When a doctor needs to assess the condition of your liver, he orders a panel of laboratory tests. The panel typically includes several liver enzymes. In patients with Turner's Syndrome, the liver enzymes are often elevated. The reasons for these findings are not entirely understood at this time.
Turner's Syndrome
TS is a genetic condition affecting girls with the prevalence 1 in 1,893 of live female births. The girls miss the paternal sex chromosome X. Consequently, their ovaries do not develop. Women with TS are infertile and have short statue. They may have additional clinical problems, including thyroid dysfunction, cardiovascular diseases, diabetes, hypertension, osteoporosis, kidney malformations and obesity. Until recently, changes in the liver enzymes have been less recognized.
Elevation of Liver Enzymes in TS
In a study of 125 women with TS, as many as 91 percent had elevated levels of one or more of the liver enzymes, including alkaline phosphatase, alanine transaminase gamma-glutamyl transaminase. This was reported by Olympia Koulouri and her colleagues from University of London College Hospitals in August 2008 issue of "Clinical Endocrinology."
Changes of Liver Enzymes Over Time
Koulouri's group then asked whether the liver dysfunction in TS women worsens as time passes. The researchers followed 30 women with TS for eight years and observed that the enzymes gradually rise. The serum levels of the liver enzymes increased between the starting and ending points by 11.9 percent. This suggest that the liver function slowly deteriorates, but it is not clear why.
Effect of Estrogen on the Liver Enzymes
If you have TS, you are not making enough of estrogen. As a part of standard care, exogenous estrogen is offered to patients with TS to help them to develop secondary sexual characteristics typical for adult women, such as breasts or pubic hair. Olympia Koulouri and colleagues asked whether the treatment with estrogen affects serum levels of the liver enzymes. Exogenous estrogen decreased the liver enzymes, suggesting that estrogen plays a protective role in the liver function of TS patients. Researchers from Aarhus University in Denmark reached a similar conclusion. In June 2007 issue of "European Journal of Endocrinology" they also reported that exogenous estrogen reduces the elevation of liver enzymes in women with TS.
Liver Enzymes and Weight Loss
According to Olympia Koulouri, TS patients have lipids in their liver cells. This resembles non-alcoholic fatty liver disease that is common in overweight and obese people. In most cases, the changes are reversible with weight loss. This may be beneficial also in patients with TS, particularly when they also have other common TS complications, such as obesity, cardiovascular diseases and diabetes.
References
- MedlinePlus: Liver Function Tests
- "Human Genetics"; Chromosome Abnormalities Found among 34,910 Newborn Children: Results From a 13-Year Incidence Study in Arhus, Denmark; J Nielsen et al.; May 1991
- National Institute of Health: Turner Syndrome
- "Clinical Endocrinology"; Liver Dysfunction in Turner's Syndrome: Prevalence, Natural History and Effect of Exogenous Oestrogen; O Koulouri; August 2008
- "European Journal of Endocrinology"; Quantitative lLver Functions in Turner Syndrome With and Without Hormone Replacement Therapy; CH Gravholt et al.; June 2007
- "Hepatology"; Randomized Comparison of Reduced Fat and Reduced Carbohydrate Hypocaloric Diets on Intrahepatic Fat in Overweight and Obese Human Subjects; S Haufe et al.; May 2011
