A 55-year-old woman was referred with a 6-month history of type 2 diabetes mellitus. She was not taking any regular medication. She was a non-smoker. She drank 10 units of alcohol per week. Her general practitioner had arranged for her to see the community dietician as the patient had made significant changes to her diet.
On examination, she was obese with a body mass index of 31.8 kg/m2 (18C25). Her liver was not palpable.
Investigations:
serum ferritin310 µg/L (15C300)
serum total bilirubin16 µmol/L (1C22)
serum alanine aminotransferase80 U/L (5C35)
serum aspartate aminotransferase75 U/L (1C31)
serum alkaline phosphatase150 U/L (45C105)
serum gamma glutamyl transferase35 U/L (4C35)
haemoglobin A1c67 mmol/mol (20C42)
serum cholesterol6.2 mmol/L (<5.2)
serum HDL cholesterol0.90 mmol/L (>1.55)
fasting serum triglycerides2.50 mmol/L (0.45C1.69)
What is the most appropriate management of her dyslipidaemia?
A . ezetimibe
B . fenofibrate
C . metformin
D . omega-3-acid ethyl esters
E . simvastatin
Answer: E
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