Systemic immune-inflammatory indices are associated with liver dysfunction in Turner syndrome

Abstract

Abstract Pathophysiological mechanisms of liver dysfunction in Turner syndrome (TS) are not well understood. We examined systemic inflammatory indices (neutrophil-lymphocyte-ratio, NLR; AST-to-platelet ratio, APRI; AST-to-lymphocyte ratio, ALRI; and GGT to platelet ratio, GPR) in patients with TS and their potential application in describing the endocrine and metabolic abnormalities of these subjects. We performed a retrospective analysis of medical records of 79 TS patients (mean age 32.5 years ± 9.2 SD) followed in the University Hospital of Nancy. Using matched-pair analyses based on age and BMI, we compared 66 TS patients (25.6 ± 7.3 years; BMI 25.9 ± 6.3 kg/m2) to 66 healthy controls (24.7 ± 6.8 years; BMI 26.0 ± 6.7 kg/m2). Liver abnormalities were present in 54% of the TS subjects. In this subgroup of patients with hepatic abnormalities, inflammatory indices (NLR, APRI, ALRI, GPR) were significantly higher than that observed in TS patients with normal liver function. In the matched-pair analyses, indices APRI, ALRI, and GPR were higher in TS patients than in healthy controls. The results of the logistic regression revealed significant associations between a diagnosis of TS and APRI, ALRI, GPR, liver dysfunction, low bone mineral density, and hypothyroidism. In conclusion, systemic inflammatory indices NLR, APRI, ALRI and GPR are significantly associated with liver dysfunction in TS. These observations increase our understanding regarding the pathophysiological mechanisms of liver dysfunction in TS. Larger prospective studies are needed to confirm our findings and to explore a prognostic value of inflammatory indices and their potential utility for clinical practice.