A Case of Metabolic Syndr...

A 40-year-old female housewife presented at the primary care clinic with a one-week history of chest discomfort. She had no prior medical history of diabetes mellitus or hypertension. She experienced early menopause at the age of 37. Her mother has a medical history of both diabetes mellitus and hypertension. She used to be a smoker and led a notably sedentary lifestyle. Upon physical examination, she exhibited obesity, with a body weight of 82 kg and a height of 165 cm, resulting in a BMI of 32 kg/m2. Her pulse rate was 78 bpm, and her blood pressure measured 160/110 mmHg in both arms. Acanthosis nigricans was observed on her neck, but all other general and systemic examinations were within normal limits. Her random blood sugar, as measured by a glucometer, was 160.2 mg/dL. She received treatment with non-steroidal anti-inflammatory drugs for her costochondritis. Upon a follow-up appointment one week later, her test results were as follows: Fasting blood sugar (FBS) 149.4 mg/dL, triglyceride 92.8 mg/dL, total cholesterol 321.0 mg/dL, LDL-cholesterol 234.7 mg/dL, HDL-cholesterol 37.9 mg/dL. Her serum creatinine and electrolyte levels were within the normal range, while liver function tests (LFT) indicated mildly elevated levels of AST and ALT. Her HbA1C was 8.46%. Thyroid function tests, serum cortisol, oestradiol, progesterone, testosterone, and DHEAS were all within normal limits. However, her FSH measured 57.1 mIU/L, and her LH was 27.9 mIU/L, both of which fell within the menopausal range. She exhibited macroalbuminuria. Electrocardiogram, chest radiograph, and Pap smear results were normal. Her blood pressure remained persistently elevated, with a 160/106 mmHg reading.