PDF(Pubmed)
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.
摘要：
乳糜泻（CD）是一种由遗传易感个体摄入含麸质食物引发的慢性自身免疫性疾病。因此，CD的处理包括永久避免小麦，黑麦,大麦,和其他含麸质食物。终身坚持无麸质饮食（GFD）可改善CD的症状，但最近的证据表明,它还与肝脏脂肪变性的高风险以及其他心脏代谢危险因素的共存或出现有关.此外，一些作者还报道,肝脏脂肪变性的风险更高,这是CD本身潜在的肠外并发症.最近的命名法变化将肝脂肪变性与五个心脏代谢危险因素中的至少一个之间的关联指定为代谢功能障碍相关的脂肪变性肝病（MASLD）。MAFLD和CD之间关联的潜在致病因素的扩展网络，在实施饮食疗法之前和之后，最近有描述。这些患者的个体化治疗较少得到证据支持,目前的大多数建议都依赖于经验性的临床判断。这篇综述集中在CD和肝损伤之间的因果关系。作为CD的肠外表现或GFD的副作用，还提到了这些个体的潜在治疗策略。
