Endocrine Abstracts

Introduction: Turner syndrome (TS), defined by the loss of X chromosome material, affecting 1/2500 females born. Associated with TS are a variety of comorbidities such as obesity and fatty liver disease, many of which increase in prevalence with age. The Turner Syndrome Life Course Project at UCLH has collected data on over 800 women over the last 20 years. Annual health surveillance in our adult TS clinic allows for screening for liver enzymes, such as Alanine Transaminase (ALT), Alkanine Phosphatase (AlKP) and Gamma-glutamyl transferase (GGT). Persistent elevation of liver enzymes may represent a risk for cirrhosis. Here we report regards to on the determinants of fatty liver disease in women with TS.

Methods: An analysis of 8,659 clinic visits from 829 women with TS and liver enzymes; ALT, AlKP and GGT. Factors affecting liver enzymes were examined such as hormone replacement therapy (HRT), age at visit and BMI. HRT was categorised as those receiving either oral oestrogens (oral contraceptive, oestradiol valerate & conjugated equine) or transdermal oestradiol. We assessed interactions between variables and liver enzyme parameters using a multiple regression. The first column of results shows the percentage of enzyme measurements that were above the reference range. Results for partial correlation coefficients on multiple linear regression are shown in the adjacent three columns with each enzyme tested separately as the dependent variable (* represents P< 0.05).

Conclusions: BMI was the greatest influence on all liver enzymes with age showing a positive influence on ALT and GGT. With regard to oestrogen use, oral oestrogen was associated with lower enzyme levels compared to transdermal oestradiol as a weak independent influence on ALT and AlkP. Weight loss is a priority for adult women with TS and raised liver enzyme although extent of reversibility is get to be proven.