Different diseases are associated with celiac disease (CD). The most common extraintestinal manifestation of CD are liver diseases. Elevated serum transaminases have been reported in 24-54% of celiac patients. Although different studies investigated the prevalence of CD in patients with NAFLD, a few studies aimed at determination of prevalence of NAFLD in patients with CD. Considering the prevalence of celiac disease in Iran and the high prevalence of fatty liver, it may be essential to study the prevalence of fatty liver disease in patients with celiac disease.

In this cross sectional study, all patients registered in celiac disease registry of East-Azerbaijan were included. According to the NCEP ATP III definition, metabolic syndrome is present if three or more of the following five criteria are met: waist circumference over 40 inches (men) or 35 inches (women), blood pressure over 130/85 mmHg, fasting triglyceride (TG) level over 150 mg/dl, fasting high-density lipoprotein (HDL) cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women) and fasting blood sugar over 100 mg/dl. Those with positive metabolic syndrome criteria were excluded from the study, and those with a higher level of liver enzymes (in the absence of other causes of the fatty liver) underwent an ultrasounography for diagnosis of nonalcoholic fatty liver disease.

Results: A total of 350 patients were evaluated. 84.8% of CD patients were euomethabolic and from the euomethabolic population, 24.1% has been shown a higher level of liver transaminases. In the present study, 16.7% had fatty liver. According to sonographic criteria, 10.4% of patients had fatty liver grade 1 and 6.3% had grade 2.

According to the results, it is suggested that due to the higher prevalence of celiac disease in patients with non-alcoholic fatty liver, evaluation of celiac patients with non-alcoholic fatty liver (in the absence of other causes of the fatty liver) should be on the agenda of physicians.