A recent study conducted by Karolinska Institutet reveals a significant association between celiac disease and an increased risk of chronic liver disease. The study, published in Lancet Regional Health – Europe, shows that patients with celiac disease are at a heightened risk of developing chronic liver conditions, with the risk persisting for at least 25 years after diagnosis. The findings highlight the need for heightened clinical awareness and monitoring to mitigate adverse liver outcomes in these patients.
The research team, led by PhD student Jialu Yao, examined data from over 48,000 patients with biopsy-confirmed celiac disease, as part of the Swedish ESPRESSO cohort, alongside a control group of over 231,000 matched individuals from the general population. The study spanned from 1969 to 2017, with a median follow-up of 16 years.
Key findings showed that patients with celiac disease had a twofold increased risk of developing any chronic liver disease compared to the general population. This elevated risk continued over the study period, with one additional case of chronic liver disease per 110 patients observed over 25 years. Notably, patients who also had autoimmune or metabolic-related conditions faced even greater risks.
Key Risk Factors for Liver Disease
“The absolute risk difference between patients with celiac disease and the general population was relatively small,” explained Jialu Yao, the study’s lead author. “However, the relative risks for autoimmune liver disease and metabolic dysfunction-associated steatotic liver disease were notably higher, with estimates of 4.86 and 2.54, respectively.”
The study’s senior author, Professor Jonas F. Ludvigsson, emphasized the importance of monitoring liver function in celiac disease patients. “In line with current guidelines, regular liver enzyme monitoring should be part of the medical follow-up for patients with celiac disease,” said Ludvigsson, a professor at Karolinska Institutet and pediatrician at Örebro University Hospital. He also recommended that clinicians educate patients about the risks of chronic liver disease and carefully track metabolic parameters, particularly when starting a gluten-free diet.
Implications for Future Research and Clinical Care
The study suggests that the connection between celiac disease and chronic liver disease could be driven by genetic, immunological factors, or potential side effects of a gluten-free diet, which may lead to nutritional imbalances. “Further research is needed to explore the underlying mechanisms and the hepatic effects of a gluten-free diet,” Yao concluded, emphasizing that understanding these factors could improve clinical care for patients with celiac disease.
The study was conducted in collaboration with researchers from Örebro University (Sweden), University Digestive Health Care Center Basel – Clarunis (Switzerland), Columbia University (USA), and Harvard University (USA). For more details on funding and conflicts of interest, please refer to the original scientific article.
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