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Role of obesity in blood pressure regulation and insulin resistance in Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in reproductive-age women. PCOS is characterized by ovulatory dysfunction, androgen excess, and polycystic appearance of the ovaries. PCOS women have an increased prevalence of cardiovascular risk factors, such as insulin resistance (IR), obesity, elevated blood pressure (BP), and cardiovascular disease. Hyperandrogenism is a key feature of PCOS and is present in about 80% of PCOS women. In the US, 80% of women with PCOS are obese or overweight. Obese PCOS women have higher BP and IR compared to normal-weight women with PCOS, but IR is also present in lean PCOS women, suggesting obesity-independent effects of androgens. Therapeutic options to treat the increases in BP and IR in PCOS are limited and compliance with medications is low due to side effects.  

As a physician-scientist, I am passionate about research. In my laboratory we seek to answer clinically relevant questions related to cardiometabolic complications of sex steroids.  The main questions that we want to answer are: 

  1. Are androgens the main factors that promote cardiometabolic derangements in women with PCOS?
  2. Why is it difficult for women with PCOS to lose weight and how does obesity impact the clinical manifestations of the syndrome?
  3. What is the role of GLP-1 and SGLT2 in the cardio metabolic manifestations of PCOS?
  4. What is the impact of the 17β-HSD enzyme and adipose-derived androgens have in modulating the cardiometabolic abnormalities in PCOS?
  5. What is the Racial and Ethnicity role in the cardio metabolic complications in PCOS?

To explore novel mechanisms responsible for the androgen-mediated cardiometabolic complications in PCOS, our lab established two clinically relevant rodent models, the hyperandrogenemic female rats and HAF mice that exhibit similar cardiometabolic characteristics as women with PCOS. We are also conducting clinical research to elucidate the role of race in the cardiometabolic complications in PCOS and cross hormonal therapy in transgender individuals.