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Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease
Open accessAbstract
Background & aims Non-alcoholic fatty liver disease is a common cause of chronic liver disease. Celiac disease alters intestinal permeability and treatment with a gluten-free diet often causes weight gain, but so far there are few reports of non-alcoholic fatty liver disease in patients with celiac disease.Methods Population-based cohort study. We compared the risk of non-alcoholic fatty liver disease diagnosed from 1997 to 2009 in individuals with celiac disease (n = 26,816) to matched reference individuals (n = 130,051). Patients with any liver disease prior to celiac disease were excluded, as were individuals with a lifetime diagnosis of alcohol-related disorder to minimize misclassification of non-alcoholic fatty liver disease. Cox regression estimated hazard ratios for non-alcoholic fatty liver disease were determined.Results During 246,559 person-years of follow-up, 53 individuals with celiac disease had a diagnosis of non-alcoholic fatty liver disease (21/100,000 person-years). In comparison, we identified 85 reference individuals diagnosed with non-alcoholic fatty liver disease during 1,488,413 person-years (6/100,000 person-years). This corresponded to a hazard ratio of 2.8 (95% CI 2.0-3.8), with the highest risk estimates seen in children (HR = 4.6; 95% CI 2.3-9.1). The risk increase in the first year after celiac disease diagnosis was 13.3 (95% CI 3.5-50.3) but remained significantly elevated even beyond 15 years after the diagnosis of celiac disease (HR = 2.5; 95% CI 1.0-5.9).Conclusion Individuals with celiac disease are at increased risk of non-alcoholic fatty liver disease compared to the general population. Excess risks were highest in the first year after celiac disease diagnosis, but persisted through 15 years after diagnosis with celiac disease.
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“It has been also shown that individuals with celiac disease, characterized by increased gut permeability, are at increased risk of NAFLD compared to the general population [296,297].”
From Gut-pancreas-liver Axis as a target for treatment of NAFLD/NASH (2020) · cites this paper as [297]
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Metadata
- Authors
- Reilly, N. R., Lebwohl, B., Hultcrantz, R., Green, P. H. R., & Ludvigsson, J. F.
- Affiliations
- Columbia University Irving Medical Center (US)
- Karolinska Institutet (SE)
- Örebro University (SE)
- Corresponding author
- Ludvigsson, Jonas F.
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 62
- Issue
- 6
- Pages
- 1405-1411
- ISSN
- 0168-8278 (ISSN-L)
- PMC
- PMC4439270
- OpenAlex
- W2089313045
- Cited by
- 110
- References
- 44
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 9 · 2023: 13 · 2022: 12 · 2021: 12 · 2020: 10 · 2019: 12 · 2018: 9 · 2017: 7 · 2016: 4 · 2015: 5
- FWCI
- 8.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000040, KL2TR001874)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- non-alcoholic fatty liver disease, celiac disease, gluten-free diet, intestinal permeability, weight gain, chronic liver disease, children
- MeSH terms
- Adolescent, Adult, Aged, Celiac Disease, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Middle Aged, Risk Factors, Sweden, Time Factors, Cohort Studies, Young Adult, Non-alcoholic Fatty Liver Disease
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