{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:34:10Z","timestamp":1783388050259,"version":"3.54.6"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,8]],"date-time":"2018-07-08T00:00:00Z","timestamp":1531008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A gluten\u2010free diet (GFD) is known to be associated with altered macronutrient intake and metabolic syndrome. Nonalcoholic fatty liver disease (<jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>) is the hepatic hallmark of metabolic syndrome. The risk of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> in patients with coeliac disease (CD) adhering to a GFD remains to be fully investigated; in particular, data from real\u2010life clinical settings are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the prevalence and relative risk of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> in CD patients treated with a GFD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Case\u2013control study, with prospective enrolment of CD outpatients following a GFD and controls. Patients were matched for demographic characteristics (age and gender) and metabolic risk factors (overweight, diabetes mellitus, total cholesterol, and triglycerides) using a 1:1 ratio. <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> was diagnosed according to the European Association for the Study of the Liver criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>202 CD patients and 202 controls were compared. The raw prevalence of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> was 34.7% and 21.8% in the CD and control group, respectively (<jats:italic>P<\/jats:italic> = 0.006). Binary logistic regression confirmed an increased risk of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> in the CD group (adjusted odds ratio = 2.90, 95% confidence interval: 1.64\u20105.15, <jats:italic>P<\/jats:italic> &lt; 0.001). Additionally, the relative risk for <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> was notably higher in non\u2010overweight CD patients (adjusted odds ratio = 5.71, 95% confidence interval: 2.30\u201014.19, <jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More than one\u2010third of CD patients adhering to a GFD had concurrent <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>, accounting for a three\u2010fold increased risk compared to the general population. Dietary advice provided using a patient\u2010tailored approach should assist CD patients with <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> in achieving an appropriate nutritional intake whilst reducing the risk of long\u2010term liver\u2010related events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14910","type":"journal-article","created":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T06:34:34Z","timestamp":1531118074000},"page":"538-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Increased risk of nonalcoholic fatty liver disease in patients with coeliac disease on a gluten\u2010free diet: beyond traditional metabolic factors"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-1155","authenticated-orcid":false,"given":"F.","family":"Tovoli","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences University of 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