Background: Liver tests abnormalities are common in adult patients with Turner Syndrome (TS). The data regarding liver tests in children and adolescents with TS remain lacking.
Design and patients: A cross-sectional review of liver function of 100 girls with TS (age range 416, the mean BMI SDS 0.63 [−1,86 −6,78]); 56 receiving rhGH therapy (9 obese, 47 normal weight), and 44 receiving rhGH therapy and estrogen or estrogen/progesterone hormone replacement therapy (HRT)(8 obese and 36 normal weight). A longitudinal study included 81 patients (mean follow-up period: 35 years).
Measurements: Activity of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured in fresh serum samples using dry chemistry (Vitros).
Results: When compared to reference ranges, 34% of girls with TS demonstrated increased AST and ALT activity (32% without HRT, 36% on HRT), with not significant yearly increase of the incidence (P<0.05). During follow-up period no patient developed serious liver disease. Ultrasound examination revealed liver steatosis in 11% patients without HRT and in 9% of patients with HRT. The difference was not significant. No architectural changes, nor bile duct alterations have been noticed. There was no significant correlation between AST and BMI SDS R=0.09; P>0.05, ALT and age (R=0.02, P>0.05), nor AST and age (R=−0.01, P>0.05). Although there was significant correlation between ALT and BMI SDS (R=0.23, P<0.05), the relative risk of increased ALT and AST activity was not higher in obese patients (OR 0.2; 95%CI 0.10.36; P=0.38, and OR 0.16; 95%CI 0.080.3, P=0.1 respectively). HRT did not increase the risk of higher ALT and AST activity in girls with TS (OR 0.8; 95%CI 0.51.2; P=0.37, and OR 0.7; 95%CI 0.41.1, P=0.27 respectively).
Conclusions: Presence of obesity and HRT do not increase the relative the risk of higher ALT and AST activity. To explain clinical signficance of this phenomenon further longitudinal investigations are needed.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology