Exxcellence pearls: Dyslipidemia and metabolic syndrome

Question 0

What history is important in the setting of metabolic syndrome?

Answer 0

Family history of type 2 diabetes, coronary artery disease, or venous thromboembolism

Question 1

What prevalence of metabolic syndrome in midlife women?

Why is metabolic syndrome important?

Answer 1

16%

The clustering of risk factors leads to greater cardiovascular morbidity than their individual risks suggest.

Question 2

What are the diagnostic criteria for metabolic syndrome?

Answer 2

Any 3 of the 5 following:
abdominal circumference 35"
Triglycerides 150 mg/dL
HDL cholesterol 50 mg/dL
Elevated blood pressure 130/85 mm Hg
Fasting glucose 110 mg/dL

Question 3

How should patients with metabolic syndrome be counseled?

Answer 3

Lifestyle modification. Moderate reduction in caloric intake sufficient to result in a 5-10% loss of bodyweight with moderate exercise. Consider nutritionist consult. Emphasize diet high in fresh fruits and vegetables and low and processed carbohydrates with low glycemic index.

Question 5

Which lipid lowering drug best treats low density lipoprotein?

HDL alone?

Triglycerides?

Answer 5

Statins.

Niacin. Flushing can be minimized by taking long-acting forms.

Bile acid sequestrants, but dietary control and statin drugs may be better tolerated.