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Eloise is a 25-year-old fitness director with high physical activity who struggles with: BMI 37.5 (class II obesity) Irregular, infrequent menses since adolescence Clinical hyperandrogenism : cystic acne and upper-lip hair Hyperinsulinemia : fasting insulin 36.1 IU/mL, fasting glucose 107 mg/dL, A1C 6.0% , HOMA-IR 9.5 Dyslipidemia : elevated triglycerides, low HDL, elevated LDL Elevated liver enzymes

Presence of eubacteria in biopsies from Crohn's disease inflammatory lesions as determined by 16S rRNA gene-based PCR

The upshot

Telomeres are protective caps at the ends of chromosomes that shorten with each cell division, contributing to aging