Celiac Disease Center, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, Suite 934, New York, NY 10032, USA.
Nutrients. 2013 May 15;5(5):1585-94. doi: 10.3390/nu5051585.
A gluten-free diet (GFD) is the treatment for celiac disease (CD), but due to its complexity, dietitian referral is uniformly recommended. We surveyed patients with CD to determine if dietitian use is associated with quality of life, symptom severity, or GFD adherence. The survey utilized three validated CD-specific instruments: the CD quality of life (CD-QOL), CD symptom index (CSI) and CD adherence test (CDAT). Four hundred and thirteen patients with biopsy-proven CD were eligible for inclusion. The majority (77%) were female and mean BMI was 24.1. Over three-quarters of patients (326, 79%) had seen a dietitian, however, 161 (39%) had seen a dietitian only once. Age, sex, and education level were not associated with dietitian use; nor was BMI (24.6 vs. 24.0, p = 0.45). On multivariate analysis, adjusting for age gender, education, duration of disease, and body mass index, dietitian use was not associated with CD-QOL, CSI, or CDAT scores. Our survey did not show an association between dietitian use and symptom severity, adherence, or quality of life. Delay in diagnosis was associated with poorer outcomes. This is a preliminary study with several limitations, and further prospective analysis is needed to evaluate the benefits and cost-effectiveness of dietitian-referral in the care of celiac disease patients.
无麸质饮食（GFD）是治疗乳糜泻（CD）的方法，但由于其复杂性，普遍建议患者向营养师寻求帮助。我们调查了 CD 患者，以确定营养师的使用是否与生活质量、症状严重程度或 GFD 依从性相关。该调查使用了三种经过验证的 CD 特异性工具：CD 生活质量（CD-QOL）、CD 症状指数（CSI）和 CD 依从性测试（CDAT）。符合条件的 413 名活检证实的 CD 患者。大多数（77%）为女性，平均 BMI 为 24.1。超过四分之三的患者（326 名，79%）曾见过营养师，但有 161 名（39%）只见过一次营养师。年龄、性别和教育程度与营养师的使用无关；BMI 也无关（24.6 与 24.0，p=0.45）。多变量分析调整年龄、性别、教育程度、疾病持续时间和 BMI 后，营养师的使用与 CD-QOL、CSI 或 CDAT 评分无关。我们的调查并未显示营养师的使用与症状严重程度、依从性或生活质量之间存在关联。诊断延迟与较差的结果相关。这是一项初步研究，存在一些局限性，需要进一步进行前瞻性分析，以评估营养师转诊在乳糜泻患者护理中的益处和成本效益。
