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Higher Risk of Non-alcoholic Fatty Liver Disease After Celiac Diagnosis

Celiac.com 06/29/2015 - Non-alcoholic fatty liver disease is a common cause of chronic liver disease. There's good data showing that celiac disease changes intestinal permeability, and that treatment with a gluten-free diet often causes weight gain, but so far there is scant documentation of non-alcoholic fatty liver disease in patients with celiac disease.

Photo: Wikimedia Commons--NephronA team of researchers recently set out to assess increased risk of non-alcoholic fatty liver disease following diagnosis of celiac disease. The research team include Norelle R. Reilly, Benjamin Lebwohl, Rolf Hultcrantz, Peter H.R. Green, and Jonas F. Ludvigsson. They are affiliated with the Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, and the Department of Pediatrics at Örebro University Hospital, Örebro University in Örebro, Sweden.

The team assessed the for risk of non-alcoholic fatty liver disease diagnosed from 1997 to 2009 in 26,816 individuals with celiac disease to 130,051 matched reference individuals.

The team excluded patients with any liver disease prior to celiac disease. They also excluded individuals with a lifetime diagnosis of alcohol-related disorder to minimize misclassification of non-alcoholic fatty liver disease. They used Cox regression estimated hazard ratios for non-alcoholic fatty liver disease.

Their results showed that over 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).

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In comparison, in the reference group showed 85 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 in the celiac group (95% CI), with the highest risk estimates of 4.6 seen in children (95% CI).

The risk increase in the first year after celiac disease diagnosis was 13.3 (95% CI), but remained significantly elevated at 2.5 even beyond 15 years after celiac diagnosis of celiac disease (95% CI).

Individuals with celiac disease do have an 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 continued at least 15 years after celiac diagnosis. This much more comprehensive study provides much clearer and convincing data than any of the previous studies, and will likely serve as a baseline that clinicians have been lacking to this point.

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1 Response:

 
Thelma King Thiel
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
30 Jun 2015 8:18:19 AM PDT
Diet is critical in dealing with Celiac disease and fatty liver disease as well. Promoting liver health is essential in controlling both diseases. I would like to share an approach that we have found successful in helping motivate both adults and children to address the issue of fatty liver disease, obesity and other liver related illnesses in their own lives.

Extensive evaluation of liver health education programs have shown that individuals who understand HOW liver damage occurs and the detrimental impact it can have on innumerable life sustaining body functions, are motivated to make informed healthful decisions about their food and lifestyle choices. Providing simple messages they can relate to about the important role the liver plays in maintaining hundreds of body functions and sustaining life itself. . . is the key to empowering them to act on what they have learned.

The following information is NEW to most Americans:

The liver has zillions of liver cells serving as the body's micro-chips, converting food into hundreds of essential body functions including producing energy, immune factors, digestive juices (bile), clotting factors, excretion of toxins (alcohol, drugs, pollutants), control of cholesterol and hundreds more. Liver cells are the employees in your personal chemical refinery.

WITHOUT WARNING excess sugar, fats, alcohol and drugs ingested can kill liver cells turning them into scar tissue called cirrhosis. Continued assault over months and years resulting in too many dead cells and too few healthy liver cells causes the liver to slow down and eventually shut down. When your liver shuts down-- so do you.
Early warning signs of liver trouble can be fatigue, a fat belly and derriere, and possibly flu- like symptoms. Assess your own risks! Look in the mirror - A waistline over 35 inches for women and 40 inches for men may indicate a fatty liver.
Making healthy food and lifestyle choices and daily exercise will help keep liver cells healthy and your body in good shape. Ask your healthcare provider to check the status of your liver.
It could save your life.




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I am very interested in this too. My daughter tested negative for celiac, but has terrible primarily neurological symptoms. Because she tested positive for SIBO at the time and was having some GI symptoms, I was told it was just a Fodmap issue. I knew better and we have been gluten free for 2 years. Fast forward to this February. She had a SIBO recurrence that I treated at home with diet and herbal antibiotics because I couldn't get the insurance referral. She was doing great. Then stupid me brought in gluten containing chick feed for the new baby chicks we got. Feed dust everywhere. Total mess. Really, no GI symptoms (she was SIBO free by then)...but the neurological symptoms! my daughter couldn't walk for three days. Burning down one leg, nerve pain in the foot. Also heaviness of limbs, headache and fatigue. Better after three days. But unfortunately she had a TINY gluten exposure at that three day mark and had another severe reaction: loss of balance, loss of feeling in her back and arms, couldn't see for a few seconds, and three days of hand numbness, fatigue, concentration problems. Well, I actually contacted Dr. Hadjivassilou by email and he confirmed that the symptoms are consistent with gluten ataxia but any testing would require a gluten challenge. Even with these exposures, antibodies would not be high enough. His suggestion was maintain vigilance gluten free. I just saw my daughter's GI at U of C and she really only recognizes celiac disease and neurological complications of that. But my impression is that gluten ataxia is another branch in the autoimmune side of things (with celiac and DH being the other two). At this point, I know a diagnosis is important. But I don't know how to get there. We homeschool right now so I can give her time to heal when she is accidentally glutened, I can keep my home safe for her (ugh, that I didn't think of the chicken feed!) But at some point, she is going to be in college, needing to take exams, and totally incapacitated because of an exposure. And doctors state side that are worth seeing? Who is looking at gluten ataxia in the US?

Caro..............monitoring only the TSH to gauge thyroid function is what endo's do who don' t do a good job of managing thyroid disease. They should do the full panel and check the actual thyroid hormone numbers.........T3 and T4. The importance of the TSH comes second to hormone levels. In order to track how severely the thyroid is under attack, you need to track antibody levels.......not the TSH. I did not stay with endocrinologists because I found they did not do a very good job and found much greater help and results with a functional medicine MD. You should not have a goiter if your thyroid is functioning well and your TSH is "normal". Maybe they should do a full panel? Going gluten free can have a profound affect for the better on thyroid function and that is something that is becoming more and more accepted today. Ask most people with Celiac and thyroid disease and they will tell you that. My thyroid never functioned well or was under control under after I discovered I had Celiac and went gluten free. It was the only way I got my antibody numbers back down close to normal and they were around 1200 when it was diagnosed with Celiac. I was diagnosed with Hashi's long before the Celiac diagnosis. I am not sure Vitamin D has anything to do with thyroid antibodies but who knows? Maybe it does have an affect for the better. It is really hard to get Vitmain D levels up, depending on where you live. Mine are going up, slowly, even after 12 years gluten-free but I live in the Northeast in the US and we don't have sun levels like they do in the South. I take 5,000 IU daily and that is a safe level to take, believe it or not. I get no sun on my job so the large dose it is! Having Celiac Disease should not stop you from being able to travel, especially S. America. I travel, although I do agree that some countries might be very difficult to be gluten free in. You can be a foodie and travel with Celiac so no worries on that front. You may not be able to sample from someone else's plate, unless they are eating gluten-free too but I have had awesome experiences with food when traveling so you can too!

I don't know what you drank or where.... so here are a few thoughts. - sure, a dive bar might have dirty glasses and serve a cocktail in a beer glass? But a nice reminder place, with a dishwasher, should be fine. If it's a sketchy place, Stick to wine, then it's served in wine glasses that aren't used for beer or bottled ciders in the bottle. - ciders on tap might, just a slight chance, have an issue. Because of beer on tap, mixed up lines, etc. - you may have a problem with alcohol - you may have issues with The high sugar content of the drink. I know I have similar issues if I drink serveral ciders of extra sugary brands - are you positive it was a gluten-free drink? Not this " redds Apple" pretending to be a cider - it's beer with apple flavor. Or one of those " gluten removed " beers?

Hi Stephanie, I'm also from the UK, I've found this site more helpful than anything we have! As already mentioned above, in my experience it could depend on what and where you were drinking. Gluten free food and drink isn't always (not usually) 100% gluten free as you may know, maybe you have become more sensitive to even a trace of gluten that is probably in gluten free food/drink. Is it possible you have a problem with corn, particularly high fructose corn syrup that is in a lot of alcoholic drinks? This was a big problem for me and the only alcoholic drinks I can tolerate are William Chase vodka and gin. I contacted the company last year and all their drinks are 100% gluten and corn free, made the old fashioned way with no additives, so maybe try their products if you like the occasional drink and see how you get on. If you drink out, not many pubs sell their products but I know Wetherspoons do and smaller wine bars may too. l was never a spirit drinker but I must say their products are absolutely lovely! Very easy on a compromised gut too considering it's alcohol. I second the suggestion on seeing a natural health practitioner. I've recently started seeing a medical herbalist, as I've got nowhere with my now many food intolerances since going gluten free last year and I've noticed a difference in my health already.

Sorry for the very late reply and thanks for the replies, I didn't get a notification of any. In case anyone else comes across this and has been wondering the same as I was, I did try a vegetable broth and I did react to it in the same way as if I'd eaten the vegetables. As for the candida, I've been using coconut oil and am seeing a medical herbalist for this and leaky gut. It's only been a few weeks but I've noticed an improvement all round.