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This case study outlines the treatment and follow-up of a 42-year-old woman with PCOS and various lipid and metabolic issues. Initial treatment included metformin and Byetta, resulting in significant improvements in lipid profile, hypertension, and metabolic syndrome markers.
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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
Lipid Profile Fasting: Not Specified NT = Not Tested
Other Labs Worth Noting Fasting: Not Specified NT = Not Tested
NMR LipoProfile Insert NMR LipoProfile
Questions to Consider Question 1 Question 2 Question 3 Question 4
Initial Treatment & Management Start metformin 1000 mg/day to lower LDL-P. Start Byetta 10 mcg/day for metabolic syndrome.
Discussion Risk Factors: Hyperlipidemia, Assessment: Hyperlipidemia
Discussion Assessment: Hypertension
Discussion Assessment: Metabolic Syndrome
Discussion Assessment: Elevated CRP
Discussion Assessment: Elevated LpPLA2
Discussion Assessment: PCOS
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.
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.
NMR LipoProfile Insert NMR LipoProfile