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42 Year Old Female with…

42 Year Old Female with…. Case Categories Primary Prevention Secondary Prevention Pediatric Case Familial Hypertriglyceridemia Diabetes Metabolic Syndrome Low HDL Familial Combined Hyperlipidemia Familial Hypercholesterolemia Elevated Lipoprotein (a) Statin Intolerance.

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42 Year Old Female with…

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  1. 42 Year Old Female with… Case Categories Primary Prevention Secondary Prevention Pediatric Case Familial Hypertriglyceridemia Diabetes Metabolic Syndrome Low HDL Familial Combined Hyperlipidemia Familial Hypercholesterolemia Elevated Lipoprotein (a) Statin Intolerance Case category: PCOS History of present illness: 42 year old female with PCOS

  2. Patient Information

  3. Patient History

  4. Current Medications

  5. Lipid Profile Fasting: Not Specified NT = Not Tested

  6. Other Labs Worth Noting Fasting: Not Specified NT = Not Tested

  7. Labs

  8. NMR LipoProfile Insert NMR LipoProfile

  9. NMR Interpretation

  10. Questions to Consider Question 1 Question 2 Question 3 Question 4

  11. Initial Treatment & Management Start metformin 1000 mg/day to lower LDL-P. Start Byetta 10 mcg/day for metabolic syndrome.

  12. Discussion Risk Factors: Hyperlipidemia, Assessment: Hyperlipidemia

  13. Discussion Assessment: Hypertension

  14. Discussion Assessment: Metabolic Syndrome

  15. Discussion Assessment: Elevated CRP

  16. Discussion Assessment: Elevated LpPLA2

  17. Discussion Assessment: PCOS

  18. Follow Up on Metformin 1000 and Byetta 10 mcg (1 of 2) • Hyperlipidemia – Improved. • Currently taking metformin 1000. • Weight loss of over 50 lbs. Excellent. • LDL-P lowered from 1529 to 1168. Optimal is <1000. Small LDL-P is 808. Optimal is <850. • Total cholesterol lowered from 175 to 151. LDL-C reduced from 117 to 96. Triglycerides are normal at 86. HDL remains low at 39. • Continue therapy. • Hypertension – Improved. • Blood pressure is 118/72. • Currently taking Cozaar 50 mg/day.

  19. Follow Up on Metformin 1000 and Byetta 10 mcg (2 of 2) • Metabolic Syndrome – Improved. • Currently taking metformin 1000 mg/day and Byetta 10 mcg/day. • HbA1c lowered from 5.8 to 5.4. • Continue therapy. • Elevated CRP – Unchanged. • Level has not been tested. • Weight loss and metformin helps lower CRP. • Elevated LpPLA2 – Improved. • Level lowered from 248 to 203. • Metformin helps lower LpPLA2. • PCOS – Unchanged.

  20. Follow Up Labs

  21. NMR LipoProfile Insert NMR LipoProfile

  22. Clinical Pearls

  23. Case Summary

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