Rispo A, Imperatore N, Guarino M, et al. - In patients with celiac disease (CD), researchers analyzed the prevalence of non‐alcoholic fatty liver disease (NAFLD) and metabolic‐associated fatty liver disease (MAFLD) at the time of CD diagnosis and after 2 years of a gluten‐free diet (GFD), as well as the role of PNPLA3 rs738409 in the development of NAFLD and MAFLD in the same population. All newly diagnosed CD patients who underwent clinical, laboratory and ultrasonography investigations both at diagnosis and after 2 years of follow‐up were enrolled retrospectively. In addition, a PNPLA3 rs738409 genotyping assay was conducted. Sixty-five (29.4%) out of 221 newly diagnosed CD patients presented with NAFLD at their CD diagnosis, while 32 (14.5%) met the MAFLD criteria. No significant differences were found between NAFLD and MAFLD, other than the higher rate of insulin resistance in MAFLD patients. Patients with MAFLD had higher transaminases, LDL‐cholesterol, BMI and waist circumference, and higher insulin resistance vs patients with NAFLD; they also exhibited higher non‐invasive liver fibrosis scores than patients with NAFLD. The new definition of MAFLD better illustrates the metabolic changes following GFD in the CD population. This new classification could be used to classify patients at higher risk of worse metabolic outcomes who require a close multidisciplinary approach to their multi-systemic disease.