C Deepak, Berry Neha, Vaiphei Kim, Dhaka Narendra, Sinha Saroj K, Kochhar Rakesh
Department of Medicine Postgraduate Institute of Medical Education and Research Chandigarh India.
Department of Gastroenterology Postgraduate Institute of Medical Education and Research Chandigarh India.
JGH Open. 2018 Jun 6;2(4):124-128. doi: 10.1002/jgh3.12056. eCollection 2018 Aug.
Patients with celiac disease (CD) have a poor health-related quality of life (HR-QOL). We assessed the QOL in patients with CD using both generic (SF-12) and specific (CD-QOL) questionnaires, and the effect of gluten-free diet (GFD) on HR-QOL.
We conducted a prospective follow-up study based on consecutive patients of suspected CD between June 2014 and November 2015. After taking a detailed history, all patients were subjected to laboratory investigations (including complete blood count, biochemistry, and the IgA tTG antibody), followed by endoscopy and duodenal biopsies for histopathology. The HR-QOL was assessed using SF-12 and CD-QOL questionnaires. Patients who were strictly adherent to GFD were re-assessed at the end of 6 months for laboratory parameters and QOL.
Sixty adult patients of CD, with mean age of 28.85 ± 12.43 years, and a M:F ratio of 1.3:1, were enrolled in the study. The mean PCS (physical health composite scale score) and MCS (mental health composite scale score) at baseline were 37.20 ± 11.09 and 41.88 ± 8.39, which showed a statistically significant improvement after GFD to 50.30 ± 9.88 and 50.22 ± 9.04, respectively. Though there was no significant difference in the total CD-QOL score after GFD, there was a significant improvement in the dysphoria and health-concern subscales. We also found a negative correlation of the pre-GFD symptom score (based on number of positive symptoms) with PCS and MCS and a positive correlation with the CD-QOL score.
This study has shown a reduced HR-QOL in adult CD patients, which improves significantly on GFD, and is associated with a higher symptom number.
乳糜泻（CD）患者的健康相关生活质量（HR-QOL）较差。我们使用通用问卷（SF-12）和特定问卷（CD-QOL）评估了CD患者的生活质量，以及无麸质饮食（GFD）对HR-QOL的影响。
我们对2014年6月至2015年11月期间连续的疑似CD患者进行了一项前瞻性随访研究。在详细询问病史后，所有患者均接受实验室检查（包括全血细胞计数、生化检查和IgA组织转谷氨酰胺酶抗体检查），随后进行内镜检查和十二指肠活检以进行组织病理学检查。使用SF-12和CD-QOL问卷评估HR-QOL。严格遵守GFD的患者在6个月末重新评估实验室参数和生活质量。
60例成年CD患者纳入研究，平均年龄为28.85±12.43岁，男女比例为1.3:1。基线时的平均生理健康综合量表评分（PCS）和心理健康综合量表评分（MCS）分别为37.20±11.09和41.88±8.39，GFD后分别显著提高至50.30±9.88和50.22±9.04。虽然GFD后CD-QOL总分无显著差异，但烦躁不安和健康担忧子量表有显著改善。我们还发现GFD前症状评分（基于阳性症状数量）与PCS和MCS呈负相关，与CD-QOL评分呈正相关。
本研究表明成年CD患者的HR-QOL降低，GFD后显著改善，且与症状数量较多有关。
