Patients with Celiac Disease Have High Prevalence of Fatty Liver and Metabolic Syndrome

Nishant Aggarwal; Ashish Agarwal; Hasan Alarouri; Vignesh Dwarakanathan; Sana Dang; Vineet Ahuja; Govind K Makharia

doi:10.1007/s10620-024-08426-5

Patients with Celiac Disease Have High Prevalence of Fatty Liver and Metabolic Syndrome

Dig Dis Sci. 2024 Apr 25. doi: 10.1007/s10620-024-08426-5. Online ahead of print.

Authors

Nishant Aggarwal¹, Ashish Agarwal², Hasan Alarouri³, Vignesh Dwarakanathan⁴, Sana Dang⁵, Vineet Ahuja⁶, Govind K Makharia⁷

Affiliations

¹ William Beaumont University Hospital, Royal Oak, MI, USA.
² All India Institute of Medical Sciences, Jodhpur, India.
³ Mayo Clinic, Rochester, MN, USA.
⁴ Employee's State Insurance Corporation Hospital, Chennai, India.
⁵ Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
⁶ All India Institute of Medical Sciences, New Delhi, India.
⁷ All India Institute of Medical Sciences, New Delhi, India. govindmakharia@gmail.com.

PMID: 38662156
DOI: 10.1007/s10620-024-08426-5

Abstract

Objective: In recent years, patients with celiac disease (CeD) have been reported to have a high prevalence of fatty liver and metabolic syndrome. We conducted a systematic review and meta-analysis to assess the prevalence of fatty liver and metabolic syndrome in patients with CeD and effect of gluten-free diet in them.

Methods: The PubMed, Embase and the Cochrane Library databases were searched for original studies upto November 18, 2022. We included full-text articles published in the English language after 1990 that used well-defined criteria for CeD, fatty liver and metabolic syndrome. A random effects model was used to calculate pooled prevalence.

Results: Of 350 studies identified, 11 studies (n = 2578) were included in the analysis. On analysis of both cross-sectional and longitudinal studies, pooled prevalence of fatty liver and metabolic syndrome in treatment-naïve patients with CeD were 18.2% (95% CI 8.3-30.8%, n = 1237) and 4.3% (95% CI 2.4-6.7, n = 1239) and in those on GFD of varying duration was 28.2% (95% CI 20.7-36.4%, n = 1368) and 21.3% (95% CI 11.7-32.9%, n = 2193), respectively. There was no difference in the prevalence of fatty liver and metabolic syndrome between low- or high-income group countries.

Conclusions: Patients with CeD have a high prevalence of fatty liver and metabolic syndrome which increases further with the initiation of GFD. Patients with CeD should thus be screened and monitored for development of fatty liver and metabolic syndrome. They should be counselled appropriately regarding their diet and inclusion of physical activity in their lifestyle.

Keywords: Abdominal obesity; Gluten free diet; Gluten sensitive enteropathy; Non-alcoholic fatty liver disease; Nontropical sprue.