Monday, December 24, 2012

Santa's Health Profile

Sometimes being an endocrinologist you can't help but wonder what metabolic or health issues a person might have. And so, watching yet another Santa ad on TV got me thinking about what he might be suffering from.
I'd say his BMI is easily 35, probably even north of 40. There would be a good chance too especially with that thick neck of his that he has obstructive sleep apnea as well. Indeed, this might explain his rosy cheeks- the polycythemia some patients with severe OSA experience. Treatment might be a problem though as his full beard would not allow for a proper fitting CPAP (continuous positive airway pressure) mask, so I imagine his doc would make him lose weight instead, or suggest surgery.
I'd bet that he would also have some lipid issues- the ones I'd anticipate would be the classic pattern seen in metabolic syndrome- low HDL and high triglycerides. Perhaps even high LDL. So, perhaps a candidate for a niacin-based treatment (except the recent AIMHIGH does confound the picture).

Insulin resistance, or even frank diabetes, might be in the picture. After all, this affects 7% of the population and with his habitus this would not be surprising. If so, aside from the usual diet and exercise, I might recommend metformin- but the frequent bowel movements/diarrhea might make his long flights difficult as I don't think his sleigh has a toilet. And should he get, err, gassy, this might give him away as he sneaks in to drop off presents. Not to mention that flatulence while climbing down a fireplace might set off an explosion.
The high salt diet (from the pretzels some kids leave him) likely will lead to hypertension as well (often also caused by the concurrent sleep apnea). Lastly, we frequently see people with central hypogonadism from OSA, too.
So, I imagine a doctor will get pretty busy treating dear old Santa. But then again, if St. Nick has lived hundreds of years so far, who are we to say?