Increased risk of nonalcoholic fatty liver disease in patients with coeliac disease on a gluten‐free diet: beyond traditional metabolic factors

Tovoli, Francesco; Negrini, Giulia; Farì, Roberto; Guidetti, Elena; Faggiano, Chiara; Napoli, Lucia; Bolondi, Luigi; Granito, Alessandro

doi:10.1111/apt.14910

Cited by 51 publications

(43 citation statements)

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“…The hazard ratio (HR) was higher in the first year after celiac disease diagnosis, with a 4.2-fold increase in the first 5 years, and was significantly higher in the male population (male 4.5, 95% CI = 2.7-7.6 vs. female 2.1, 95% CI = 1.3-3.2) (Table 4) [36]. Similar results were reported in a case-control study involving 202 patients with CD on a GFD for at least six months [37]. Patients with CD were compared to control patients matched based on demographic characteristics (age and gender) and metabolic risk factors (BMI, Diabetes Mellitus, triglycerides, and cholesterol).…”

Section: Celiac Disease Following a Gfd And Nafldsupporting

confidence: 76%

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Celiac Disease, Gluten-Free Diet, and Metabolic and Liver Disorders

et al. 2020

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Celiac disease (CD) is a chronic autoimmune enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. At the time of diagnosis, the frequency of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis in individuals with CD appears to be similar to that of the general population, although a lower body mass index and a lower rate of hypercholesterolemia and type 2 diabetes mellitus are observed at diagnosis in CD patients. The effect of a gluten-free diet (GFD) in individuals with these liver and metabolic disorders is still a matter of debate. The aim of this study was to investigate the links between a GFD and metabolic/liver disorders in CD patients. A systematic electronic search of the literature from January 2009 to December 2019 was performed using Medline, Web of Science, Scopus, and the Cochrane Library. Only papers written in English concerning metabolic and liver disorders in adult patients with CD were included. Out of 1195 citations, 14 eligible studies were identified. Increases in the frequency of NAFLD, weight gain, and alterations of the lipid profile suggest that important changes happen in celiac patients on a GFD, though the physiopathology of these conditions is unclear. Although a GFD is the only effective treatment available for CD, liver function, body weight, and metabolic and nutritional profiles should be monitored in patients on a GFD.

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Section: Celiac Disease Following a Gfd And Nafldsupporting

confidence: 76%

“…There were four studies found that assessed the frequency of NAFLD/NASH before and after the start of a GFD (Table 4) [35][36][37][38]. Three of them evaluated any predictive factors that could increase metabolic risk during the GFD [19,33,38].…”

Section: Celiac Disease Following a Gfd And Nafldmentioning

confidence: 99%

Celiac Disease, Gluten-Free Diet, and Metabolic and Liver Disorders

et al. 2020

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“…[26][27][28] The results of the present study show a higher prevalence of fatty liver than that reported in an earlier study. 18 The higher prevalence of fatty liver in these patients may partly be because of use of a more sensitive and more reliable technique such as FibroScan for detection of fatty liver in comparison to ultrasonographic examination, which is mostly qualitative, subjective and operator dependent and more likely to miss the lower degrees of fat accumulation in the liver. 29 While 13% patients had a BMI in overweight/obese category at the diagnosis of CeD, the proportion increased to approximately 25% after 1 year of GFD in them.…”

Section: Discussionmentioning

confidence: 99%

“…12 There are studies to suggest that patients with CeD are at 3-fold higher risk of developing NAFLD. [13][14][15][16][17][18] Furthermore, patients with CeD are at a higher risk of cardiovascular diseases (HR, 1.10; 95% CI, 1.03-1.28) and stroke (OR, 1.11; 95% CI, 1.02-1.20). 19 Since there is a limited data globally and none from Asia on the prevalence of metabolic syndrome and fatty liver disease in patients with CeD, we conducted a study to assess the prevalence of metabolic syndrome in treatment naïve patients with CeD before and after 1 year of GFD prospectively and in another cohort of patients with CeD who were on GFD for at least 1 year.…”

Section: Introductionmentioning

confidence: 99%

Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver

et al. 2021

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studies have made similar observations and up to 44% of the patients were found to be overweight or obese at the time of diagnosis of CeD. 2,3 Furthermore, many studies have uniformly shown that underweight patients at the time of diagnosis tend to gain weight on gluten-free diet (GFD). 4-6 Contradictory to that while 22% to 82% of overweight and obese patients gain weight on a GFD; 4,7 some of the overweight and obese patients with CeD lose weight on GFD. 6,8 As described above, many studies have looked into the effect of a GFD on BMI but the association between CeD and metabolic syndrome has not been explored in much detail. In a recent prospective study, Tortora et al. 9 reported an increase in the prevalence of metabolic syndrome from 2% at the time of diagnosis to 30% after 12 months of GFD. Although there is emerging evidence that a sizeable proportion of patients with CeD gain weight

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“…Copper deficiency in patients with malabsorption syndromes, especially in celiac disease, is also associated with hepatic steatosis, 10 but this has not been evaluated in systematic studies.P. FerenciInternal Medicine 3, Medical University of Vienna, Austria Währinger Gürtel 18‐20 A1090 Vienna, Austria…”

Section: Copper Deficiencymentioning

confidence: 99%

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Liver International

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These proceedings of the PHC 2019 reflect the remarkable recent advances in all fields of hepatology that are covered during this conference.Thirty years after the discovery of the hepatitis C virus (HCV), we can tell our patients that they have almost a 100% chance of cure with pangenotypic DAAs. The rare patients who relapse with resistanceassociated substitutions after DAAs therapy are cured with appropriate retreatment. Cure means eradication of HCV infection with improved quality of life and outcome. Although the WHO HCV program, which seeks the elimination of hepatitis C by 2030 may be difficult to achieve, it is accompanied by active national programs worldwide.We can tell our patients with hepatitis B that they have a 100% chance of viral suppression. Long term studies of patients receiving last generation NUCs demonstrate sustained remission without resistance, regression of liver lesions and improved outcome. WHO has set priorities to achieve global goals including more effective vaccination and easy access to therapy programs. The next objective is a cure. This objective becomes realistic with the development of effective drugs of different viral targets. Future treatment will certainly include combinations that are adapted to the different phases of hepatitis B. Patients with hepatitis delta can be told that new treatments are on the way. Ongoing phase 3 trials of Myrcludex and Lonafarnib should confirm their efficacy, which is synergistic in combination with interferon.Patients with NAFLD must be receiving counselling. However, in this emerging liver disease, which affects 25% of the population, | 2421 ABSTRACT life style counselling is only effective in a minority of patients. As we learned from NANB hepatitis before discovering the HCV, our lack of knowledge explains the problems we now face with NAFLD.The key issue is differentiating NASH from simple steatosis. There is An alternative option is the combination of SOF plus GLE/ PIB ± RBV for 12-16 weeks. Moreover, triple FDC is recommended either in combination with weight-based dose RBV and/ or to extend treatment to 16 or 14 weeks in very difficult-to-cure patients with NS5A RASs who have failed to achieve SVR twice after several DAAs regimens including protease and/or N5A inhibitors. SUMMARYIn conclusion, the single pill triple FDC SOF/VEL/VOX for 12 weeks or the triple combination SOF plus GLE/PIB with or without ribavirin for 12 weeks achieves a 96% SVR rate in the few patients who fail DAAs combinations, even the most recent pangenotypic regimens.Therefore, with the current available rescue regimens, DAAs treatment failure is no longer significant issue.

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Increased risk of nonalcoholic fatty liver disease in patients with coeliac disease on a gluten‐free diet: beyond traditional metabolic factors

Cited by 51 publications

References 37 publications

Celiac Disease, Gluten-Free Diet, and Metabolic and Liver Disorders

Celiac Disease, Gluten-Free Diet, and Metabolic and Liver Disorders

Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver

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