Quantitative liver functions in Turner syndrome with and without hormone replacement therapy
Abstract
BACKGROUND: Studies have documented elevated levels of liver enzymes in many females with Turner syndrome (TS). Histology has shown a range of changes. Treatment with female hormone replacement therapy (HRT) reduces liver enzymes. AIM: To study quantitative liver functions in TS in detail with and without HRT. DESIGN: Randomized crossover study with active treatment (HRT in TS and P-pill in controls) or no treatment. SUBJECTS: Women with TS (n = 8, age 29.7 +/- 5.6 (mean +/- s.d.) years), verified by karyotype, and age-matched controls (C; n = 8, age 27.3 +/- 4.9 years). METHODS: We determined liver enzymes in blood, used the galactose elimination capacity to assess hepatocyte cytosol activity, plasma clearance of indocyanine green to assess excretory function, antipyrine clearance to estimate microsomal activity, and the functional hepatic nitrogen clearance (FHNC) to assess mitochondrial-cytosolic metabolic capacity for conversion of amino-nitrogen. RESULTS: Liver enzymes were elevated in untreated TS and reduced by HRT. The hepatic capacities for conversion of galactose, indocyanine green, and antipyrine were normal and did not change by HRT. The FHNC was marginally reduced (untreated TS vs C: 19.4 +/- 5.4 vs 25.2 +/- 7.3 L/h, P = 0.1). FHNC changed slightly with HRT in TS (19.4 +/- 5.4 vs 24.4 +/- 10.2 L/h, P = 0.2). CONCLUSIONS: The elevations of liver enzymes in untreated TS are readily suppressed by HRT. Quantitative liver functions in TS are comparable to controls and are not affected by HRT.
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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 [347]
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“As women with TS have short stature and abnormal body proportions, they are more likely to be overweight and obese (4,17,18,19,30).”
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- Authors
- Gravholt, C. H., Poulsen, H. E., Ott, P., Christiansen, J. S., & Vilstrup, H.
- Affiliations
- Aarhus University Hospital (DK)
- Rigshospitalet (DK)
- Corresponding author
- Gravholt, Claus Højbjerg
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-06
- Volume
- 156
- Issue
- 6
- Pages
- 679-686
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2135755215
- Cited by
- 56
- References
- 48
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 1 · 2022: 7 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 2 · 2013: 5 · 2012: 4
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- Turner syndrome, liver function, liver enzymes, galactose elimination capacity, indocyanine green clearance, antipyrine clearance, hepatocyte function
- MeSH terms
- Adult, Alanine Transaminase, Alkaline Phosphatase, Anti-Inflammatory Agents, Non-Steroidal, Antipyrine, Body Composition, Calorimetry, Indirect, Coloring Agents, Estradiol, Female, Galactose, gamma-Glutamyltransferase, Humans, Indocyanine Green, Liver, Liver Function Tests, Nitrogen, Progestins, Turner Syndrome, Cross-Over Studies, Hormone Replacement Therapy
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