Problem: An asymptomatic, nonsmoking 44 year-old white woman presents for medical evaluation because of elevated triglycerides. She went through menopause early at age 40. She is a nondrinker of alcohol. She has a strong family history of early coronary heart disease and diabetes mellitus type 2 (DM2). Her father had a myocardial infarction (heart attack) at age 38 and subsequently developed diabetes at age 52. Her mother developed DM2 at age 59 and had a myocardial infarction at age 64, and an older brother has DM2. On physical exam, her weight is 150 lbs., height 5 feet 0 in. (BMI 29.3 kg/m2). Blood pressure is 110/76. The exam is entirely normal except for abdominal girth of 40.5 inches. No known fractures, but she did state that she has low back pain. Fasting blood chemistries: Glucose is 70 mg/dL Hemoglobin A1c :6.5% (normal range, 4.3% to 6.0%) Total cholesterol: 212 mg/dL (normal under 200) HDL cholesterol: 30 mg/dL (normal 40-50) LDL cholesterol: 180 mg/dL (normal 100-129) Creatine: 1.4 mg/dL (normal levels are 0.5-1.1) Blood urea nitrogen (BUN): 22 mg/dL (normal 7-20) Albumin in urine: 80 mg protein (less than 30 mg is normal) Bone mineral densitometry scan was >2.5 standard deviations below