D0510 - Liver Abnormalities in Celiac Disease and Response to a Gluten-Free Diet: A Systematic Review and Meta-Analysis

Daryl Ramai, MD, MSc¹, Anuraag Jena, MBBS², Praveen Kumar, MBBS², Antriksh Kumar, MBBS², Chhagan Birda, MBBS², Arup Choudhury, MBBS², Naveen Kumar, MBBS², Antonio Facciorusso, MD, PhD³, Jayanta Samanta, MBBS, MD, DM^2
1University of Utah, Salt Lake City, UT; ²Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India; ³University of Foggia, Foggia, Puglia, Italy

Introduction: Clinical presentation of Celiac's disease (CeD) may vary from asymptomatic to patients presenting with malabsorption, growth impediment, osteoporosis, and iron deficiency anemia. There is a paucity of data on CeD and liver involvement as well as the effect of a gluten free diet on hepatic function.

Methods: We searched PubMed, Medline & Embase databases from inception for studies reporting on CeD and liver abnormalities. Pooled proportion of patients of CeD with deranged transaminases, etiology of liver diseases with CeD, and the response to a gluten free diet in form of normalization of transaminases were estimated using a random effects model. Subgroup and influence analysis based on age group, geographic distribution, and duration of gluten free diet was also performed.

Results: Total 38 studies (8167 patients) were included. The pooled proportion of patients of CeD with elevated transaminases was 22.85% (95% CI: 18.82-27.44, I 2=94%) overall with similar prevalence noted among adults (23.24%) and children (22.38%). The commonest etiology for the liver abnormalities was reported as celiac hepatitis at 49.54% (95% CI: 31.79-67.4, I 2=87%) followed by other liver diseases. Compliance to a gluten free diet was noted in 88.16% of adults and 94.01% of children (overall 90.11%). The proportion of CeD patients with liver abnormalities who showed response to a gluten free diet was 86.83% (95% CI: 82.35-90.31, I2=66%) overall with similar response among adults (86.01%) and pediatric population (89.24%). Western studies reported better response to a gluten free diet at 87.75% compared to the east (78.84%)

Discussion: Hepatic involvement was noted in 23% of CeD patients. Celiac hepatitis was reported in more than half of affected patients. Patients who had good adherence to a gluten free diet showed good recovery and normalization of liver transaminases.



Disclosures:


Daryl Ramai, MD, MSc¹, Anuraag Jena, MBBS², Praveen Kumar, MBBS², Antriksh Kumar, MBBS², Chhagan Birda, MBBS², Arup Choudhury, MBBS², Naveen Kumar, MBBS², Antonio Facciorusso, MD, PhD³, Jayanta Samanta, MBBS, MD, DM². D0510 - Liver Abnormalities in Celiac Disease and Response to a Gluten-Free Diet: A Systematic Review and Meta-Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.