Evidence map›Paper›PMID 29503733›Full record

ArticleBMJ open gastroenterology2018

Clinicopathological and immunological characteristics and outcome of concomitant coeliac disease and non-alcoholic fatty liver disease in adults: a large prospective longitudinal study.

Sanaa Kamal, Khaled K Aldossari, Dhalia Ghoraba, Sara Mahmoud Abdelhakam, Amgad H Kamal, Mohamad Bedewi, Leila Nabegh, Khaled Bahnasy, Tamer Hafez

Open access · goldAbstract read
In one paragraph

Article in BMJ open gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 15 citations in OpenAlex.

  1. Prevalence and Risk Factors of Celiac Disease in Patients With Non-Alcoholic Fatty Liver Disease: A Meta-Analysis.JGH open : an open access journal of gastroenterology and hepatology · 2026
    Review
  2. Liver Involvement in Celiac Disease and Immune-Mediated Diseases of the Small Bowel.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Review
  3. Review
  4. Review
  5. Review
  6. Fatty liver and celiac disease: Why worry?World journal of hepatology · 2023
    Review
  7. Article
  8. Article
  9. The Liver and Celiac Disease.Clinics in liver disease · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Sanaa KamalDepartment of Gastroenterology and Tropical Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt.ORCID MD/Ph.D,0000-0002-2052-7956
Khaled K AldossariDepartment of Family Medicine, Prince Sattam Bin Abdul Aziz College of Medicine, Al-Kharj, Riyadh, Saudi Arabia.
Dhalia GhorabaDepartment of Gastroenterology and Tropical Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt.
Sara Mahmoud AbdelhakamDepartment of Gastroenterology and Tropical Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt.
Amgad H KamalDepartment of Gastroenterology and Tropical Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt.ORCID MD
Mohamad BedewiDepartment of Radiodiagnosis, Prince Sattam Bin Abdul Aziz College of Medicine, Kharj, Riyadh, Saudi Arabia.
Leila NabeghDepartment of Pathology, Ain Shams Faculty of Medicine, Cairo, Egypt.ORCID MD
Khaled BahnasyDepartment of Bioinformatics, Faculty of Computer Science, Ain Shams University, Cairo, Egypt.ORCID PhD
Tamer HafezDepartment of Immunology and Molecular Biology, American University, Cairo, Egypt.ORCID PHD
Ain Shams University · EGPrince Sattam Bin Abdulaziz University · SAAmerican University in Cairo · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveConcomitant non-alcoholic fatty liver disease (NAFLD) and coeliac disease (CD) have not been adequately studied. This study investigated the frequency of CD among NAFLD patients and the clinicopathological and immunological patterns and outcome of concomitant NAFLD and CD.

designThis prospective longitudinal study screened patients with NAFLD for CD (tissue transglutaminase antibodies (TTGA); anti-TTGA and antiendomysial antibodies (EMA)). Patients with concomitant NAFLD and CD and patients with either NAFLD or CD were enrolled and followed. Duodenal biopsy, transient elastography, tumour necrosis factor (TNF)-alpha, transforming growth factor-beta, interleukins (ILs) 1, 6, 10, 15 and 17, folic acid and vitamins B12 and D were performed at baseline and 1 year after gluten-free diet (GFD).

resultsCD was confirmed in 7.2% of patients with NAFLD. Refractory anaemia and nutritional deficiencies were frequent in patients with concomitant NAFLD and CD who had advanced intestinal and hepatic lesions, higher levels of TNF-α, IL-15 and IL-17 compared with patients with CD and NAFLD. Patients concomittant CD and NAFLD showed clinical response to GFD, but intestinal histological improvement was suboptimal. Combining EMA-IgA or anti-TTGA with either IL-15 or IL-17 enhances the prognostic performance of both tests in predicting histological response to GFD.

conclusionConcomitant NAFLD and CD is not uncommon. Recurrent abdominal symptoms, refractory anaemia, nutritional deficiencies in patients with NAFLD warrant screening for CD. The study has important clinical implications since failure in diagnosing CD in patients with NAFLD patients results in marked intestinal and hepatic damage and suboptimal response to GFD that can be alleviated by early diagnosis and initiation of GFD.

Indexed as

celiac diseasecytokinesgluten free dietnonalcoholic steatohepatitissmall intestinal biopsy

Identifiers

PMID29503733
PMCPMC5808634
OpenAlexW2786347694

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.