title: The prevalence of celiac disease among patients with non-alcoholic fatty liver disease in Iran.
abstract: OBJECTIVE
  Some patients with non-alcoholic fatty liver disease have no obesity-related etiologies. Celiac disease could potentially present with elevated liver enzymes and chronic liver disease. The aim of this study was to evaluate the prevalence of celiac disease among patients with non-alcoholic fatty liver disease.
  
  
  METHODS
  Three hundred sixteen patients defined as non-alcoholic fatty liver disease based on elevated transaminases, liver ultrasound and/or liver biopsy were enrolled. Body mass index, waist circumference and symptoms were recorded. All were tested for recombinant IgA anti-tissue transglutaminase antibody and total IgA level. In patients with positive serology for anti-tissue transglutaminase, IgA class endomysial antibody values were determined with a commercially available indirect immunofluorescence method, and then endoscopy with duodenal biopsies was performed.
  
  
  RESULTS
  The mean age of patients was 40.56±11.48 years and 50.9% were female. Celiac disease was confirmed in 7 patients (2.2%). Of these, all had body mass index between 18.37 and 26.91 kg/m². Celiac disease was more commonly diagnosed among non-alcoholic fatty liver disease patients with body mass index <27 kg/m² compared to patients with body mass index >27 kg/m² (5.83% vs. 0%; p=0.001).
  
  
  CONCLUSIONS
  The prevalence of celiac disease among patients with non-alcoholic fatty liver disease is significantly higher than what was previously reported in the general population of Iran; thus, screening for celiac disease in these patients is reasonable, particularly in patients with body mass index <27 kg/m².
authors.affiliation: GI and Hepatology Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Islamic Republic of, Iran. alirezarahimii@yahoo.com
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Rahimi
authors.forename: Nasser Ebrahimi
authors.initials: NE
authors.lastname: Daryani
authors.forename: Hadi
authors.initials: H
authors.lastname: Ghofrani
authors.forename: Mohammad
authors.initials: M
authors.lastname: Taher
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Pashaei
authors.forename: Sina
authors.initials: S
authors.lastname: Abdollahzade
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kalani
authors.forename: Hosein
authors.initials: H
authors.lastname: Ajdarkosh
mesh_terms: D000328:Adult; D001706:Biopsy; D015992:Body Mass Index; D002446:Celiac Disease / Q000453:epidemiology*; D016009:Chi-Square Distribution; D016099:Endoscopy, Gastrointestinal; D004797:Enzyme-Linked Immunosorbent Assay; D005234:Fatty Liver / Q000453:epidemiology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007492:Iran / Q000453:epidemiology; D008111:Liver Function Tests; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055105:Waist Circumference
chemical_list: D007070:Immunoglobulin A