Health-related quality of life in children and adult with celiac disease

Abstract

Goal is to assess and compare Health related quality of life (HRQOL) in children and adults with celiac decease (CD) and explores how both clinical characteristics and adherence of gluten free diet (GFD) affect their perceived health status. Materials and methods. We recruited 149 respondents from 12 to 70 years old with CD Group 1 consisted of 98 children, average age 12.5 years; group 2 included 51 adults, average age 35.2 years. The comparison group consisted of 22 healthy children, average age 12.3 years. For the HRQOL assessment, we used the SF-36 questionnaire. Patients, aged 12 to 18 years, were guided in filling out the questionnaire by trained pediatric gastroenterologists. Additionally, we assessed age at the time of the survey and at the time of diagnosis, and the duration of the gluten-free diet. We analyzed parametric or non-parametric variables and frequencies as appropriate. Results. The age of adult patients at the time of diagnosis was 28.2±4.6 years; the average duration of gluten-free diet was 5 years. In children, the age at the time of diagnosis was 7.6±1.7 years; the average duration of the diet was 2.5 years. The period from the onset of symptoms to diagnosis was 6.8 years in adults and 2.4 years in children (p=0.001). We found that HRQOL of children with celiac disease approaches those of healthy children, with the exception of a significant decrease in the Social Functioning (SF) index. HRQOL scores in adults were significantly worse than in children, especially scores assessing psychological and mental component summary score: Vitality (VT), Social Functioning (SF), Role-Emotional Functioning (RE), and Mental Health (MH). Conclusions. Health-related quality of life indicators in children and adults with celiac disease characterized by lower values in adult patients. HRQOL indicators in children with celiac disease are close to those of healthy children, with the exception of reduced indicator of social adaptation, which is probably associated with adherence to a restrictive diet. In adult patients, low scores on scales characterizing the psychological aspects of health perception may be associated with later diagnosis of the disease, late prescription of a gluten-free diet, and the presence of concomitant pathology.