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. 2015 Jun;62(6):1405-11.
doi: 10.1016/j.jhep.2015.01.013. Epub 2015 Jan 21.

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Norelle R Reilly  1 , Benjamin Lebwohl  2 , Rolf Hultcrantz  3 , Peter H R Green  4 , Jonas F Ludvigsson  5
Affiliations

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Norelle R Reilly et al. J Hepatol. 2015 Jun.

Abstract

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.

Keywords: Autoimmune; Celiac disease; Gluten; NAFLD; NASH; Steatohepatitis.

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Conflict of interest statement

Conflict of Interest: None.

Figures

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Log-minus-log curve examining proportional hazards
See this image and copyright information in PMC

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