Postprandial Lipemia as Cardiovascular Disease Risk Factor

Postprandial lipemia (PPL) is characterized by prolonged and increased levels of lipids especially triglycerides (TG) and triglyceride-rich lipoprotein levels after a meal. There are an increasing number of evidence that postprandial lipemia is a significant risk factor for cardiovascular disease because of its causative role in atherosclerosis and endothelial dysfunction. This has serious implications because common dietary patterns are characterized by high fat content and meal consumption; hence, most will be in a postprandial state resulting to frequent and prolonged exposure to high lipid levels. The review will present the current evidences for the role of postprandial lipemia as a risk factor for cardiovascular disease and its association with other cardiovascular risk factors, namely, diabetes and obesity. We will also present recommendations on the diagnosis and management of postprandial lipemia

Osteoporosis and Prevalent Fractures among Adult Filipino Men Screened for Bone Mineral Density in a Tertiary Hospital

BackgroundOsteoporosis in men is markedly underdiagnosed and undertreated despite higher morbidity and mortality associated with fractures. This study aimed to characterize adult Filipino men with osteopenia, osteoporosis and prevalent fractures.MethodsA cross-sectional study of 184 Filipino men ≥50 years screened for bone mineral density was performed. Age, weight, body mass index (BMI), Osteoporosis Self-Assessment Tool for Asians (OSTA) score, smoking status, family history of fracture, diabetes mellitus, physical inactivity, and T-score were considered.ResultsOf the 184 patients, 40.2% and 29.9% have osteopenia and osteoporosis. Sixteen (21.6%) and 18 (32.1%) osteopenic and osteoporotic men have fragility hip, spine, or forearm fractures. Men aged 50 to 69 years have the same risk of osteoporosis and fractures as those ≥70 years. While hip fractures are higher in osteoporotic men, vertebral fractures are increased in both osteopenic and osteoporotic men. Mere osteopenia predicts the presence of prevalent fractures. A high risk OSTA score can predict fracture. A BMI <21 kg/m2 (P<0.05) and current smoking are associated with osteoporosis.ConclusionA significant fraction of Filipino men with osteopenia and osteoporosis have prevalent fractures. Our data suggest that fractures occur in men <70 years even before osteoporosis sets in. Low BMI, high OSTA score, and smoking are significant risk factors of osteoporosis

Clinical profile and etiology of hypopituitarism at the University Of Santo Tomas Hospital

Objective: To establish data determining the etiology of hypopituitarism in the University of Santo Tomas Hospital (USTH) and to describe the clinical and biochemical profile of these patients. Methodology: A retrospective descriptive study in a tertiary hospital (USTH) involving patients diagnosed by clinical evaluation and biochemical tests to have hypopituitarism, admitted or seen at the outpatient department from January 2001 to December 2009 and whose charts were available for review. The clinical profile, manifestations and biochemical profile were defined and causes of hypopituitarism identified. Descriptive statistics were applied using percentages and frequency distribution. Results: In the nine-year period (2001-2009), a total of 191 patients were recorded to have hypopituitarism but only 143 (75%) have adequate data available for review. Sixtyone (43%) were males and 82 (51%) were females with mean age was 45±6 years. Hypopituitarism was found to be most prevalent in the fourth to fifth decade of life and clinical manifestations were noted with mean duration of 20±4 months. The most predominant documented pituitary hormone deficiency was gonadotrophic hormone (60%) manifesting prominently as decreased libido (82%). The most common target end organ hormone deficiency was secondary adrenal insufficiency (90%) and most prevalent etiology of hypopituitarism was pituitary tumors (40%). Sheehan\u27s syndrome (8%) and tuberculosis (3%) were also noted as a cause of hypopituitarism. Conclusion: This study shows that the leading clinical manifestation and documented hormone deficiency of hypopituitarism is hypogonadism. Pituitary adenoma is the most common cause of hypopituitarism along with its treatment. Other causes not commonly seen in other countries but proved to be more prevalent here include Sheehan\u27s syndrome and tuberculosis infection

Consensus on best practice standards for Fracture Liaison Service in the Asia-Pacific region

Summary: The Fracture Liaison Service (FLS) Consensus Meeting endorsed by the International Osteoporosis Foundation (IOF), Asian Federation of Osteoporosis Societies (AFOS), and Asia Pacific Osteoporosis Foundation (APOF) was hosted by the Taiwanese Osteoporosis Association on October 14, 2017. International and domestic experts reviewed the 13 Best Practice Framework (BPF) standards and concluded that all standards were generally applicable in the Asia-Pacific region and needed only minor modifications to fit the healthcare settings in the region. Purpose: To review and generate consensus on best practices of fracture liaison service (FLS) in the Asia-Pacific (AP) region. Methods: In October 2017, the Taiwanese Osteoporosis Association (TOA) invited experts from the AP region (n = 23), the Capture the Fracture Steering Committee (n = 2), and the USA (n = 1) to join the AP region FLS Consensus Meeting in Taipei. After two rounds of consensus generation, the recommendations on the 13 Best Practice Framework (BPF) standards were reported and reviewed by the attendees. Experts unable to attend the on-site meeting reviewed the draft, made suggestions, and approved the final version. Results: Because the number of FLSs in the region is rapidly increasing, experts agreed that it was timely to establish consensus on benchmark quality standards for FLSs in the region. They also agreed that the 13 BPF standards and the 3 levels of standards were generally applicable, but that some clarifications were necessary. They suggested, for example, that patient and family education be incorporated into the current standards and that communication with the public to promote FLSs be increased. Conclusions: The consensus on the 13 BPF standards reviewed in this meeting was that they were generally applicable and required only a few advanced clarifications to increase the quality of FLSs in the region