Makharia GK, Singh P, Catassi C et al. The global burden of coeliac disease: opportunities and challenges. Nat Rev Gastroenterol Hepatol 2022;19:313–327.

Article  CAS  PubMed  Google Scholar 

Cheng J, Brar PS, Lee AR et al. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol 2010;44:267–271.

Article  PubMed  Google Scholar 

Kabbani TA, Goldberg A, Kelly CP et al. Body mass index and the risk of obesity in coeliac disease treated with the gluten-free diet. Aliment Pharmacol Ther 2012;35:723–729.

Article  CAS  PubMed  Google Scholar 

Singh I, Agnihotri A, Sharma A et al. Patients with celiac disease may have normal weight or may even be overweight. Indian J Gastroenterol 2016;35:20–24.

Article  PubMed  Google Scholar 

Barone M, Iannone A, Cristofori F, et al. Risk of obesity during a gluten-free diet in pediatric and adult patients with celiac disease: a systematic review with meta-analysis. Nutr Rev August 2022:nuac052.

Younossi ZM, Koenig AB, Abdelatif D et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016;64:73–84.

Article  PubMed  Google Scholar 

Noubiap JJ, Nansseu JR, Lontchi-Yimagou E et al. Geographic distribution of metabolic syndrome and its components in the general adult population: A meta-analysis of global data from 28 million individuals. Diabetes Res Clin Pract 2022;188:109924.

Article  CAS  PubMed  Google Scholar 

Singh S, Allen AM, Wang Z, et al. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol 2015;13:643–654.e1–9; quiz e39–40.

Kasper P, Martin A, Lang S et al. NAFLD and cardiovascular diseases: a clinical review. Clin Res Cardiol 2021;110:921–937.

Article  PubMed  Google Scholar 

Mottillo S, Filion KB, Genest J et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010;56:1113–1132.

Article  PubMed  Google Scholar 

Raiteri A, Granito A, Faggiano C et al. Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods. Nutrients 2022;14:2942.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Manka P, Sydor S, Schänzer-Ocklenburg JM et al. A Potential Role for Bile Acid Signaling in Celiac Disease-Associated Fatty Liver. Metabolites 2022;12:130.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Agarwal A, Singh A, Mehtab W et al. Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver. Intest Res 2021;19:106–114.

Article  PubMed  Google Scholar 

Rispo A, Imperatore N, Guarino M et al. Metabolic-associated fatty liver disease (MAFLD) in coeliac disease. Liver Int 2021;41:788–798.

Article  CAS  PubMed  Google Scholar 

Remes-Troche JM, Cobos-Quevedo ODJ, Rivera-Gutiérrez X et al. Metabolic effects in patients with celiac disease, patients with nonceliac gluten sensitivity, and asymptomatic controls, after six months of a gluten-free diet. Revista de Gastroenterología de México 2020;85:109–117.

Article  CAS  PubMed  Google Scholar 

Ciccone A, Gabrieli D, Cardinale R et al. Metabolic Alterations in Celiac Disease Occurring after Following a Gluten-Free Diet. Digestion 2019;100:262–268.

Article  CAS  PubMed  Google Scholar 

Tovoli F, Negrini G, Farì R et al. Increased risk of nonalcoholic fatty liver disease in patients with coeliac disease on a gluten-free diet: beyond traditional metabolic factors. Aliment Pharmacol Ther 2018;48:538–546.

Article  CAS  PubMed  Google Scholar 

Tortora R, Rispo A, Alisi A et al. PNPLA3 rs738409 Polymorphism Predicts Development and Severity of Hepatic Steatosis but Not Metabolic Syndrome in Celiac Disease. Nutrients 2018;10:E1239.

Article  Google Scholar 

Imperatore N, Tortora R, Testa A et al. Proton pump inhibitors as risk factor for metabolic syndrome and hepatic steatosis in coeliac disease patients on gluten-free diet. J Gastroenterol 2018;53:507–516.

Article  CAS  PubMed  Google Scholar 

Tortora R, Capone P, De Stefano G et al. Metabolic syndrome in patients with coeliac disease on a gluten-free diet. Alimentary Pharmacology & Therapeutics 2015;41:352–359.

Article  CAS  Google Scholar 

Kabbani TA, Kelly CP, Betensky RA et al. Patients With Celiac Disease Have a Lower Prevalence of Non–Insulin-Dependent Diabetes Mellitus and Metabolic Syndrome. Gastroenterology 2013;144:912-917.e1.

Article  PubMed  Google Scholar 

Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008–2012.

Revised criteria for diagnosis of coeliac disease. Report of Working Group of European Society of Paediatric Gastroenterology and Nutrition. Arch Dis Child 1990;65:909–911.

Article  Google Scholar 

Ludvigsson JF, Leffler DA, Bai JC et al. The Oslo definitions for coeliac disease and related terms. Gut 2013;62:43–52.

Article  PubMed  Google Scholar 

Hill ID, Dirks MH, Liptak GS et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005;40:1–19.

Article  PubMed  Google Scholar 

Felber J, Aust D, Baas S, et al. [Results of a S2k-Consensus Conference of the German Society of Gastroenterolgy, Digestive- and Metabolic Diseases (DGVS) in conjunction with the German Coeliac Society (DZG) regarding coeliac disease, wheat allergy and wheat sensitivity]. Z Gastroenterol 2014;52:711–743.

Husby S, Koletzko S, Korponay-Szabó I et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J Pediatr Gastroenterol Nutr 2020;70:141–156.

Article  PubMed  Google Scholar 

Hamaguchi M, Kojima T, Itoh Y et al. The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterol 2007;102:2708–2715.

Article  PubMed  Google Scholar 

Sabir N, Sermez Y, Kazil S et al. Correlation of abdominal fat accumulation and liver steatosis: importance of ultrasonographic and anthropometric measurements. Eur J Ultrasound 2001;14:121–128.

Article  CAS  PubMed  Google Scholar 

Ferraioli G, Wong VW-S, Castera L, et al. Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations. Ultrasound Med Biol 2018;44:2419–2440.

Rout G, Kedia S, Nayak B et al. Controlled Attenuation Parameter for Assessment of Hepatic Steatosis in Indian Patients. J Clin Exp Hepatol 2019;9:13–21.

Article  PubMed  Google Scholar 

Authors/Task Force Members, Rydén L, Grant PJ, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013;34:3035–3087.

Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006;23:469–480.

Misra A, Chowbey P, Makkar BM et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57:163–170.

CAS  PubMed  Google Scholar 

Sinay I, Costa, de Loreto. Consenso Latinoamericano de la Asociación Latinoamericana de Diabetes (ALAD): Epidemiología, Diagnóstico, Control, Prevención y Tratamiento del Síndrome Metabólico en Adultos. https://www.scienceopen.com/document?vid=e533b22a-02e7-4eeb-834a-165d8f5121c2. Accessed June 27, 2022.

Study Quality Assessment Tools | NHLBI, NIH. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. Accessed July 4, 2022.

Altman DG, Bland JM. How to obtain the P value from a confidence interval. BMJ 2011;343:d2304.

Article  PubMed  Google Scholar 

Rosenblad A. Introduction to Meta-Analysis by Michael Borenstein, Larry V. Hedges, Julian P.T. Higgins, Hannah R. Rothstein. International Statistical Review 2009;77:478–479.

Egger M, Davey Smith G, Schneider M et al. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629–634.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Valvano M, Longo S, Stefanelli G et al. Celiac Disease, Gluten-Free Diet, and Metabolic and Liver Disorders. Nutrients 2020;12:940.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Taetzsch A, Das SK, Brown C et al. Are Gluten-Free Diets More Nutritious? An Evaluation of Self-Selected and Recommended Gluten-Free and Gluten-Containing Dietary Patterns. Nutrients 2018;10:E1881.

Article  Google Scholar 

Barone M, Della Valle N, Rosania R et al. A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects. Eur J Clin Nutr 2016;70:23–27.

Article  CAS  PubMed  Google Scholar 

Miranda J, Lasa A, Bustamante MA et al. Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten. Plant Foods Hum Nutr 2014;69:182–187.

Article  CAS  PubMed  Google Scholar 

Sainsbury K, Halmos EP, Knowles S et al. Maintenance of a gluten free diet in coeliac disease: The roles of self-regulation, habit, psychological resources, motivation, support, and goal priority. Appetite 2018;125:356–366.

Article  PubMed  Google Scholar 

Vereczkei Z, Farkas N, Hegyi P et al. It Is High Time for Personalized Dietary Counseling in Celiac Disease: A Systematic Review and Meta-Analysis on Body Composition. Nutrients 2021;13:2947.

Article  PubMed  PubMed Central  Google Scholar 

Gami AS, Witt BJ, Howard DE et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007;49:403–414.

Article  CAS  PubMed  Google Scholar 

Chen J, Muntner P, Hamm LL, et al. The metabolic syndrome and chronic kidney