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Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States; Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, United States .
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States; Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medicine, Karolinska Institutet, Stockholm, Sweden .
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States .
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2015 (English)In: Journal of Hepatology, ISSN 0168-8278, E-ISSN 1600-0641, Vol. 62, no 6, 1405-1411 p.Article in journal (Refereed) Published
Abstract [en]

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. (C) 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
2015. Vol. 62, no 6, 1405-1411 p.
Keyword [en]
Autoimmune; Celiac disease; Gluten; NAFLD; NASH; Steatohepatitis
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-44864DOI: 10.1016/j.jhep.2015.01.013ISI: 000354574800025PubMedID: 25617505Scopus ID: 2-s2.0-84929606483OAI: oai:DiVA.org:oru-44864DiVA: diva2:818815
Funder
Swedish Research Council
Note

Funding Agencies:

National Center for Advancing Translational Sciences, National Institutes of Health UL1 TR000040

Swedish Society of Medicine

Swedish Celiac Society

Available from: 2015-06-09 Created: 2015-06-09 Last updated: 2017-03-17Bibliographically approved

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Ludvigsson, Jonas F.
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School of Health and Medical Sciences, Örebro University, SwedenOrebro University Hospital
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