Abstract #801

# 801
The biology of hyperinsulenemia induction of polycystic ovarian syndrome and its complications.
Jean-Patrice Baillargeon*1,2, 1Université de Sherbrooke, Sherbrooke, QC, Canada, 2Research Center of Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada.

Polycystic ovarian syndrome (PCOS) is a common condition affecting 6 to 10% of women of childbearing age. It is the most frequent endocrine disorder among young women in North America. In addition of being the most frequent cause of female infertility, PCOS is the commonest cause of hyperandrogenism in women, thus leading to esthetical concerns such as excessive hair growth, acne and alopecia. Accordingly, PCOS women are more likely to have impaired quality of life, including depression, anxiety and increased risk of social phobia and suicide attempts. In addition, PCOS is currently considered as a paradigm of cardiometabolic disease, because the prevalence of metabolic syndrome, dyslipidemia and type 2 diabetes (T2D) are much higher in PCOS than in normal age- and BMI-matched women. Indeed, PCOS women demonstrate metabolic insulin resistance (IR) and compensatory hyperinsulinemia, which play a critical role in the syndrome’s development. Yet, many questions remain unanswered regarding the mechanisms by which metabolic IR and hyperinsulinemia leads to hyperandrogenemia and PCOS infertility. The existence of women developing PCOS without IR suggests that it is not a requisite for the development of this syndrome. Nevertheless, several evidences suggest that impairment in insulin signaling may be implicated in androgen overproduction at the level of androgen producing tissues. This talk will therefore review potential metabolic mechanisms in the development of PCOS in predisposed women. This talk’s objectives are to (1) review briefly the PCOS and some characteristics of insulin resistance in PCOS; (2) describe the mechanisms of insulin action on androgen biosynthesis in PCOS; and (3) discuss the implication of nonesterified fatty acids (NEFAs) in PCOS hyperandrogenemia and its metabolic complications. This talk will discuss the hypothesis that lipotoxicity (the cellular adverse consequences of NEFAs) may cause both the hyperandrogenemia and insulin resistance that characterize PCOS women. Lipotoxicity could therefore explain PCOS symptoms, mainly due to hyperandrogenism, and long-term metabolic consequences.

Key Words: polycystic ovary syndrome, insulin, lipotoxicity

Speaker Bio
Jean-Patrice Baillargeon, MD, MSc is board-certified in endocrinology and metabolism, professor of medicine at the University of Sherbrooke and researcher at the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CHUS). Dr Baillargeon primary areas of expertise include reproductive endocrinology, polycystic ovary syndrome, obesity, health system improvement and biostatistics/epidemiology. He completed a postdoctoral fellowship on the metabolic aspects of polycystic ovary syndrome (PCOS) under the supervision of Dr Nestler in 2003 and obtained a Master’s in Clinical research and Biostatistics from the Virginia Commonwealth University, Richmond VA. He is director of the Reproductive Endocrinology clinic of the CHUS and an active member of the Lifestyle Multidisciplinary Management Clinic of the CHUS. Dr. Baillargeon is awarded senior clinical-investigator of the Fonds de recherche en santé du Québec (FRSQ) and currently holds national public funding for ongoing research studies on the role of free fatty acids in the pathogenesis of PCOS and the management of obesity in infertile women or in primary care. The ultimate goal of his research is thus to reduce the impact of obesity, mainly on women’s health, and facilitate rapid knowledge transfer to clinical application through a translational approach. Dr Baillargeon is Secretary Treasurer of the Canadian Society of Endocrinology and Metabolism Council (CSEM). He has published 65 peer-reviewed original studies, 24 refereed review articles, 6 book chapters and >245 peered-reviewed abstracts.