Summer 2013 LipidSpin Articles | National Lipid Association Online

Matthew K. Ito, PharmD, CLS, FNLA	From the NLA President: Engaging Our Communities Thank you for the honor of being able to serve as your next President of the NLA. The 2013–2014 program year will be an exciting time, and I look forward to working with our Board of Directors in the continued growth of our organization to meet the educational and scientific needs of you and your patients. I especially would like to thank my predecessor, Peter Toth, MD, PhD, who just stepped down as NLA President, for his tremendous dedication and service to the... more
ELIZABETH JACKSON, MSN, CLS, FNLA	From the SWLA President: Physical Findings Still Relevant Each of us should strive "to rise above the routines of the daily ward round and to see in every patient an opportunity not only to serve mankind in the best tradition of medical excellence, but to add to the store of medical knowledge." –A. McGehee Harvey (1973) Welcome to this issue of the Lipid Spin! This publication serves a wonderful adjunct to the Journal of Clinical Lipidology in bringing science to the forefront for practical... more
JAMES A. UNDERBERG, MD, MS, FACPM, FACP, FNLA	Letter From the Lipid Spin Editors: Where Have All the Exams Gone? In this issue of Lipid Spin, several articles and a tear sheet focus on the importance of the physical exam in the evaluation of the patient with lipid disorders. While the physical examination remains the cornerstone of patient evaluation and ongoing treatment, all too often those of us in a teaching role find this a rapidly disappearing art. In our lipid clinic, medical housestaff evaluate the patients prior to presenting them to our group for discussion. We then return to... more
KARI UUSINARKAUS, MD, FAAFP, FNLA MUNNI SELAGAMSETTY, MD	Clinical Feature: Central Obesity and Southeast Asians Chances are that each of us has and takes care of patients from Southeast Asia. This ethnic group is growing significantly in the United States. According to 2010 census data, while the U.S. population grew almost 9.7% between 2000 and 2010, the Asian population alone increased by more than four times that rate—by 43% in that 10-year period.¹ By definition, "Asian" refers to a person having origins in any of the original peoples of the Far East, Southeast... more
ROBERT A. WILD, MD, PhD, MPH, FNLA	EBM Tools for Diagnosis: Some Preliminary Thoughts This issue of Lipid Spin has a theme of physical findings. One of my colleagues e-mailed me and said I was such an evidence-based guy that he applauded me for choosing a topic that was not evidence based. While I understand where he was coming from, I submit that nothing could be farther from the truth. Tools for evidencebased practice include history and physical findings from the get-go. This is because those are our best tools for determining how to arrive at a diagnosis... more
HENRY J. POWNALL, PhD, MS ANTONIO M. GOTTO JR., MD, DPhil	Lipid Luminations: Translating Physical Studies of Lipoproteins into Clinical Lipidology Physical chemistry is, in part, the study of macroscopic and particulate phenomena in terms of laws and concepts of physics, and it can include the physical concepts determining motion, energy, force, time, thermodynamics, light and equilibrium. Physical chemistry, in contrast to chemical physics, is a macroscopic science, because its concepts are relevant to bulk scales rather than molecular and/or atomic scales. Physical methods are applicable to studies of lipids and lipoproteins, with... more
JOSEPH L. LILLO, DO, FNLA	Specialty Corner: Abdominal Obesity and the American Diet—A Closer Look at High Fructose Corn Syrup In keeping with the theme of this issue of Lipid Spin, I have chosen waist circumference as the physical finding that can lead us to so much more in terms of atherosclerosis risk assessment. As we know, nearly 80 million Americans have metabolic syndrome, and enlarged waist circumference is the physical expression of this syndrome.¹ To borrow a phrase from my good friend and mentor, Tom Dayspring, metabolic syndrome patients are diabetics in-training. It is my goal... more
AMY LAMBERT, MD, PGY4	Practical Pearls: Polycystic Ovarian Syndrome She is sitting in your office waiting room. That fat, hairy woman for whom you can pretty much guarantee her chief complaint —amenorrhea, abnormal hair growth or knee pain. You know the Pandora’s Box of diagnoses she really should be worried about: diabetes, hyperlipidemia, endometrial cancer. So many problems, so little time, so little compensation. The average woman with polycystic ovarian syndrome (PCOS) fits this picture, but not all do. Approximately 30% of women with PCOS are... more
ASHLEY DAVILA, RN, CNS, CLS	Case Study: Not So Specific Physical Findings of an Unusual Lipid Disorder A 37-year-old patient was referred to our lipid clinic from his primary care provider. A basic lipid panel revealed: total cholesterol (TC) 715 mg/dL, triglyceride (TG) 901 mg/dL; HDL-C 45 mg/dL, Lipoprotein(a) [Lp(a)] mass was elevated (44 mg/dL); Lp(a)- cholesterol levels were not measured. The patient, who was generally very healthy, had not seen a physician for several years. He presented with bilateral palmar xanthomas (see Photo 1). He had noticed them for approximately 2 years but did... more
ADIL LOKHANDWALA, MD ABHIJEET DHOBLE, MBBS, MPH, FACP	Chapter Update: Therapeutic Interventions to Increase HDL-C and its Impact on Cardiovascular Risk Modification Multiple observational studies have found an inverse relationship between highdensity lipoprotein cholesterol (HDL-C) levels and cardiovascular disease (CVD).^1-3 The cumulative mechanism(s) by which HDL-C is associated with reduction in CVD is/are intricate and multifactorial.² Pharmacologic approaches to increase HDL-C have been successful, but the studies assessing the cardio protective effect(s) of these interventions often has been conflicting and is debatable.^{... more}
RANDY W. BURDEN, PharmD, MDiv, PhC, CLS, FNLA	Member Spotlight: Randy Burden, PharmD Randy Burden, PharmD, often traveled to the eight northern Pueblo tribes in New Mexico as part of his job with the U.S. Indian Health Service cardiovascular risk reduction program. At each site visit, he became engulfed in addressing lipid disorders, diabetes, the metabolic syndrome, and blood pressure problems in his patient population. During that period, he realized he specifically wanted to focus on one of these precursors to heart disease, a leading cause of death for Native Americans... more
ANNE C. GOLDBERG, MD, FNLA	Foundation Update The Foundation of the NLA constantly strives to support research, medical education and community outreach activities, particularly those that fall within our primary areas of focus for grant funding: children, genetic disorders, Familial Hypercholesterolemia (FH), primordial prevention, and underserved populations. Collaborations between the Foundation and the NLA have resulted in many "firsts," including the launch of our inaugural FH awareness campaign in May 2011. The... more