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Review

Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease

by
Georgiana-Diana Cazac
1,2,†,
Bogdan-Mircea Mihai
1,2,*,
Gabriela Ștefănescu
3,4,†,
Georgiana-Emmanuela Gîlcă-Blanariu
3,4,
Cătălina Mihai
3,4,†,
Elena-Daniela Grigorescu
1,2,*,
Alina Onofriescu
1,2 and
Cristina-Mihaela Lăcătușu
1,2
1
Unit of Diabetes, Nutrition, and Metabolic Diseases, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
2
Clinical Center of Diabetes, Nutrition and Metabolic Diseases, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
3
Unit of Medical Semiology and Gastroenterology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
4
Institute of Gastroenterology and Hepatology, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2024, 16(13), 2008; https://doi.org/10.3390/nu16132008
Submission received: 5 June 2024 / Revised: 21 June 2024 / Accepted: 22 June 2024 / Published: 25 June 2024

Abstract

Celiac disease (CD) is a chronic autoimmune disorder triggered by the ingestion of gluten-containing food by genetically predisposed individuals. Hence, treatment of CD consists of permanent avoidance of wheat, rye, barley, and other gluten-containing foods. Lifelong adherence to a gluten-free diet (GFD) improves the symptoms of CD, but recent evidence suggests it is also associated with a higher risk for hepatic steatosis and the coexistence or emergence of other cardiometabolic risk factors. Moreover, a higher risk for liver steatosis is also reported by some authors as a potential extraintestinal complication of the CD itself. Recent nomenclature changes designate the association between hepatic steatosis and at least one of five cardiometabolic risk factors as metabolic dysfunction-associated steatotic liver disease (MASLD). An extended network of potentially causative factors underlying the association between MAFLD and CD, before and after dietary therapy is implemented, was recently described. The individualized treatment of these patients is less supported by evidence, with most of the current recommendations relying on empiric clinical judgment. This review focuses on the causative associations between CD and hepatic injury, either as an extraintestinal manifestation of CD or a side effect of GFD, also referring to potential therapeutic strategies for these individuals.
Keywords: celiac disease; gluten; gluten-free diet; non-alcoholic fatty liver disease; liver steatosis; MASLD celiac disease; gluten; gluten-free diet; non-alcoholic fatty liver disease; liver steatosis; MASLD

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MDPI and ACS Style

Cazac, G.-D.; Mihai, B.-M.; Ștefănescu, G.; Gîlcă-Blanariu, G.-E.; Mihai, C.; Grigorescu, E.-D.; Onofriescu, A.; Lăcătușu, C.-M. Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease. Nutrients 2024, 16, 2008. https://doi.org/10.3390/nu16132008

AMA Style

Cazac G-D, Mihai B-M, Ștefănescu G, Gîlcă-Blanariu G-E, Mihai C, Grigorescu E-D, Onofriescu A, Lăcătușu C-M. Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease. Nutrients. 2024; 16(13):2008. https://doi.org/10.3390/nu16132008

Chicago/Turabian Style

Cazac, Georgiana-Diana, Bogdan-Mircea Mihai, Gabriela Ștefănescu, Georgiana-Emmanuela Gîlcă-Blanariu, Cătălina Mihai, Elena-Daniela Grigorescu, Alina Onofriescu, and Cristina-Mihaela Lăcătușu. 2024. "Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease" Nutrients 16, no. 13: 2008. https://doi.org/10.3390/nu16132008

APA Style

Cazac, G.-D., Mihai, B.-M., Ștefănescu, G., Gîlcă-Blanariu, G.-E., Mihai, C., Grigorescu, E.-D., Onofriescu, A., & Lăcătușu, C.-M. (2024). Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease. Nutrients, 16(13), 2008. https://doi.org/10.3390/nu16132008

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