Case history
Case history #1
A 55-year-old man presents with elevated aminotransferases on laboratory investigation. He also has episodes of sleep apnoea. He smokes about 20 cigarettes a day and his father had a myocardial infarction at the age of 52 years. Physical examination reveals hypertension (BP 152/90 mmHg) and abdominal obesity (waist circumference 110 cm [43 inches]). He has an impaired fasting glucose (6.3 mmol/L [113 mg/dL]), and the lipid profile shows high triglycerides (2.7 mmol/L [240 mg/dL]), high total cholesterol (5.52 mmol/L [213 mg/dL]) and LDL-cholesterol (3.36 mmol/L [130 mg/dL]) levels, and low HDL-cholesterol (0.91 mmol/L [35 mg/dL]) levels.
Case history #2
A 27-year-old woman presents with abdominal obesity, hirsutism, acne, and polycystic ovaries on gonadal ultrasonography. She reports 3 to 4 menstrual periods per year. On examination, her BMI is 33 kg/m², waist circumference is 94 cm (37 inches), and BP is 130/83 mmHg. Her serum total testosterone level is elevated (101 nanograms/dL; normal range 20-75 nanograms/dL). She has an impaired fasting glucose (6.5 mmol/L [117 mg/dL]), and the lipid profile shows high triglycerides (2.1 mmol/L [190 mg/dL]), high total cholesterol (5.21 mmol/L [201 mg/dL]) and LDL-cholesterol (3.24 mmol/L [125 mg/dL]) levels, and low HDL-cholesterol (0.98 mmol/L [38 mg/dL]) levels.
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