Steatotic Liver Disease in Newly Diagnosed and Gluten-Free Diet-Treated Adults with Celiac Disease

Background and Aims: Celiac disease (CD) is increasingly recognized as a driver of metabolic alterations and liver dysfunction, also after initiation of the gluten-free diet (GFD). Our aim was to evaluate the metabolic profile and hepatic steatosis prevalence in patients with CD at diagnosis compared with those on long-term GFD.

Methods

We conducted an observational cross-sectional study with an exploratory longitudinal analysis, including adult CD patients evaluated either at diagnosis (CD_new group) or during follow-up after at least 24 months of self-reported adherence to GFD (CD_GFD group); a non-CD patient group, who underwent the same diagnostic pathway but in whom CD was excluded, was used as control. Patients with diabetes and other chronic liver diseases were excluded. Clinical, metabolic, and hepatic parameters were assessed, including lipid profile, fasting glucose, and liver steatosis, determined by abdominal ultrasound and transient elastography with controlled attenuation parameter (CAP). Steatosis was defined as CAP ≥ 248 dB/m.