Fasting lipid profile

Fasting lipid profile total cholesterol 233 mg/dL (6.03 mmol/L), HDL cholesterol 30 mg/dL (0.78 mmol/L), LDL cholesterol 165 mg/dL (4.27 mmol/L), triglycerides 188 mg/dL (2.12 mmol/L) other labs within normal limits... 

LC is a 51 -year-old female with a history of CHD (stent placement in the left anterior descending coronary artery 3 years prior) and type 2 diabetes who is referred to you for follow-up of her cholesterol. She is taking simvastatin 20 mg once daily in the evening for her cholesterol, and metformin 2000 mg once daily in the evening and piogliti-zone 15 mg once daily for diabetes. Her diabetes is well controlled. Her laboratory test results are within normal limits, except for her fasting lipid profile total cholesterol 215 mg/dL (5.57 mmol/L), triglycerides 135 mg/dL (1.53 mmol/L), HDL cholesterol 51 mg/dL (1.32 mmol/L), and LDL cholesterol 137 mg/dL (3.55 mmol/L). 

Routinely assess acromegaly complications, including blood pressure, glucose tolerance, fasting lipid profile, cardiac evaluations (if clinically indicated), colonoscopy, dual-energy x-ray absorptiometry (DEXA) scan (hypogonadal only), evaluation of residual pituitary function, and evaluation of sleep apnea. 

Routine monitoring of fasting lipid profile, bone mineral density, and body composition in children is not typically required during GH replacement but should be done before and after discontinuation of therapy.35... 

Fasting lipid profiles should be obtained at each follow- up visit if not at goal, annually if stable and at goal, or every 2 years if the profile suggests low risk. 

Women with controlled dyslipidemias can use low-dose CHCs, with periodic monitoring of fasting lipid profiles. Women with uncontrolled dysiipidemia (LDL greater than 160 mg/dL, HDL less than 35 mg/dL, triglycerides greater than 250 mg/dL) and additional risk factors (e.g., coronary artery disease, diabetes, hypertension, smoking, or a positive family history) should use an alternative method of contraception. 

Weight should be monitored monthly for 3 months, then quarterly. Body mass index, waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile should be monitored at the end of 3 months, then annually. The use of patient self-assessments are encouraged. 

Lipid analysis revealed low plasma cholesterol. A fasting lipid profile showed total cholesterol was 1 mmol/L (normal is 3.5-5.0 mmol/L). On fractionation, HDL was found to be normal while LDL was undetectable. Postprandial electrophoresis of plasma lipoproteins demonstrated the presence of HDL, but absence of chylomicrons, VLDL, and LDL. Plasma levels of apolipoprotein B (apoB) were well below the sensitivity of the test used for their measurement... 

Fasting lipid profiles should be obtained at each follow-up visit if not at goal, annually if stable and at goal, or every 2 years if the profile suggests low risk. Regular frequency of foot exams (each visit), urine albumin assessment (annually), and dilated ophthalmologic exams (yearly or more frequently with abnormalities) should also be documented. 

Get waistline circumference (at umbilicus), blood pressure, fasting plasma glucose, and fasting lipid profile... 

A complete fasting lipid profile including total cholesterol, LDL, HDL, and triglycerides should be done in all CKD patients. Lipoprotein levels may be inflnenced by several factors inclnding GFR and proteinuria. It is recommended that these patients have their lipid profile assessed more freqnently than in the general popnlation in order to identify abnormahties and treat them early. In patients on hemodialysis the hpid profile shonld be done prior to dialysis or on nondialysis days. Patients shonld also be evalnated for other conditions that are known to cause dyslipidemias (e.g., liver disease and hypothyroidism). 

Tolerability in children is good, and most common adverse effects are limited to abdominal pain and headaches. Adverse effects such as renal toxicity were mild and reversible in a long-term multicenter study of safety of cyclosporine use in adults. Even so, appropriate monitoring parameters—electrolytes, renal function, complete blood counts, fasting lipid profiles, and uric acid levels—should be measured at baseline and periodically. Cyclosporine is also involved... 

At least two fasting lipid profiles should be performed before starting any form of lipid-lowering therapy. 

---