Management of Hypertriglyceridemia in the Diabetic Patient

The hypertriglyceridemia of diabetes can be classified into mild to moderate (triglycerides between 150–499 mg/dL) and severe hypertriglyceridemia (triglycerides ≥500 mg/dL). As in any other individuals with hypertriglyceridemia, secondary causes need to be excluded. The management of severe hypertriglyceridemia (chylomicronemia syndrome) includes aggressive reduction of triglycerides with intravenous insulin, fibrates, omega-3 fatty acids, and/or niacin therapy to avert the risk of pancreatitis. In patients with mild to moderate hypertriglyceridemia, the treatment of choice is statin therapy to achieve the low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) target goals. The evidence base would favor niacin therapy in combination with statin therapy to achieve the goals pertaining to LDL cholesterol and non-HDL cholesterol. The data about the combination of fibrate therapy with statin therapy are disappointing

Association between global leukocyte DNA methylation and cardiovascular risk in postmenopausal women

BACKGROUND: Genetic studies to date have not provided satisfactory evidence regarding risk polymorphisms for cardiovascular disease (CVD). Conversely, epigenetic mechanisms, including DNA methylation, seem to influence the risk of CVD and related conditions. Because postmenopausal women experience an increase in CVD, we set out to determine whether global DNA methylation was associated with cardiovascular risk in this population. METHODS: In this cross sectional study carried out in a university hospital, 90 postmenopausal women without prior CVD diagnosis (55.5 ± 4.9 years, 5.8 [3.0–10.0] years since menopause) were enrolled. DNA was extracted from peripheral leukocytes and global DNA methylation levels were obtained with an ELISA kit. Cardiovascular risk was estimated by the Framingham General Cardiovascular Risk Score (10-year risk) (FRS). Clinical and laboratory variables were assessed. Patients were stratified into two CVD risk groups: low (FRS: <10 %, n = 69) and intermediate/high risk (FRS ≥10 %, n = 21). RESULTS: Age, time since menopause, blood pressure, total cholesterol, and LDL-c levels were higher in FRS ≥10 % group vs. FRS <10 % group. BMI, triglycerides, HDL-c, HOMA-IR, glucose and hsC-reactive protein levels were similar in the two groups. Global DNA methylation (% 5mC) in the overall sample was 26.5 % (23.6–36.9). The FRS ≥10 % group presented lower global methylation levels compared with the FRS <10 % group: 23.9 % (20.6–29.1) vs. 28.8 % (24.3–39.6), p = 0.02. This analysis remained significant even after adjustment for time since menopause (p = 0.02). CONCLUSIONS: Our results indicate that lower global DNA methylation is associated with higher cardiovascular risk in postmenopausal women

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to I. H. Kempner acknowledging receipt of Kempner's letter and the proposed solicitation letter for replenishing the committee's funds. Whayne praises the letter and suggests only a slight rewording for a similar letter to be sent to those who did not subscribe in 1951

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to I. H. Kempner providing Mr. I. H. Kempner with Pass No. 6 for free admission to Marine Ballroom events and fishing pier access for 1956. It instructs Kempner to sign the pass for identification and requests the return of the 1955 pass for cancellation, offering holiday wishes

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to I. H. Kempner informing Kempner that the new addition to the hospital and medical college will be completed and opened late this year. He suggests organizing a banquet to honor the Medical College staff at the same time as the opening, proposing the Marine Room of the Pleasure Pier as the venue, accommodating approximately 1,100 guests. He assures full cooperation from all Chamber committees

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to Isaac H. Kempner expressing his approval of an arrangement outlined in previous letters

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to I. H. Kempner discussing being appointed as Vice-Chairman of the Medical College Committee. Included is a copy of the same

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to I. H. Kempner acknowledging his re-appointment to the committee and expresses his willingness to cooperate. He also mentions receiving a letter from Dr. Chauncey Leake, supporting his membership. Whayne emphasizes the importance of organizing a banquet to honor the administrative heads and others involved in the recent major enlargement of the Medical Branch, suggesting it as a key project for the year

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to Isaac H. Kempner discussing a pass for the latter to use for the fishing pier

Personal Papers (MS 80-0002)

Letter from A. T. Whayne to Isaac H. Kempner discussing a pamphlet in relation to a recent meeting