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A recent study from Karolinska Institutet highlights the long-term risk of chronic liver disease in patients diagnosed with celiac disease, emphasizing the need for vigilant monitoring even decades post-diagnosis.
This finding is significant as it informs healthcare providers about the necessity for ongoing liver health monitoring in celiac patients, potentially guiding better long-term outcomes.
A study conducted by researchers at Karolinska Institutet and published in The Lancet Regional Health—Europe indicates that individuals diagnosed with celiac disease are at a doubled risk for chronic liver disease, an elevated risk that persists over 25 years. The research analyzed data from over 48,000 celiac patients and more than 231,000 matched controls from the Swedish ESPRESSO cohort, covering the years 1969 to 2017. The study suggests the need for continued vigilance in monitoring liver health in celiac patients and highlights the importance of addressing metabolic parameters upon starting a gluten-free diet. The findings underscore the potential genetic, immunological, and dietary factors involved in the increased risk.
Recent research conducted by the Karolinska Institutet and published in The Lancet Regional Health—Europe underscores a critical health issue. Patients diagnosed with celiac disease exhibit a doubled risk of developing chronic liver disease compared to those without the disease. This study utilized data from the Swedish ESPRESSO cohort to explore this link comprehensively.
"The absolute risk difference for any chronic liver disease between patients with celiac disease and the reference individuals was small," says the study's first author Jialu Yao, Ph.D. student at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
Despite the small absolute risk difference, the implications for relative risk are significant, highlighting the need for medical professionals to remain vigilant in monitoring patients with celiac disease for potential liver complications.
The research findings align with existing guidelines suggesting that monitoring liver enzymes should be an integral part of the medical follow-up for celiac patients. This recommendation is particularly important since the risk persists for at least 25 years after diagnosis.
"Clinicians working with patients with celiac disease should inform them about risk factors of chronic liver disease and be attentive to metabolic parameters when they initiate a gluten-free diet," says senior author Jonas F. Ludvigsson.
The advice from Jonas F. Ludvigsson underscores the importance of addressing metabolic health as part of the care for individuals on a gluten-free diet, to mitigate potential dietary imbalances that might contribute to liver disease risks.
The study authors suggest that the link between celiac disease and chronic liver disease might be mediated by genetic and immunological factors, as well as potential dietary effects from a gluten-free diet.
Jialu Yao noted, "The positive association between celiac disease and chronic liver disease may be mediated by genetic and immunological factors, or the side effect of a gluten-free diet with unbalanced nutritional content."
Further investigation into these areas could lead to improved management strategies for celiac patients, focusing on tailored dietary plans and genetic counseling where appropriate.
Yao, J., Ludvigsson, J. F., et al. (2025). Long-term risk of chronic liver disease in patients with celiac disease: a nationwide population-based, sibling-controlled cohort study. The Lancet Regional Health - Europe, 11(1), 1012-1019.
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