King's College London, Department of Nutritional Sciences, London, United Kingdom.
The University of East Anglia, The Medical School, Norwich, United Kingdom.
Nutrition. 2021 Oct;90:111249. doi: 10.1016/j.nut.2021.111249. Epub 2021 Mar 26.
This study aimed to identify the relationship between adherence to a gluten-free diet (GFD) and demographic characteristics, knowledge, attitudes, and beliefs regarding celiac disease (CD) and GFD, experiences of following a GFD, symptoms, and quality of life (QoL).
Patients with CD were recruited from outpatient clinics. Adherence to GFD was assessed using the CD adherence test (CDAT) and GFD score (GFD-S). Knowledge, attitudes, experiences, symptoms, and QoL were assessed using existing questionnaires. A multivariate logistic regression was performed.
Overall, 116 patients with CD were included (48 ± 16 y; 70% female). Based on the CDAT, 58 patients (50%) were adequate adherers, but 86 patients (74%) were adequate adherers according to GFD-S. When adherence was measured using the CDAT, being female was associated with lower odds of adherence (odds ratio [OR]: 0.36; P = 0.028), and better emotional wellbeing was associated with higher odds of adherence (OR: 1.19; P < 0.001). When adherence was measured using GFD-S, membership in a support group (OR: 6.17; P = 0.002), stronger beliefs about the chronicity of CD (OR: 1.15; P = 0.059), and weaker beliefs on accident/chance causing CD (OR: 1.94; P = 0.05) were associated with greater odds of adherence. Difficulties when eating with family/friends (OR: 0.98; P = 0.005) and weaker beliefs on immunity causing CD (OR: 0.77; P = 0.031) were associated with lower odds of adherence.
The association between gender, attending support groups, attitudes, experiences, and QoL with adherence to a GFD should be considered by health care professionals managing patients with CD.
本研究旨在确定对 gluten-free diet（GFD）的依从性与人口统计学特征、对乳糜泻（CD）和 GFD 的知识、态度和信念、遵循 GFD 的经验、症状和生活质量（QoL）之间的关系。
从门诊诊所招募 CD 患者。使用 CD 依从性测试（CDAT）和 GFD 评分（GFD-S）评估 GFD 的依从性。使用现有的问卷评估知识、态度、经验、症状和 QoL。进行了多变量逻辑回归分析。
共纳入 116 例 CD 患者（48±16 岁；70%为女性）。根据 CDAT，58 例患者（50%）为充分依从者，但根据 GFD-S，86 例患者（74%）为充分依从者。当使用 CDAT 测量依从性时，女性的依从性较低（比值比[OR]：0.36；P=0.028），情绪健康状况较好的患者的依从性较高（OR：1.19；P<0.001）。当使用 GFD-S 测量依从性时，参加支持小组（OR：6.17；P=0.002）、对 CD 的慢性认识更强（OR：1.15；P=0.059）、对导致 CD 的意外/偶然因素的信念较弱（OR：1.94；P=0.05）与更高的依从性几率相关。与家人/朋友一起用餐时遇到困难（OR：0.98；P=0.005）和对免疫引起 CD 的信念较弱（OR：0.77；P=0.031）与较低的依从性几率相关。
医疗保健专业人员在管理 CD 患者时应考虑依从 GFD 的性别、参加支持小组、态度、经验和 QoL 之间的关系。
