{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T17:53:49Z","timestamp":1793987629463,"version":"4.8.0"},"reference-count":173,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T00:00:00Z","timestamp":1735344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Palermo","award":["D.R.4186\/2023 (prot. 90342-06\/15\/2023)"],"award-info":[{"award-number":["D.R.4186\/2023 (prot. 90342-06\/15\/2023)"]}]},{"name":"University of Palermo","award":["CdA resolution 07\/07\u201309\/14\/2023 prot. 135120\/2023"],"award-info":[{"award-number":["CdA resolution 07\/07\u201309\/14\/2023 prot. 135120\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: An increasing number of studies have reported liver involvement in both children and adults with celiac disease (CD). This often manifests as isolated hypertransaminasemia or hepatic steatosis (HS). The aim of this study was to define the prevalence of hypertransaminasemia and HS in a pediatric population with CD before starting a gluten-free diet (GFD) and to analyze how the introduction of a GFD could modify this condition. We also conducted a state-of-the-art literature review of the association between hypertransaminasemia, metabolic dysfunction-associated steatotic liver disease (MASLD) and CD. Methods: We retrospectively reviewed the clinical charts of pediatric CD patients diagnosed in three different pediatric units of Sicily, analyzing clinical, laboratory, ultrasound, and histology data before and 12 months after the introduction of a GFD. Results: A total of 160 patients (65.0% females, median age 6.4 (0.8\u201313.2) years) were included; hypertransaminasemia and HS prevalences at diagnosis were 8.1% and 6.1%, respectively. Subjects with hypertransaminasemia were younger (p = 0.01) than those without and had higher frequencies of HS (p = 0.034) and anti-tissue transglutaminase (tTg) immunoglobulin (Ig)G positivity (p = 0.046). Subjects with HS were younger (p = 0.0001) and had a higher frequency of hypertransaminasemia (p = 0.029) compared to non-steatotic ones. After 12 months of a GFD, hypertransaminasemia and HS persisted in 53.8% and 50.0% of patients, respectively. Conclusions: The prevalences of hypertransaminasemia and HS in Sicilian pediatric CD patients seem to be lower than those reported in other geographical areas. A GFD can reverse the trend of liver involvement, although periods of longer than 12 months may be necessary. However, a GFD has been associated with an increased prevalence of HS, and so regular follow-up involving a nutritionist should be recommended to guide physicians in patient management.<\/jats:p>","DOI":"10.3390\/nu17010085","type":"journal-article","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T14:35:42Z","timestamp":1735742142000},"page":"85","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Celiac Disease and Liver Damage: The Gut\u2013Liver Axis Strikes Back (Again)? A Retrospective Analysis in the Light of a Literature Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4080-2641","authenticated-orcid":false,"given":"Aurelio","family":"Seidita","sequence":"first","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"},{"name":"Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1127-8903","authenticated-orcid":false,"given":"Federica","family":"Latteri","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"Pistone","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-5462","authenticated-orcid":false,"given":"Alessandra","family":"Giuliano","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bertoncello","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1307-153X","authenticated-orcid":false,"given":"Marta","family":"Chiavetta","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Faraci","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Nigro","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Termini","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Verona","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Ammannato","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Accomando","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"},{"name":"Department of Pediatrics, University Hospital of Palermo, 90134 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cavataio","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, \u201cDi Cristina\u201d Hospital, Palermo, 90134 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Letizia","family":"Lospalluti","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, \u201cDi Cristina\u201d Hospital, Palermo, 90134 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Citrano","sequence":"additional","affiliation":[{"name":"Pediatrics Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7327-8121","authenticated-orcid":false,"given":"Diana","family":"Di Liberto","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Biochemistry, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7850-555X","authenticated-orcid":false,"given":"Maurizio","family":"Soresi","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0406-0583","authenticated-orcid":false,"given":"Pasquale","family":"Mansueto","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8913-7916","authenticated-orcid":false,"given":"Antonio","family":"Carroccio","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, \u201cV. Cervello\u201d Hospital, Ospedali Riuniti \u201cVilla Sofia-Cervello\u201d, Via Trabucco, 180, 90146 Palermo, Italy"},{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A New Definition for Metabolic Dysfunction-Associated Fatty Liver Disease: An International Expert Consensus Statement","volume":"73","author":"Eslam","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S2468-1253(20)30213-2","article-title":"Nomenclature and Definition of Metabolic-Associated Fatty Liver Disease: A Consensus from the Middle East and North Africa","volume":"6","author":"Shiha","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"329","DOI":"10.14218\/JCTH.2021.00178","article-title":"Metabolic-Associated Fatty Liver Disease (MAFLD): A Multi-Systemic Disease Beyond the Liver","volume":"10","author":"Kaya","year":"2022","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20420188221145549","DOI":"10.1177\/20420188221145549","article-title":"MAFLD: A Multisystem Disease","volume":"14","author":"Pipitone","year":"2023","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.jhep.2024.04.031","article-title":"EASL\u2013EASD\u2013EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)","volume":"81","author":"Tacke","year":"2024","journal-title":"J. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A Multisociety Delphi Consensus Statement on New Fatty Liver Disease Nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO) (2016). EASL\u2013EASD\u2013EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. J. Hepatol., 64, 1388\u20131402.","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","article-title":"The Global Epidemiology of Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH): A Systematic Review","volume":"77","author":"Younossi","year":"2023","journal-title":"Hepatology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S2468-1253(22)00317-X","article-title":"Global Prevalence of Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis in the Overweight and Obese Population: A Systematic Review and Meta-Analysis","volume":"8","author":"Quek","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jhep.2023.03.040","article-title":"Global Incidence of Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of 63 Studies and 1,201,807 Persons","volume":"79","author":"Le","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MPG.0000000000002497","article-title":"European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020","volume":"70","author":"Husby","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1177\/2050640619844125","article-title":"European Society for the Study of Coeliac Disease (ESsCD) Guideline for Coeliac Disease and Other Gluten-related Disorders","volume":"7","author":"Volta","year":"2019","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"820","DOI":"10.14309\/ajg.0000000000002123","article-title":"Prevalence of Celiac Disease in Patients with Liver Diseases: A Systematic Review and Meta-Analyses","volume":"118","author":"Yoosuf","year":"2023","journal-title":"Am. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.jhep.2015.01.013","article-title":"Increased Risk of Non-Alcoholic Fatty Liver Disease after Diagnosis of Celiac Disease","volume":"62","author":"Reilly","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1111\/apt.14910","article-title":"Increased Risk of Nonalcoholic Fatty Liver Disease in Patients with Coeliac Disease on a Gluten-free Diet: Beyond Traditional Metabolic Factors","volume":"48","author":"Tovoli","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1089\/jmf.2014.0025","article-title":"Functional and Metabolic Disorders in Celiac Disease: New Implications for Nutritional Treatment","volume":"17","author":"Farnetti","year":"2014","journal-title":"J. Med. Food"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cardoso-Silva, D., Delbue, D., Itzlinger, A., Moerkens, R., Withoff, S., Branchi, F., and Schumann, M. (2019). Intestinal Barrier Function in Gluten-Related Disorders. Nutrients, 11.","DOI":"10.3390\/nu11102325"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1007\/s10620-015-4020-2","article-title":"Gut Microbiota and Celiac Disease","volume":"61","author":"Marasco","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Hoffmanov\u00e1, I., S\u00e1nchez, D., Tu\u010dkov\u00e1, L., and Tlaskalov\u00e1-Hogenov\u00e1, H. (2018). Celiac Disease and Liver Disorders: From Putative Pathogenesis to Clinical Implications. Nutrients, 10.","DOI":"10.3390\/nu10070892"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Valvano, M., Longo, S., Stefanelli, G., Frieri, G., Viscido, A., and Latella, G. (2020). Celiac Disease, Gluten-Free Diet, and Metabolic and Liver Disorders. Nutrients, 12.","DOI":"10.3390\/nu12040940"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e2020009829","DOI":"10.1542\/peds.2020-009829","article-title":"Alternative Etiologies of Liver Disease in Children with Suspected NAFLD","volume":"147","author":"Yodoshi","year":"2021","journal-title":"Pediatrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/MPG.0000000000003535","article-title":"Drug-Induced Liver Injury in Pediatrics","volume":"75","year":"2022","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Liu, Y., Li, H., Huang, L., Wan, C., Wang, H., Jiao, X., Zeng, L., Jia, Z., Cheng, G., and Zhang, L. (2023). Liver Injury in Children: Signal Analysis of Suspected Drugs Based on the Food and Drug Administration Adverse Event Reporting System. BMC Pediatr., 23.","DOI":"10.1186\/s12887-023-04097-9"},{"key":"ref_24","first-page":"731","article-title":"Drug-Induced Fatty Liver Disease: Pathogenesis and Treatment","volume":"9","author":"Kolaric","year":"2021","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/0016-5085(92)91819-P","article-title":"Gluten, Major Histocompatibility Complex, and the Small Intestine. A Molecular and Immunobiologic Approach to the Spectrum of Gluten Sensitivity (\u2019celiac Sprue\u2019)","volume":"102","author":"Marsh","year":"1992","journal-title":"Gastroenterology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1097\/00042737-199910000-00019","article-title":"The Histopathology of Coeliac Disease","volume":"11","author":"Oberhuber","year":"1999","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/MPG.0b013e318252a13f","article-title":"Diagnosis of Nonalcoholic Fatty Liver Disease in Children and Adolescents","volume":"54","author":"Vajro","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/MPG.0b013e31818fc63b","article-title":"Age- and Sex-related Reference Ranges of Alanine Aminotransferase Levels in Children: European Paediatric HCV Network","volume":"49","author":"England","year":"2009","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/MPG.0000000000001482","article-title":"NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children","volume":"64","author":"Vos","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), European Association for the Study of the Liver (EASL), North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN), Latin-American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (LASPGHAN), Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN), Pan Arab Society for Pediatric Gastroenterology and Nutrition (PASPGHAN), Commonwealth Association of Paediatric Gastroenterology & Nutrition (CAPGAN), and Federation of International Societies of Pediatric Hepatology, Gastroenterology and Nutrition (FISPGHAN) (2024). Paediatric Steatotic Liver Disease Has Unique Characteristics: A Multisociety Statement Endorsing the New Nomenclature. J. Pediatr. Gastroenterol. Nutr., 78, 1190\u20131196.","DOI":"10.1002\/jpn3.12156"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/MPG.0b013e31821b4b61","article-title":"Ultrasonographic Quantitative Estimation of Hepatic Steatosis in Children with NAFLD","volume":"53","author":"Shannon","year":"2011","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1136\/bmj.317.7170.1401","article-title":"Body Mass Index Standards for Children. Are Useful for Clinicians but Not yet for Epidemiologists","volume":"317","author":"Prentice","year":"1998","journal-title":"BMJ"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e253","DOI":"10.1016\/S2352-3026(24)00030-9","article-title":"Haemoglobin Thresholds to Define Anaemia from Age 6 Months to 65 Years: Estimates from International Data Sources","volume":"11","author":"Braat","year":"2024","journal-title":"Lancet Haematol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1053\/jhep.2003.50346","article-title":"A Simple Noninvasive Index Can Predict Both Significant Fibrosis and Cirrhosis in Patients with Chronic Hepatitis C","volume":"38","author":"Wai","year":"2003","journal-title":"Hepatology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a Simple Noninvasive Index to Predict Significant Fibrosis in Patients with HIV\/HCV Coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1017\/S0007114511007367","article-title":"A Score That Verifies Adherence to a Gluten-Free Diet: A Cross-Sectional, Multicentre Validation in Real Clinical Life","volume":"108","author":"Biagi","year":"2012","journal-title":"Br. J. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.gtc.2012.06.004","article-title":"Celiac Disease","volume":"41","author":"Evans","year":"2012","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_38","first-page":"595","article-title":"Liver Involvement in Celiac Disease","volume":"99","author":"Murray","year":"2008","journal-title":"Minerva Med."},{"key":"ref_39","first-page":"23","article-title":"Patient and Community Health Global Burden in a World with More Celiac Disease","volume":"167","author":"Gatti","year":"2024","journal-title":"Gastroenterology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.dld.2021.11.016","article-title":"Improving the Diagnostic Approach to Celiac Disease: Experience from a Regional Network","volume":"54","author":"Mansueto","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.giec.2012.07.003","article-title":"Pathophysiology of Celiac Disease","volume":"22","author":"Kupfer","year":"2012","journal-title":"Gastrointest Endosc Clin. N. Am."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"7505","DOI":"10.3748\/wjg.v23.i42.7505","article-title":"Intestinal Epithelium, Intraepithelial Lymphocytes and the Gut Microbiota\u2014Key Players in the Pathogenesis of Celiac Disease","volume":"23","author":"Cukrowska","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1023\/A:1018896015530","article-title":"Sideropenic Anemia and Celiac Disease: One Study, Two Points of View","volume":"43","author":"Carroccio","year":"1998","journal-title":"Dig. Dis. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2360","DOI":"10.1111\/j.1572-0241.2008.01977.x","article-title":"Age-Related Clinical, Serological, and Histopathological Features of Celiac Disease","volume":"103","author":"Vivas","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_45","first-page":"667","article-title":"Clinical Picture of Classical, Atypical and Silent Celiac Disease in Children and Adolescents","volume":"22","author":"Matusiewicz","year":"2013","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_46","first-page":"78","article-title":"Gastrointestinal and Non-Gastrointestinal Presentation in Patients with Celiac Disease","volume":"16","author":"Villanacci","year":"2013","journal-title":"Arch. Iran Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"5813","DOI":"10.3748\/wjg.v21.i19.5813","article-title":"Liver Involvement in Pediatric Celiac Disease","volume":"21","author":"Anania","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Seidita, A., Mansueto, P., Compagnoni, S., Castellucci, D., Soresi, M., Chiarello, G., Cavallo, G., De Carlo, G., Nigro, A., and Chiavetta, M. (2022). Anemia in Celiac Disease: Prevalence, Associated Clinical and Laboratory Features, and Persistence after Gluten-Free Diet. J. Pers. Med., 12.","DOI":"10.3390\/jpm12101582"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/MCG.0b013e318074dd98","article-title":"Oral Manifestations of Celiac Disease","volume":"42","author":"Pastore","year":"2008","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1515\/JPEM.1996.9.S1.101","article-title":"Clinical Aspects of Coeliac Disease in Children with Insulin-Dependent Diabetes Mellitus","volume":"9","author":"Lorini","year":"1996","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/127589","article-title":"Celiac Disease and Autoimmune-Associated Conditions","volume":"2013","author":"Lauret","year":"2013","journal-title":"BioMed. Res. Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.dld.2016.10.016","article-title":"Nomenclature and Diagnosis of Gluten-Related Disorders: A Position Statement by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO)","volume":"49","author":"Elli","year":"2017","journal-title":"Dig. Liver Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.dld.2015.11.013","article-title":"Celiac Disease-Related Hepatic Injury: Insights into Associated Conditions and Underlying Pathomechanisms","volume":"48","author":"Marciano","year":"2016","journal-title":"Dig. Liver Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S0140-6736(97)11222-3","article-title":"Coeliac Disease Hidden by Cryptogenic Hypertransaminasaemia","volume":"352","author":"Volta","year":"1998","journal-title":"Lancet"},{"key":"ref_55","first-page":"833","article-title":"Prevalence of Hypertransaminasemia in Adult Celiac Patients and Effect of Gluten-Free Diet","volume":"22","author":"Bardella","year":"1995","journal-title":"Hepatology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1111\/j.1572-0241.2005.00244.x","article-title":"Anti-Tissue Transglutaminase Antibodies in Patients with Abnormal Liver Tests: Is It Always Coeliac Disease?","volume":"100","author":"Iacono","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S1542-3565(03)00313-6","article-title":"Liver Abnormalities in Celiac Disease","volume":"2","author":"Abdo","year":"2004","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1136\/adc.65.9.917","article-title":"Management of Infantile Gastroenteritis","volume":"65","year":"1990","journal-title":"Arch. Dis. Child."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/S0140-6736(09)60254-3","article-title":"Coeliac Disease","volume":"373","author":"Corazza","year":"2009","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.dld.2022.06.023","article-title":"Guidelines of the Italian Societies of Gastroenterology on the Diagnosis and Management of Coeliac Disease and Dermatitis Herpetiformis","volume":"54","author":"Zingone","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"656","DOI":"10.3109\/00365529008997589","article-title":"Hepatic Lesions in Adult Coeliac Disease","volume":"25","author":"Jacobsen","year":"1990","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/00042737-199903000-00012","article-title":"Prevalence and Clinical Importance of Hypertransaminasaemia in Coeliac Disease","volume":"11","author":"Novacek","year":"1999","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_63","first-page":"959","article-title":"Hepatic Damage in Celiac Disease in Children","volume":"38","author":"Bonamico","year":"1986","journal-title":"Minerva Pediatr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3176","DOI":"10.1111\/j.1572-0241.2002.07127.x","article-title":"Hypertransaminasemia in Pediatric Celiac Disease Patients and Its Prevalence as a Diagnostic Clue","volume":"97","author":"Farre","year":"2002","journal-title":"Am. J. Gastroenterol."},{"key":"ref_65","first-page":"700","article-title":"The Effects of Gluten-Free Diet on Hypertransaminasemia in Patients with Celiac Disease","volume":"4","author":"Shalmani","year":"2013","journal-title":"Int. J. Prev. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/MPG.0000000000001153","article-title":"Hypertransaminasemia in Newly Diagnosed Pediatric Patients with Celiac Disease","volume":"63","author":"Lee","year":"2016","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5114\/polp.2018.76249","article-title":"Assessment of Hypertransaminasaemia in Children with Newly Diagnosed Coeliac Disease","volume":"93","author":"Bukowski","year":"2018","journal-title":"Pediatr. Pol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"200","DOI":"10.34172\/mejdd.2022.273","article-title":"Liver Involvement in Children during the Diagnosis of Celiac Disease: A Single-Center Experience from Turkey","volume":"14","author":"Altay","year":"2022","journal-title":"Middle East J. Dig. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00431-021-04259-w","article-title":"Elevated Liver Enzymes of Newly Diagnosed Pediatric Celiac Patients\u2014A Prospective-Observational Study","volume":"181","author":"Regev","year":"2022","journal-title":"Eur. J. Pediatr."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"129","DOI":"10.5114\/ceh.2019.84783","article-title":"Liver Pathology in Children with Newly Diagnosed Celiac Disease","volume":"5","author":"Werpachowska","year":"2019","journal-title":"Clin. Exp. Hepatol."},{"key":"ref_71","first-page":"158","article-title":"Liver Damage in Children and Adolescents with Newly Diagnosed Celiac Disease: Clinical and Anamnestic, Serological and Morphological Patterns","volume":"95","author":"Cherkasova","year":"2023","journal-title":"Ter. Arkh."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/jgh.16039","article-title":"Liver Abnormalities in Celiac Disease and Response to Gluten Free Diet: A Systematic Review and Meta-analysis","volume":"38","author":"Jena","year":"2023","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_73","first-page":"333","article-title":"Liver Complications in Celiac Disease","volume":"11","author":"Zali","year":"2011","journal-title":"Hepat. Mon."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1309\/AJCPDOMY5RI5TPMN","article-title":"The Liver in Celiac Disease: Clinical Manifestations, Histologic Features, and Response to Gluten-Free Diet in 30 Patients","volume":"136","author":"Mounajjed","year":"2011","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1136\/adc.87.4.293","article-title":"Coeliac Disease and Liver Dysfunction","volume":"87","author":"Davison","year":"2002","journal-title":"Arch. Dis. Child."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1080\/00365520500235334","article-title":"Gliadin, Zonulin and Gut Permeability: Effects on Celiac and Non-Celiac Intestinal Mucosa and Intestinal Cell Lines","volume":"41","author":"Drago","year":"2006","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1053\/j.gastro.2008.03.023","article-title":"Gliadin Induces an Increase in Intestinal Permeability and Zonulin Release by Binding to the Chemokine Receptor CXCR3","volume":"135","author":"Lammers","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2324709617705679","DOI":"10.1177\/2324709617705679","article-title":"Association of Autoimmune Hepatitis and Celiac Disease: Role of Gluten-Free Diet in Reversing Liver Dysfunction","volume":"5","author":"Iqbal","year":"2017","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1136\/gut.34.3.354","article-title":"Intestinal Permeability in Patients with Coeliac Disease and Relatives of Patients with Coeliac Disease","volume":"34","author":"Uil","year":"1993","journal-title":"Gut"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/00004836-198506000-00009","article-title":"Small Intestinal Permeability as an Indicator of Jejunal Mucosal Recovery in Patients with Celiac Sprue on a Gluten-Free Diet","volume":"7","author":"Cooper","year":"1985","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1136\/gut.35.1.84","article-title":"Liver Disease in Ulcerative Colitis: An Epidemiological and Follow up Study in the County of Stockholm","volume":"35","author":"Broome","year":"1994","journal-title":"Gut"},{"key":"ref_82","first-page":"116","article-title":"Celiac Disease and Elevated Liver Enzymes: A Review","volume":"9","author":"Wu","year":"2020","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.cgh.2006.09.034","article-title":"Celiac Disease and Risk of Liver Disease: A General Population-Based Study","volume":"5","author":"Ludvigsson","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/S0022-3476(05)83430-4","article-title":"Elevated Serum Aminotransferase Activity as an Early Manifestation of Gluten-Sensitive Enteropathy","volume":"122","author":"Vajro","year":"1993","journal-title":"J. Pediatr."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/S0140-6736(78)90480-4","article-title":"Primary biliary cirrhosis and c\u0153liac disease","volume":"311","author":"Logan","year":"1978","journal-title":"Lancet"},{"key":"ref_86","first-page":"547","article-title":"Primary Biliary Cirrhosis and Adult Celiac Disease","volume":"156","author":"Ginn","year":"1992","journal-title":"West J. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1136\/gut.44.5.594","article-title":"PBC and the Gut: The Villi Atrophy, the Plot Thickens","volume":"44","author":"NEUBERGER","year":"1999","journal-title":"Gut"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1136\/gut.42.1.120","article-title":"The Association between Primary Biliary Cirrhosis and Coeliac Disease: A Study of Relative Prevalences","volume":"42","author":"Kingham","year":"1998","journal-title":"Gut"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/00004836-199707000-00006","article-title":"High Prevalence of Celiac Sprue among Patients with Primary Biliary Cirrhosis","volume":"25","author":"Dickey","year":"1997","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/MPG.0b013e31828dc5c5","article-title":"Pediatric Celiac Disease, Cryptogenic Hypertransaminasemia, and Autoimmune Hepatitis","volume":"56","author":"Vajro","year":"2013","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"713","DOI":"10.7326\/0003-4819-109-9-713","article-title":"Primary Sclerosing Cholangitis and Celiac Disease","volume":"109","author":"Hay","year":"1988","journal-title":"Ann. Intern. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/S0168-8278(05)80618-X","article-title":"Risk Factors in Primary Sclerosing Cholangitis","volume":"21","author":"Schrumpf","year":"1994","journal-title":"J. Hepatol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1111\/j.1572-0241.2002.06031.x","article-title":"Celiac Disease in Autoimmune Cholestatic Liver Disorders","volume":"97","author":"Volta","year":"2002","journal-title":"Am. J. Gastroenterol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1023\/A:1026650118759","article-title":"Frequency and Significance of Anti-Gliadin and Anti-Endomysial Antibodies in Autoimmune Hepatitis","volume":"43","author":"Volta","year":"1998","journal-title":"Dig. Dis. Sci."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/j.1365-2036.2009.04186.x","article-title":"Autoimmune Liver Diseases in a Paediatric Population with Coeliac Disease\u2014A 10-year Single-centre Experience","volume":"31","author":"Colecchia","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0168-8278(99)80079-8","article-title":"Autoimmune Cholangitis in a Patient with Celiac Disease: A Case Report and Review of the Literature","volume":"30","author":"Gogos","year":"1999","journal-title":"J. Hepatol."},{"key":"ref_97","first-page":"256","article-title":"Massive Hepatic Steatosis Disclosing Adult Celiac Disease. Study of a Case and Review of the Literature","volume":"7","author":"Capron","year":"1983","journal-title":"Gastroenterol. Clin. Biol"},{"key":"ref_98","first-page":"1186","article-title":"Massive Hepatic Steatosis Complicating Adult Celiac Disease: Report of a Case and Review of the Literature","volume":"82","author":"Naschitz","year":"1987","journal-title":"Am. J. Gastroenterol."},{"key":"ref_99","first-page":"156","article-title":"Nonalcoholic Steatohepatitis, Obesity and Celiac Disease","volume":"22","author":"Sood","year":"2003","journal-title":"Indian J. Gastroenterol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1002\/hep.510290318","article-title":"Chronic Unexplained Hypertransaminasemia May Be Caused by Occult Celiac Disease","volume":"29","author":"Bardella","year":"1999","journal-title":"Hepatology"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.jhep.2014.05.020","article-title":"Prevalence of Celiac Disease in Cirrhosis and Outcome of Cirrhosis on a Gluten Free Diet: A Prospective Study","volume":"61","author":"Pagadala","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1053\/gast.2002.32416","article-title":"Celiac Disease in Patients with Severe Liver Disease: Gluten-Free Diet May Reverse Hepatic Failure","volume":"122","author":"Kaukinen","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/gutjnl-2011-301346","article-title":"The Oslo Definitions for Coeliac Disease and Related Terms","volume":"62","author":"Ludvigsson","year":"2013","journal-title":"Gut"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.dld.2005.07.011","article-title":"Increasing Numbers at a Specialist Coeliac Clinic: Contribution of Serological Testing in Primary Care","volume":"37","author":"Dickey","year":"2005","journal-title":"Dig. Liver Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1136\/bmj.317.7168.1290","article-title":"Prospective Study of Body Mass Index in Patients with Coeliac Disease","volume":"317","author":"Dickey","year":"1998","journal-title":"BMJ"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s12664-016-0620-9","article-title":"Patients with Celiac Disease May Have Normal Weight or May Even Be Overweight","volume":"35","author":"Singh","year":"2016","journal-title":"Indian J. Gastroenterol."},{"key":"ref_107","first-page":"11","article-title":"Patients with Coeliac Disease Are Increasingly Overweight or Obese on Presentation","volume":"21","author":"Tucker","year":"2012","journal-title":"J. Gastrointestin Liver Dis."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/MCG.0000000000000422","article-title":"Obesity and Cardiovascular Risk in Adults with Celiac Disease","volume":"50","author":"Stein","year":"2016","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1097\/MPG.0b013e3182276d5e","article-title":"Celiac Disease in Normal-weight and Overweight Children","volume":"53","author":"Reilly","year":"2011","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1111\/j.1572-0241.2006.00750.x","article-title":"Overweight in Celiac Disease: Prevalence, Clinical Characteristics, and Effect of a Gluten-Free Diet","volume":"101","author":"Dickey","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.jhep.2021.06.034","article-title":"Non-Alcoholic Fatty Liver Disease in Children and Young Adults Is Associated with Increased Long-Term Mortality","volume":"75","author":"Simon","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jhep.2024.01.014","article-title":"Clinical Profiles and Mortality Rates Are Similar for Metabolic Dysfunction-Associated Steatotic Liver Disease and Non-Alcoholic Fatty Liver Disease","volume":"80","author":"Younossi","year":"2024","journal-title":"J. Hepatol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.dld.2004.01.012","article-title":"Searching for Coeliac Disease in Patients with Non-Alcoholic Fatty Liver Disease","volume":"36","author":"Bardella","year":"2004","journal-title":"Dig. Liver Dis."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"300","DOI":"10.4318\/tjg.2011.0216","article-title":"The Prevalence of Celiac Disease among Patients with Non-Alcoholic Fatty Liver Disease in Iran","volume":"22","author":"Rahimi","year":"2011","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/MCG.0b013e3181557e67","article-title":"Prevalence of Small Intestine Bacterial Overgrowth Diagnosed by Quantitative Culture of Intestinal Aspirate in Celiac Disease","volume":"43","author":"Barton","year":"2009","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1002\/hep.22848","article-title":"Increased Intestinal Permeability and Tight Junction Alterations in Nonalcoholic Fatty Liver Disease","volume":"49","author":"Miele","year":"2009","journal-title":"Hepatology"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1136\/gut.48.2.206","article-title":"The Role of Small Intestinal Bacterial Overgrowth, Intestinal Permeability, Endotoxaemia, and Tumour Necrosis Factor Alpha in the Pathogenesis of Non-Alcoholic Steatohepatitis","volume":"48","author":"Wigg","year":"2001","journal-title":"Gut"},{"key":"ref_118","first-page":"89","article-title":"Liver Steatosis in Celiac Disease: The Open Door","volume":"59","author":"Abenavoli","year":"2013","journal-title":"Minerva Gastroenterol. Dietol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/apt.13062","article-title":"Metabolic Syndrome in Patients with Coeliac Disease on a Gluten-free Diet","volume":"41","author":"Tortora","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1136\/gutjnl-2011-300327","article-title":"Intestinal Permeability in Coeliac Disease: Insight into Mechanisms and Relevance to Pathogenesis","volume":"61","author":"Heyman","year":"2012","journal-title":"Gut"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1126\/science.aad0135","article-title":"A Gut-Vascular Barrier Controls the Systemic Dissemination of Bacteria","volume":"350","author":"Spadoni","year":"2015","journal-title":"Science"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"86","DOI":"10.7570\/jomes.2017.26.2.86","article-title":"The Roles of the Gut Microbiota and Toll-like Receptors in Obesity and Nonalcoholic Fatty Liver Disease","volume":"26","author":"Miura","year":"2017","journal-title":"J. Obes. Metab. Syndr."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/apt.14397","article-title":"Review Article: The Gut Microbiome as a Therapeutic Target in the Pathogenesis and Treatment of Chronic Liver Disease","volume":"47","author":"Woodhouse","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1007\/s10620-012-2112-9","article-title":"Nutrition, Intestinal Permeability, and Blood Ethanol Levels Are Altered in Patients with Nonalcoholic Fatty Liver Disease (NAFLD)","volume":"57","author":"Volynets","year":"2012","journal-title":"Dig. Dis. Sci."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1097\/MPG.0b013e3181c7bdf1","article-title":"Endotoxin and Plasminogen Activator Inhibitor-1 Serum Levels Associated with Nonalcoholic Steatohepatitis in Children","volume":"50","author":"Alisi","year":"2010","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/S0016-5085(98)70599-2","article-title":"Steatohepatitis: A Tale of Two \u201cHits\u201d?","volume":"114","author":"Day","year":"1998","journal-title":"Gastroenterology"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"e000150","DOI":"10.1136\/bmjgast-2017-000150","article-title":"Clinicopathological and Immunological Characteristics and Outcome of Concomitant Coeliac Disease and Non-Alcoholic Fatty Liver Disease in Adults: A Large Prospective Longitudinal Study","volume":"5","author":"Kamal","year":"2018","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"106","DOI":"10.5217\/ir.2019.00136","article-title":"Patients with Celiac Disease Are at High Risk of Developing Metabolic Syndrome and Fatty Liver","volume":"19","author":"Agarwal","year":"2021","journal-title":"Intest. Res."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1159\/000495749","article-title":"Metabolic Alterations in Celiac Disease Occurring after Following a Gluten-Free Diet","volume":"100","author":"Ciccone","year":"2019","journal-title":"Digestion"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1111\/liv.14767","article-title":"Metabolic-associated Fatty Liver Disease (MAFLD) in Coeliac Disease","volume":"41","author":"Rispo","year":"2021","journal-title":"Liver Int."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"3029","DOI":"10.1007\/s10620-024-08426-5","article-title":"Patients with Celiac Disease Have High Prevalence of Fatty Liver and Metabolic Syndrome","volume":"69","author":"Aggarwal","year":"2024","journal-title":"Dig. Dis. Sci."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1038\/ejcn.2010.161","article-title":"Celiac Disease and Obesity: Need for Nutritional Follow-up after Diagnosis","volume":"64","author":"Valletta","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/MCG.0b013e3181b7ed58","article-title":"Body Mass Index in Celiac Disease","volume":"44","author":"Cheng","year":"2010","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.ejim.2011.12.012","article-title":"Changes in Body Mass Index on a Gluten-Free Diet in Coeliac Disease: A Nationwide Study","volume":"23","author":"Ukkola","year":"2012","journal-title":"Eur. J. Intern. Med."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"5658","DOI":"10.3748\/wjg.v19.i34.5658","article-title":"Cardiovascular Disease Risk Factor Profiles in Children with Celiac Disease on Gluten-Free Diets","volume":"19","author":"Norsa","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/nutrit\/nuac052","article-title":"Risk of Obesity during a Gluten-Free Diet in Pediatric and Adult Patients with Celiac Disease: A Systematic Review with Meta-Analysis","volume":"81","author":"Barone","year":"2023","journal-title":"Nutr. Rev."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/j.1365-2036.2008.03820.x","article-title":"Systematic Review: The Evidence Base for Long-term Management of Coeliac Disease","volume":"28","author":"Haines","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/MPG.0000000000001251","article-title":"Patients with Celiac Disease Reported Higher Consumption of Added Sugar and Total Fat Than Healthy Individuals","volume":"64","author":"Babio","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1093\/ajcn\/72.4.937","article-title":"Body Composition and Dietary Intakes in Adult Celiac Disease Patients Consuming a Strict Gluten-Free Diet","volume":"72","author":"Bardella","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1093\/ajcn\/72.1.76","article-title":"Changes in Body Composition, Substrate Oxidation, and Resting Metabolic Rate in Adult Celiac Disease Patients after a 1-y Gluten-Free Diet Treatment","volume":"72","author":"Capristo","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/ejcn.2015.114","article-title":"A Comparison of the Nutritional Status between Adult Celiac Patients on a Long-Term, Strictly Gluten-Free Diet and Healthy Subjects","volume":"70","author":"Barone","year":"2016","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/jhn.12018","article-title":"Nutritional Inadequacies of the Gluten-free Diet in Both Recently-diagnosed and Long-term Patients with Coeliac Disease","volume":"26","author":"Shepherd","year":"2013","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1365-277X.2005.00607.x","article-title":"Gluten-free Diet Survey: Are Americans with Coeliac Disease Consuming Recommended Amounts of Fibre, Iron, Calcium and Grain Foods?","volume":"18","author":"Thompson","year":"2005","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/j.1365-2036.2010.04386.x","article-title":"Evidence of High Sugar Intake, and Low Fibre and Mineral Intake, in the Gluten-free Diet","volume":"32","author":"Wild","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1111\/jhn.12026","article-title":"Intakes of Nutrients in <scp>I<\/Scp> Talian Children with Celiac Disease and the Role of Commercially Available Gluten-free Products","volume":"26","author":"Zuccotti","year":"2013","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/j.1365-2036.2012.05001.x","article-title":"Body Mass Index and the Risk of Obesity in Coeliac Disease Treated with the Gluten-free Diet","volume":"35","author":"Kabbani","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/j.1365-2036.2004.02008.x","article-title":"Risk of Vascular Disease in Adults with Diagnosed Coeliac Disease: A Population-based Study","volume":"20","author":"West","year":"2004","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_148","unstructured":"WHO Consultation (2000). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. World Health Organ. Tech. Rep. Ser., 894, 1\u2013253."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the Metabolic Syndrome","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_150","first-page":"341","article-title":"Does a Gluten-Free Diet Increase Body Mass Index and Lipid Profile in Celiac Patients? A Systematic Review and Meta-Analysis","volume":"12","author":"Nikniaz","year":"2019","journal-title":"Med. J. Nutr. Metab."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/jgh.14039","article-title":"Effect of the Gluten-free Diet on Cardiovascular Risk Factors in Patients with Coeliac Disease: A Systematic Review","volume":"33","author":"Potter","year":"2018","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128\u00b79 Million Children, Adolescents, and Adults","volume":"390","author":"Abdeen","year":"2017","journal-title":"Lancet"},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1001\/archinte.163.13.1566","article-title":"Causes of Death in Patients with Celiac Disease in a Population-Based Swedish Cohort","volume":"163","author":"Peters","year":"2003","journal-title":"Arch. Intern. Med."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.dld.2015.06.004","article-title":"Cardiovascular Disease in Patients with Coeliac Disease: A Systematic Review and Meta-Analysis","volume":"47","author":"Emilsson","year":"2015","journal-title":"Dig. Liver Dis."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic Syndrome\u2014A New World-wide Definition. A Consensus Statement from the International Diabetes Federation","volume":"23","author":"Alberti","year":"2006","journal-title":"Diabet. Med."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.2337\/diabetes.50.8.1844","article-title":"Nonalcoholic Fatty Liver Disease","volume":"50","author":"Marchesini","year":"2001","journal-title":"Diabetes"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S0002-9343(99)00271-5","article-title":"Association of Nonalcoholic Fatty Liver Disease with Insulin Resistance","volume":"107","author":"Marchesini","year":"1999","journal-title":"Am. J. Med."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1053\/jhep.2003.50161","article-title":"Nonalcoholic Fatty Liver, Steatohepatitis, and the Metabolic Syndrome","volume":"37","author":"Marchesini","year":"2003","journal-title":"Hepatology"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3390\/nu6010207","article-title":"Celiac Disease and Overweight in Children: An Update","volume":"6","author":"Diamanti","year":"2014","journal-title":"Nutrients"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/eci.12193","article-title":"Incretins, Amylin and Other Gut-brain Axis Hormones in Children with Coeliac Disease","volume":"44","author":"Papastamataki","year":"2014","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_161","doi-asserted-by":"crossref","unstructured":"Raiteri, A., Granito, A., Faggiano, C., Giamperoli, A., Catenaro, T., Negrini, G., and Tovoli, F. (2022). Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods. Nutrients, 14.","DOI":"10.3390\/nu14142942"},{"key":"ref_162","first-page":"519","article-title":"The Gluten-Free Diet: A Nutritional Risk Factor for Adolescents with Celiac Disease?","volume":"27","author":"Mariani","year":"1998","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/j.1365-277X.2010.01060.x","article-title":"Dietary Shortcomings in Children on a Gluten-free Diet","volume":"23","author":"Olsson","year":"2010","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/01.mpg.0000228102.89454.eb","article-title":"Nutritional Management of the Gluten-Free Diet in Young People with Celiac Disease in The Netherlands","volume":"43","author":"Hopman","year":"2006","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1093\/ajcn\/45.5.946","article-title":"The Effect of Starch-Protein Interaction in Wheat on the Glycemic Response and Rate of in Vitro Digestion","volume":"45","author":"Jenkins","year":"1987","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/ajcn\/76.1.5","article-title":"International Table of Glycemic Index and Glycemic Load Values: 2002","volume":"76","author":"Holt","year":"2002","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1046\/j.1464-5491.2000.00356.x","article-title":"The Glycaemic Index of a Range of Gluten-free Foods","volume":"17","author":"Packer","year":"2000","journal-title":"Diabet. Med."},{"key":"ref_168","first-page":"296","article-title":"High Fat Consumption in Children with Celiac Disease","volume":"72","author":"Ferrara","year":"2009","journal-title":"Acta Gastroenterol. Belg."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1126\/science.7678183","article-title":"Adipose Expression of Tumor Necrosis Factor-\u03b1: Direct Role in Obesity-Linked Insulin Resistance","volume":"259","author":"Hotamisligil","year":"1993","journal-title":"Science"},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0168-8227(00)00247-3","article-title":"Relationship between Serum Tumor Necrosis Factor-\u03b1 and Insulin Resistance in Obese Men with Type 2 Diabetes Mellitus","volume":"52","author":"Mishima","year":"2001","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_171","first-page":"4","article-title":"Recent Advances in the Relationship between Obesity, Inflammation, and Insulin Resistance","volume":"17","author":"Bastard","year":"2006","journal-title":"Eur. Cytokine Netw."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1136\/gut.2009.183608","article-title":"Lysosomal Accumulation of Gliadin P31-43 Peptide Induces Oxidative Stress and Tissue Transglutaminase-Mediated PPAR Downregulation in Intestinal Epithelial Cells and Coeliac Mucosa","volume":"59","author":"Luciani","year":"2010","journal-title":"Gut"},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1093\/bfgp\/elr008","article-title":"Genome-Wide Association Studies and Type 2 Diabetes","volume":"10","author":"Wheeler","year":"2011","journal-title":"Brief. Funct. Genom."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/1\/85\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:55:39Z","timestamp":1760115339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/1\/85"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,28]]},"references-count":173,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["nu17010085"],"URL":"https:\/\/doi.org\/10.3390\/nu17010085","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,28]]}}}