S1550 Fatty Liver and Metabolic Syndrome in Patients with Celiac Disease: A Systematic Review and Meta-Analysis

Abstract

Introduction: Studies have suggested a high prevalence of fatty liver and metabolic syndrome in patients with celiac disease (CeD). We conducted a systematic review and meta-analysis to assess the prevalence of fatty liver and metabolic syndrome in treatment-naïve patients with CeD and in patients on a gluten-free diet (GFD). Methods: The PubMed, Embase, and the Cochrane Library databases were searched for original studies. We included full-text articles published in the English language after 1990 that used well-defined criteria for CeD, fatty liver and metabolic syndrome. Of 185 studies identified, 7 were included for the analysis. Random effects model was used to calculate pooled prevalence. Results: The pooled prevalence of fatty liver in treatment-naïve patients with CeD was 15.3% (0.153 [95%CI 0.056-0.285], n=867). After initiation of GFD, the prevalence increased to 29.1% (0.291 [95%CI 0.172-0.427],n=869). The pooled prevalence of metabolic syndrome in treatment-naïve patients with CeD was 4.3% (0.043 [95%CI 0.024-0.067], n=1239), which increased to 24.2% (0.242 [95%CI 0.195-0.293], n=1239) with the initiation of GFD (Figure). We did not observe any significant publication bias. Subgroup analysis was performed to further explain heterogeneity. Conclusion: The present review has suggested a high prevalence of fatty liver and metabolic syndrome in patients with CeD. With the initiation of GFD, the prevalence of fatty liver and metabolic syndrome increases further. Patients with CeD should thus be screened and monitored for the development of fatty liver and metabolic syndrome. They should be counseled appropriately regarding their diet and inclusion of physical activity in their lifestyle.Figure 1.: Schematic representation of the results: (A) Of 100 treatment-naïve patients with celiac disease (CeD), 15 have fatty liver (FL) at baseline (blue). After initiation of a gluten-free diet (GFD), the prevalence of FL increases to 29. (B) Of every 100 treatment-naïve patients with celiac disease (CeD), 4 have metabolic syndrome (MS) at baseline (blue). After initiation of GFD, the prevalence of MS increases to 24