A 46-year-old man is being evaluated by his physician in the course of a routine physical examination for his new job. He denies any complaints at present, nor any recent history of illness or injury. His last physical examination was over 10 years ago for a job-related injury to his knee. He has no allergies, takes no prescription medications, but takes acetaminophen occasionally for his "aches and pains." Family history is significant for his mother and brother having heart disease, hypertension, and obesity. His mother has had 2 myocardial infarctions, and his older brother takes oral medication for type 2 diabetes. He carries a significant amount of central fat, his waist is 44 in, and his calculated BMI is 36 kg/m2. The working diagnoses of obesity and hypertension are attributed to the patient's history and is suggestive of the metabolic syndrome. Testing for which of the following would be most beneficial to ensure proper diagnosis and treatment in this patient?

Question

Quizplus · Accepted Answer

Serum insulin levels are the most beneficial test to ensure proper diagnosis and treatment in this patient because they can help to identify insulin resistance, which is a key component of the metabolic syndrome.  The metabolic syndrome, MetS is a disorder that defines a combination of metabolic and cardiovascular risk determinants. These risk factors include insulin resistance, hyperinsulinemia, central adiposity (obesity associated with excess fat deposits around the waist), dyslipidemia, glucose intolerance, hypertension, proinflammatory status, and microalbuminemia. The hallmark feature of MetS is indeed insulin resistance which can be assessed by the presence of hyperinsulinemia, especially in the presence of hyperglycemia.

A 46-Year-Old Man Is Being Evaluated by His Physician in the Course