri C, Perrone F, Dorizzi R, Castello R, et al. Hyperinsulinemia amplifies GnRH agonist stimulated ovarian steroid secretion in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2012;97:1712–9.

    Article  CAS  PubMed  Google Scholar 

  7. Semple RK, Savage DB, Cochran EK, Gorden P, O’Rahilly S. Genetic syndromes of severe insulin resistance. Endocr Rev. 2011;32:498–514.

    Article  CAS  PubMed  Google Scholar 

  8. Pierpoint T, McKeigue P, Isaacs A, Wild S, Jacobs H. Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol. 1998;51:581–6.

    Article  CAS  PubMed  Google Scholar 

  9. Margolin E, Zhornitzki T, Kopernik G, Kogan S, Schattner A, et al. Polycystic ovary syndrome in post-menopausal women—marker of the metabolic syndrome. Maturitas. 2005;50:331–6.

    Article  CAS  PubMed  Google Scholar 

  10. Bell GI, Horita S, Karam JH. A polymorphic locus near the human insulin gene is associated with insulin-dependent diabetes melliitus. Diabetes. 1984;33:176–83.

    Article  CAS  PubMed  Google Scholar 

  11. Bennett ST, Wilson AJ, Cucca F, Nerup J, Pociot F, et al. IDDM2-VNTR-encoded susceptibility to type 1 diabetes: dominant protection and parental transmission of alleles of the insulin gene-linked minisatellite locus. J Autoimmun. 1996;9:415–21.

    Article  CAS  PubMed  Google Scholar 

  12. Vafiadis P, Bennett ST, Colle E, Grabs R, Goodyer CG, et al. Imprinted and genotype-specific expression of genes at the IDDM2 locus in pancreas and leucocytes. J Autoimmun. 1996;9:397–403.

    Article  CAS  PubMed  Google Scholar 

  13. Vafiadis P, Bennett ST, Todd JA, Nadeau J, Grabs R, et al. Insulin expression in human thymus is modulated by INS VNTR alleles at the IDDM2 locus. Nat Genet. 1997;15:289–92.

    Article  CAS  PubMed  Google Scholar 

  14. Le Fur S, Auffray C, Letourneur F, Cruaud C, Le Stunff C, et al. Heterogeneity of class I INS VNTR allele association with insulin secretion in obese children. Physiol Genomics. 2006;25:480–4.

    Article  PubMed  Google Scholar 

  15. Bazaes R, Petry C, Ong K, Avila A, Dunger D, et al. Insulin gene VNTR genotype is associated with insulin sensitivity and secretion in infancy. Clin Endocrinol. 2003;59:599–603.

    Article  CAS  Google Scholar 

  16. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2003;327:557.

    Article  Google Scholar 

  17. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.

    Article  CAS  PubMed  Google Scholar 

  18. Mantel N, Haenszel W Statistical aspects of the analysis of data from retrospective studies of disease. The challenge of epidemiology: issues and selected readings. 2004;1:533–53.

  19. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Copas J, Shi JQ. Meta-analysis, funnel plots and sensitivity analysis. Biostatistics. 2000;1:247–62.

    Article  CAS  PubMed  Google Scholar 

  21. Waterworth DM, Bennett ST, Gharani N, McCarthy MI, Hague S, et al. Linkage and association of insulin gene VNTR regulatory polymorphism with polycystic ovary syndrome. Lancet. 1997;349:986–90.

    Article  CAS  PubMed  Google Scholar 

  22. Vanková M, Vrbíková J, Hill M, Cinek O, Bendlová B. Association of insulin gene VNTR polymorphism with polycystic ovary syndrome[J]. Ann NY Acad Sci. 2002;967:558–65.

    Google Scholar 

  23. Powell BL, Haddad L, Bennett A, Gharani N, Sovio U, et al. Analysis of multiple data sets reveals no association between the insulin gene variable number tandem repeat element and polycystic ovary syndrome or related traits. J Clin Endocrinol Metab. 2005;90:2988–93.

    Article  CAS  PubMed  Google Scholar 

  24. Haller K, Laisk T, Peters M, Talving E, Karits P, et al. VNTR I/I genotype of insulin gene is associated with the increase of follicle number independent from polycystic ovary syndrome. Acta Obstet Gynecol Scand. 2007;86:726–32.

    Article  CAS  PubMed  Google Scholar 

  25. Ferk P, Perme MP, Gersak K. Insulin gene polymorphism in women with polycystic ovary syndrome. J Int Med Res. 2008;36:1180–7.

    Article  CAS  PubMed  Google Scholar 

  26. Xu Y, Wei Z, Zhang Z, Xing Q, Hu P, et al. No association of the insulin gene VNTR polymorphism with polycystic ovary syndrome in a Han Chinese population. Reprod Biol Endocrinol. 2009;7:141.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Zhang Q-F, Han S-P, Cui Y-G, Li Y, Ma X, et al. Polymorphism of insulin gene variable number tandem repeats correlation with polycystic ovary syndrome. J Int Reprod Health/Fam Plan. 2010;29:252–5.

    Google Scholar 

  28. Zhen L. Genetic polymorphism of CYP17, INS and LHβ genes in patients with polycystic ovary syndrome. Master’s thesis Guangzhou Medical University. 2011.

  29. Yun JH, Gu BH, Kang YB, Choi BC, Song S, et al. Association between INS-VNTR polymorphism and polycystic ovary syndrome in a Korean population. Gynecol Endocrinol. 2012;28:525–8.

    Article  CAS  PubMed  Google Scholar 

  30. Skrgatic L, Baldani DP, Gersak K, Cerne JZ, Ferk P, et al. Genetic polymorphisms of INS, INSR and IRS-1 genes are not associated with polycystic ovary syndrome in Croatian women. Coll Anthropol. 2013;37:141–6.

    CAS  Google Scholar 

  31. Lohmueller KE, Pearce CL, Pike M, Lander ES, Hirschhorn JN. Meta-analysis of genetic association studies supports a contribution of common variants to susceptibility to common disease. Nat Genet. 2003;33:177–82.

    Article  CAS  PubMed  Google Scholar 

  32. Munafo MR, Flint J. Meta-analysis of genetic association studies. Trends Genet. 2004;20:439–44.

    Article  CAS  PubMed  Google Scholar 

  33. Carmina E, Wong L, Chang L, Paulson RJ, Sauer MV, et al. Endocrine abnormalities in ovulatory women with polycystic ovaries on ultrasound. Hum Reprod. 1997;12:905–9.

    Article  CAS  PubMed  Google Scholar 

  34. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol. 2007;66:513–7.

    CAS  Google Scholar 

  35. Michelmore K, Ken Ong SM, Bennett S, Perry L, Vessey M, et al. Clinical features in women with polycystic ovaries: relationships to insulin sensitivity, insulin gene VNTR and birth weight. Clin Endocrinol. 2001;55:439–46.

    Article  CAS  Google Scholar 

  36. Calvo RM, Telleria D, Sancho J, San Millan JL, Escobar-Morreale HF. Insulin gene variable number of tandem repeats regulatory polymorphism is not associated with hyperandrogenism in Spanish women. Fertil Steril. 2002;77:666–8.

    Article  PubMed  Google Scholar 

  37. Ahmed S, Bennett S, Huxtable S, Todd J, Matthews D, et al. INS VNTR allelic variation and dynamic insulin secretion in healthy adult non-diabetic Caucasian subjects. Diabet Med. 1999;16:910–7.

    Article  CAS  PubMed  Google Scholar 

  38. Lawson MA, Jain S, Sun S, Patel K, Malcolm PJ, et al. Evidence for insulin suppression of baseline luteinizing hormone in women with polycystic ovarian syndrome and normal women. J Clin Endocrinol Metab. 2008;93:2089–96.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  39. Eagleson CA, Bellows AB, Hu K, Gingrich MB, Marshall JC. Obese patients with polycystic ovary syndrome: evidence that metformin does not restore sensitivity of the gonadotropin-releasing hormone pulse generator to inhibition by ovarian steroids. J Clin Endocrinol Metab. 2003;88:5158–62.

    Article  CAS  PubMed  Google Scholar 

  40. Moghetti P, Castello R, Negri C, Tosi F, Perrone F, et al. Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation. J Clin Endocrinol Metab. 2000;85:139–46.

    CAS  PubMed  Google Scholar 

  41. Lord JM, Flight IH, Norman RJ. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ. 2003;327:951.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Trikalinos TA, Salanti G, Khoury MJ, Ioannidis JP. Impact of violations and deviations in Hardy-Weinberg equilibrium on postulated gene-disease associations. Am J Epidemiol. 2006;163:300–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

No funding was provided for the analysis.

Conflict of interest

None Declared.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Shan Li or Xue Qin.

Additional information

Capsule INS VNTR polymorphism implicate in PCOS by influence insulin sensitivity and secretion, but this meta-analysis found no association between INS VNTR polymorphism and PCOS risk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Song, Ly., Luo, Jr., Peng, Ql. et al. Lack of association of INS VNTR polymorphism with polycystic ovary syndrome: a meta-analysis. J Assist Reprod Genet 31, 675–681 (2014). https://doi.org/10.1007/s10815-014-0211-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-014-0211-6

Keywords

Navigation