Combining UAB's Lipid and Endocrinology Clinics allows endocrinologists Fernando Ovalle, MD, and Richard Rosenthal, MD, to offer comprehensive care for patients with diabetes, hypogly-cemia, thyroid, adrenal, pituitary, and gonadal disorders, bone and calcium problems, and complex lipid abnormalities.

For 18 years, cholesterol expert and Professor of Medicine and Biochemistry Jere Segrest, MD, PhD, directed the Lipid Clinic, most often focusing on patients with complex and difficult-to-treat disorders. Albert Oberman, MD, professor of preventive medicine, also evaluated and treated these patients until his retirement last summer.

Dr. Segrest ended full-time involvement with the clinic to concentrate on directing the Center for Structural and Computational Biology, which began operation last November. He is no longer seeing patients, but is attending Thursday morning clinic conferences to discuss individual cases and offer advice.

"When Dr. Segrest decided to devote more time to the new center, it made sense for us to see his patients, since many individuals with lipid abnormalities have coexisting diabetes, obesity, or metabolic syndrome — all conditions we have experience managing," Dr. Rosenthal says. "Patients get comprehensive treatment for the cluster of disorders that often accompany endocrine and lipid abnormalities and can still benefit from Dr. Segrest's expertise."

Patients who are not reaching recommended cholesterol or triglyceride goals and those who cannot tolerate lipid-lowering medications may benefit from evaluation in the clinic, Dr. Rosenthal says. "While statins remain the mainstay of cholesterol treatment, some newer agents make tighter control possible. The July 2004 update to the National Cholesterol Education Program's ATP III guidelines suggests reducing LDL cholesterol to less than 70 mg/dL is an option for very high-risk patients — those who have had a recent heart attack, cardiovascular disease combined with either diabetes, severe or poorly controlled risk factors (such as continued smoking), or the metabolic syndrome. Drugs such as ezetimibe and colesevelam make this an attainable goal for some patients who need aggressive control."

The Endcocrinolgy/Lipid Clinic meets on the first and third Thursdays each month on the fourth floor of The Kirklin Clinic®. "Sometimes physicians may feel a patient's therapy is 'stuck,' and we're available for consultation in those cases," Dr. Rosenthal says. "Physicians can refer patients to us for evaluation and are also welcome to present cases at our Thursday morning conferences."

Physicians interested in attending a morning conference should e-mail Dr. Rosenthal at rrosenth@uabmc.edu.