Pt M P of age 40 years male came for edema feet and pain in ankle joints with raised Uric acid for which he was taking treatment at various places without any relief. I looked at his physique and ordered all metabolic penal tests. In results, he was found to have very high triglyceridemia cholesterol Uric acid. But urea, creatinine, TSH homocysteine etc normal. Reports of TG was 665 sc 268 in spite of treatment with statin and Fenofibrate. TG keep on increasing 665, 760, 667, 980 and Total lipids 1069 to 1380, 1680, 1900.
He was treated with all possible treatment statins 20 mg, Fenofibrate, niacin, folic acid, omega 3 fatty acids, pitavastatin 4 mg, metformin etc. He is symptomatically OK but readings are not normal. In between he had a mild elevation of blood glucose TIA , treated accordingly. HE is MR. How should this condition be managed?
