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Abstract
The quality of life (QOL) of patients with celiac disease (CD) can be altered by both symptoms of the disease and by the restrictions of the gluten-free diet (GFD). The objective was to determine the factors associated with better QOL in a large cohort of CD patients. A link to an online survey was sent to the members of the French Association of Gluten Intolerant People (AFDIAG). The French-Celiac Disease Questionnaire (F-CDQ), scoring from 0 to 100, was used to measure the QOL. Other data collected were sociodemographic characteristics, information on CD, purchasing and consumption habits of gluten-free products, and a self-assessment scale (ranging from 0 to 10) to determine the compliance with the GFD. Among the 907 CD patients who returned the questionnaire, 787 were analyzed (638 women (81%); median age: 49 years; 71% with self-assessed GFD compliance > 8). Their median F-CDQ was 73 (range: 59–82). In multivariate analysis, the main factors associated with a better quality of life were the long duration of the GFD, good compliance with the GFD, and the number of follow-up visits. Compliance with and duration of the GFD are associated with a better quality of life in patients with CD. Taking this into consideration would offset its restrictive aspect and improve its adherence.
Highlights
Celiac disease (CD) is an immune-mediated systemic disorder with chronic inflammation of the small intestinal mucosa due to the ingestion of gluten proteins in genetically predisposed patients
The main objective in the present study was to determine the disease and clinical factors associated with better quality of life (QOL) in a large cohort of French celiac disease (CD) patients
In a large French cohort of CD patients, gluten-free diet (GFD) duration and compliance, gender, socioprofessional category, frequency of medical follow-up visits, enjoying gluten-free products, and feeling comfortable in GFD-non-specific restaurants/bakeries were the main factors associated with QOL assessed by the French-Celiac Disease Questionnaire (F-CDQ), the only validated questionnaire in French [13]
Summary
Celiac disease (CD) is an immune-mediated systemic disorder with chronic inflammation of the small intestinal mucosa due to the ingestion of gluten proteins in genetically predisposed patients. To reduce the symptoms and complications, the only current treatment available for CD is a strict long-life gluten-free diet (GFD), which is restrictive, socially limiting, and costly [3,4]. Quality of life (QOL) is determined by the interaction of physical wellbeing, mental state, degree of family and social support, effects of treatment, and the presence of disease complications [5]. Previous studies showed that CD itself, as well as a GFD, could significantly alter the quality of life of these patients [8–11]. The determinants of altered QOL in CD patients remain largely unknown and may be influenced by cultural factors [12]. The main objective in the present study was to determine the disease and clinical factors associated with better QOL in a large cohort of French CD patients
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