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Increased liver enz...
Increased liver enzymes in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
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- Falhammar, Henrik (author)
- Karolinska Institutet
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- Filipsson, Helena, 1966 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin,Institute of Medicine, Department of Internal Medicine
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- Holmdahl, Gundela, 1956 (author)
- Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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- Janson, Per-Olof, 1940 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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- Nordenskjöld, Agneta (author)
- Karolinska Institutet
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- Hagenfeldt, Kerstin (author)
- Karolinska Institutet
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- Thorén, Marja (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2009
- 2009
- English.
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In: Endocrine journal. - 1348-4540. ; 56:4, s. 601-8
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Abstract
Subject headings
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- The aims were assessing liver function tests (LFT) in women with congenital adrenal hyperplasia (CAH) on glucocorticoids. Sixty-one women with genetically verified CAH due to 21-hydroxylase deficiency, aged 18-63 years were compared to 61 controls. Serum alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT), anthropometry and fat mass (dual energy X-ray absorptiometry) were measured. ALT and GGT were higher in the entire patient group (p=0.01 and 0.002); AST, GGT and ALP in patients > or =30 years (p=0.007-0.045); all LFT in salt-wasting (p<0.001-0.042); GGT in simple virilizing (p=0.008); ALT, GGT and ALP in Null/Null genotype (p=0.018-0.040); ALT and GGT in I2splice genotype (p<0.001 and 0.011). Using a recently proposed cut-off level for ALT (>0.317 microkat/L), 54% of patients vs 23% of controls had elevated levels (p=0.028). In patients, GGT and ALP correlated with waist circumference and with total body and trunk fat (r=0.274-0.406, p=0.001-0.043). However, ALT, GGT and ALP were increased even in non-obese patients (waist circumference < or =88 cm and body mass index <30 kg/m(2)) (p=0.012-0.045) mainly attributed to the patients > or =30 years who also demonstrated elevated insulin levels and HOMA-indices. In conclusion, compared with controls, women with CAH have higher LFT, in particular patients > or =30 years and those with severe forms, probably reflecting a higher lifetime glucocorticoid exposure. LFT were positively correlated to measurements of body fat. These women might have increased frequency of NAFLD. The finding of higher LFT also in non-obese patients suggests that not only central obesity but also glucocorticoids per se may influence.
Keyword
- Adolescent
- Adrenal Hyperplasia
- Congenital
- enzymology
- Adult
- Alanine Transaminase
- blood
- Alkaline Phosphatase
- blood
- Aspartate Aminotransferases
- blood
- Blood Glucose
- metabolism
- Female
- Humans
- Insulin
- blood
- Liver
- enzymology
- Liver Function Tests
- Middle Aged
- Steroid 21-Hydroxylase
- Waist Circumference
- gamma-Glutamyltransferase
- blood
Publication and Content Type
- ref (subject category)
- art (subject category)
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