Case history
Case history #1
A 55-year-old man presents with elevated aminotransferases on laboratory investigation. He also has episodes of sleep apnea. He smokes about 20 cigarettes a day and his father had a myocardial infarction at the age of 52 years. Physical exam reveals hypertension (BP 152/90 mmHg) and abdominal obesity (waist circumference 43 inches [110 cm]). He has an impaired fasting glucose (113 mg/dL), and the lipid profile shows high triglycerides (240 mg/dL), high total cholesterol (213 mg/dL) and LDL-cholesterol (130 mg/dL) levels, and low HDL-cholesterol (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 37 inches (94 cm), 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 (117 mg/dL), and the lipid profile shows high triglycerides (190 mg/dL), high total cholesterol (201 mg/dL) and LDL-cholesterol (125 mg/dL) levels, and low HDL-cholesterol (38 mg/dL) levels.
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