Inflammatory Bowel Disease Services, The Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, Woodville South, SA, Australia.
School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.
J Hum Nutr Diet. 2022 Feb;35(1):234-244. doi: 10.1111/jhn.12920. Epub 2021 Jun 11.
BACKGROUND: Measuring food-related quality of life (FRQoL) quantifies the psychosocial impact of eating and drinking. FRQoL and associated factors are not well explored in people with inflammatory bowel disease (IBD), despite IBD being a chronic disease affecting the digestive tract. The present study aimed to characterise and identify any patient or disease-related predictors of FRQoL in individuals with IBD. METHODS: Adults with a formal diagnosis of IBD were recruited to a prospective multicentre cross-sectional study between April 2018 and December 2019. Participants completed questionnaires measuring FRQoL (FRQoL-29), clinical disease activity (Harvey Bradshaw Index and Simple Clinical Colitis Activity Index), restrictive eating behaviour (Nine-Item Avoidant/Restrictive Food Intake Disorder Screen), mental health (Depression Anxiety Stress Scale-21) and other patient and disease-related variables. A multivariable regression was performed to identify factors associated with FRQoL. RESULTS: One hundred and eight participants completed the questionnaires (n = 39, Crohn's disease; n = 69, ulcerative colitis). The mean FRQoL was 79 (95% confidence interval = 75-84) (poor, 0; superior, 145). Poorer FRQoL was observed in those with restrictive eating behaviour associated with fear of a negative consequence from eating (p < 0.0001) and reduced appetite (p < 0.030). Greater FRQoL was observed in those with lower disease activity (p < 0.0001) and previous IBD surgery (p = 0.024). FRQoL was not associated either way by IBD phenotype, duration, or gender. The majority of participants obtained their dietary information from the internet (60%) or gastroenterologist (46%). CONCLUSIONS: FRQoL in people with IBD is poorer in those with restrictive eating behaviours and clinically active disease. Interestingly, it was greater in those with previous IBD surgery. Further research is required to validate these associations and explore longitudinal effects of poor FRQoL on patient outcomes and potential strategies for prevention or management of impaired FRQoL in IBD.
背景：衡量与食物相关的生活质量（FRQoL）可量化进食和饮水对心理社会的影响。尽管炎症性肠病（IBD）是一种影响消化道的慢性疾病，但 FRQoL 及其相关因素在 IBD 患者中尚未得到充分探讨。本研究旨在描述并确定 IBD 患者 FRQoL 的任何患者或疾病相关预测因素。
方法：2018 年 4 月至 2019 年 12 月期间，我们招募了确诊为 IBD 的成年人参与前瞻性多中心横断面研究。参与者完成了测量 FRQoL（FRQoL-29）、临床疾病活动（Harvey Bradshaw 指数和简单临床结肠炎活动指数）、限制进食行为（九项回避/限制食物摄入障碍筛查）、心理健康（抑郁焦虑压力量表-21）和其他患者和疾病相关变量的问卷。进行多变量回归以确定与 FRQoL 相关的因素。
结果：108 名参与者完成了问卷（n=39，克罗恩病；n=69，溃疡性结肠炎）。FRQoL 的平均值为 79（95%置信区间为 75-84）（差，0；优，145）。在与因进食而害怕产生负面后果（p<0.0001）和食欲下降（p<0.030）相关的限制进食行为患者中，FRQoL 较差。在疾病活动度较低（p<0.0001）和既往 IBD 手术（p=0.024）患者中，FRQoL 较高。IBD 表型、持续时间或性别均未对 FRQoL 产生任何影响。大多数参与者从互联网（60%）或胃肠病学家（46%）获取饮食信息。
结论：在 IBD 患者中，限制进食行为和疾病活跃的患者 FRQoL 较差。有趣的是，既往 IBD 手术患者的 FRQoL 更高。需要进一步研究来验证这些关联，并探讨 FRQoL 不良对患者结局的潜在纵向影响，以及预防或管理 IBD 中 FRQoL 受损的潜在策略。
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