{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:29:12Z","timestamp":1788827352830,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Abnormal liver chemistries are common in Turner syndrome (TS). Guidelines suggest that TS patients undergo annual screening of liver enzymes, but the role of non\u2010invasive screening for steatosis and fibrosis is not clearly defined. We compared the prevalence of hepatic steatosis and fibrosis among TS patients to healthy controls using ultrasound with shear\u2010wave elastography (SWE) and assessed for risk factors associated with steatosis and fibrosis in TS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective case\u2013control study of TS versus control patients from 2019 to 2021. All patients underwent abdominal ultrasound with doppler and SWE to assess hepatic fibrosis and steatosis. Risk factors were compared between TS and controls, as well as within the TS group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 55 TS and 50 control patients were included. Mean age was 23.6\u2009years vs. 24.6\u2009years in the control group (<jats:italic>p<\/jats:italic>\u2009=\u2009.75). TS patients had significantly more steatosis (65% vs. 12%, stage 1 vs. 0, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) and fibrosis (39% vs. 2%, average Metavir F2 vs. F0, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.00001) than controls. These findings remained significant after adjusting for body mass index (BMI) (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). GGT is more sensitive than AST or ALT in identifying these changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TS is associated with an increased prevalence of hepatic steatosis and fibrosis compared to healthy controls. Our findings suggest that serum GGT and ultrasound with SWE may help identify TS patients with liver disease. Early risk factor mitigation including timely oestrogen replacement, weight control, normalization of lipids and promoting multidisciplinary collaboration should be encouraged.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15840","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T12:39:03Z","timestamp":1708691943000},"page":"1309-1315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of hepatic steatosis and fibrosis in Turner syndrome: A prospective case\u2013control study"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5423-8749","authenticated-orcid":false,"given":"Patrick","family":"Twohig","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Divisions of Gastroenterology University of Nebraska Medical Center\/Nebraska Medicine  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Divisions of Cardiology  Omaha Nebraska USA"},{"name":"Department of Pediatrics, Division of Cardiology Children's Hospital &amp; Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Danford","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology Children's Hospital &amp; Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Craft","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology Children's Hospital &amp; Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anji T.","family":"Yetman","sequence":"additional","affiliation":[{"name":"Divisions of Cardiology  Omaha Nebraska USA"},{"name":"Department of Pediatrics, Division of Cardiology Children's Hospital &amp; Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15358"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0430"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12007"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4274\/jcrpe.galenos.2019.2018.0271"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-020-0839-y"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200102153440706"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajg.2013.05.002"},{"key":"e_1_2_11_9_1","first-page":"218","article-title":"Non\u2010invasive assessment of liver fibrosis","volume":"25","author":"Papastergiou V","year":"2012","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12476"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.15.03036"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22748"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2010.02397.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13811"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/kjm2.12395"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-019-02155-w"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15099"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/20014091084227"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.20517\/mtod.2022.20"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.15557\/JoU.2021.0030"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13246"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030025"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvac124"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15840","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T11:57:26Z","timestamp":1716379046000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.15840"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,23]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/liv.15840"],"URL":"https:\/\/doi.org\/10.1111\/liv.15840","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,23]]},"assertion":[{"value":"2023-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}