Hormone replacement therapy may improve hepatic function in women with Turner's syndrome
Abstract
OBJECTIVE: Women with Turner's syndrome (TS) have recently been shown to be at an increased risk of developing chronic liver disease. There has been some concern that oestrogen replacement therapy may exacerbate hepatic dysfunction. The aim of this study was to assess hepatic function in women with TS and to determine the effect of oral oestradiol valerate on liver enzymes. DESIGN AND PATIENTS: A retrospective review of liver enzymes of 80 women with TS, followed by a prospective study looking at serum liver enzyme concentrations in 20 women with TS following 3 months on and off hormone replacement therapy (HRT) (oestradiol valerate, 2 mg/levonorgestril 75 microg). MEASUREMENTS: Liver enzymes (gamma glutamyl transferase, aspartate transaminase and alkaline phosphatase), albumin and bilirubin were measured on and off HRT. Viral hepatitis serology and liver autoantibodies were tested in patients with abnormal liver function. RESULTS: Thirty-five out of 80 women (44%) had elevated serum liver enzyme concentrations. Two women (2.5%) had a mildly raised serum bilirubin, but protein synthesis was normal in all subjects. HRT resulted in a significant fall in all liver enzymes (P < 0.05) but did not affect serum protein concentrations CONCLUSIONS: Women with Turner's syndrome often have elevated liver enzymes. Oestrogen/progestagen therapy using oestradiol valerate improves liver function in this group of patients. The mechanisms behind this are unclear.
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There is no evidence of liver toxicity from E2 treatment.
“No evidence of liver toxicity”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [349]
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“More recent studies also found elevated LFTs in young patients before HRT, and some showed a beneficial impact of estrogen replacement (4,28,31).”
BackgroundBourcigaux, N., Dubost, E., Buzzi, J.-C., Donadille, B., Corpechot, C., Poujol-Robert, A., & Christin-Maitre, S. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad108 · Cited by 8 · see citing works
- Authors
- Elsheikh, M., Hodgson, H. J. F., Wass, J. A. H., & Conway, G. S.
- Affiliations
- University of Oxford (GB)
- The Royal Free Hospital (GB)
- Corresponding author
- Conway, G. S.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2001-08
- Volume
- 55
- Issue
- 2
- Pages
- 227-231
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2044446803
- Cited by
- 109
- References
- 24
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 8 · 2021: 3 · 2020: 4 · 2019: 12 · 2018: 6 · 2017: 2 · 2016: 3 · 2014: 6 · 2013: 6 · 2012: 4
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Keywords
- Turner syndrome, hormone replacement therapy, estradiol valerate, levonorgestrel, liver function, liver enzymes, chronic liver disease, gamma-glutamyl transferase, aspartate aminotransferase, alkaline phosphatase, serum bilirubin, protein synthesis
- MeSH terms
- Adolescent, Adult, Alkaline Phosphatase, Aspartate Aminotransferases, Estradiol, Female, gamma-Glutamyltransferase, Humans, Karyotyping, Liver Cirrhosis, Middle Aged, Prospective Studies, Retrospective Studies, Turner Syndrome, Estrogen Replacement Therapy, Statistics, Nonparametric
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