Investigation of the relationship between subcutaneous and viserial fat tissue measurements and non-invasive fibrosis scores (FIB-4, APRI, AAR) in the evaluation of liver damage associated with celiac disease

Celiac disease (CD) is a chronic, autoimmune small intestinal enteropathy that develops in genetically predisposed individuals upon the ingestion of gluten. Although CD primarily affects the intestine, its clinical course can vary and it can affect many extra-intestinal systems and organs, including the liver. This study aimed to evaluate the relationship between demographic data, metabolic parameters, and non-invasive fibrosis markers (FIB-4, APRI, AAR) in assessing liver damage in patients diagnosed with CD. A retrospective cohort of 103 CD patients and 51 healthy controls from Fırat University Faculty of Medicine Hospital was examined. In the CD group, AST and ALT levels were significantly higher than in the control group (p<.001) , while metabolic parameters such as glucose, triglycerides, LDL, HDL, vitamin D, and HbA1c were significantly lower (p<.001 to p=.009). However, the performance of FIB-4, APRI, and AAR scores in determining the severity of hepatosteatosis was found to be poor in both groups (p>.05). The findings of the study indicate that liver damage in CD has a unique mechanism and that these commonly used non-invasive scores are insufficient to reliably reflect liver damage. This study concludes that a holistic approach is necessary for evaluating liver involvement in CD patients.