The following is a summary of “Prevalence of Celiac Disease in Patients With Liver Diseases: A Systematic Review and Meta-Analyses,” published in the May 2023 issue of Gastroenterology by Yoosuf, et al.
Liver involvement, including hypertransaminasemia, liver cirrhosis, and autoimmune hepatitis, can occur in a subset of patients with celiac disease (CeD). For a systematic review with meta-analyses, researchers sought to determine the pooled prevalence of CeD in patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasemia, and all-cause hypertransaminasemia.
A comprehensive search of PubMed and EMBASE databases up to January 2022 was conducted. The inclusion criteria encompassed cross-sectional, case-control, and prospective cohort studies that performed serological tests and/or intestinal biopsy for CeD in patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasemia, and all-cause hypertransaminasemia. Pooled estimates of seroprevalence and the prevalence of biopsy-confirmed CeD were calculated for these four groups.
Among the 6,871 articles screened, 20 articles were included in the final analysis, comprising three meta-analyses for cryptogenic cirrhosis, all-cause cirrhosis, and cryptogenic hypertransaminasemia. Due to significant differences in the studies, a qualitative review was conducted for the all-cause hypertransaminasemia group instead of a meta-analysis. The pooled prevalence (95% CI) of biopsy-confirmed CeD in cryptogenic cirrhosis was 4.6% (2.2%–7.5%), while the pooled prevalence of biopsy-confirmed CeD in all-cause cirrhosis was 0.8% (0%–3.4%). The pooled prevalence of biopsy-confirmed CeD in cryptogenic hypertransaminasemia was 5.7% (3.2%–8.8%).
The results indicated that nearly 1 in 20 patients with both cryptogenic cirrhosis and cryptogenic hypertransaminasemia have CeD. Therefore, these groups should be considered high-risk for CeD and may benefit from screening. Although the prevalence of CeD in individuals with all-cause cirrhosis is similar to that in the general population, screening for CeD in the population could be warranted due to the potential reversibility of liver pathology.