Dota Michele, Rubbini Lorenzo, Massetti Giulio, Scarcella Chiara, Maimaris Stiliano, Bianchi Paola Ilaria, Maniero Daria, Di Sabatino Antonio, Biagi Federico, Zingone Fabiana, Schiepatti Annalisa
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Istituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute, Pavia, Italy.
Dig Dis Sci. 2025 Aug 6. doi: 10.1007/s10620-025-09183-9.
Data on work absenteeism in celiac disease (CD) are scarce. This study aimed to evaluate the hours of work lost, reasons for work absenteeism, and their association with quality of life (QOL) and psychological morbidity in celiac patients on a gluten-free diet (GFD).
Adult celiac patients on a GFD were enrolled in a cross-sectional Italian study between October-2022 and October-2024. The survey included the Work Productivity and Activity Impairment (WPAI:CD), the Celiac Disease-specific Quality of Life scale (CD-QOL), the Beck Depression Inventory scale (BDI), and the State-Trait Anxiety Inventory scale (STAI-Y). A multivariable analysis was conducted to identify factors independently associated with work absenteeism.
167 patients (121F, mean age at diagnosis of CD 32 ± 13 years) were enrolled. 23/167 (13.8%) lost working hours in the previous 30 days (mean of 6.61 h missed at work at 30 days). Reasons behind work absenteeism included outpatient clinic attendance (55.4%), symptom persistence despite a GFD (30.4%), and issues with GFD adherence (14.3%). Over a 30-day span, absentees had more ongoing symptoms despite the GFD (95.7% vs 67.4%, p = 0.05), higher scores on depression (median BDI-II score 12 vs 6, p = 0.04), and lower QOL (median CD-QOL score 79.0 vs 85.5, p = 0.015) than those who did not lose working hours. At multivariable analysis, being on a GFD for < 1 year (p = 0.001), and persistent symptoms despite a GFD (p = 0.04) were strongly associated with work absenteeism at 30 days.
CD can significantly impair work activities. Persistent symptoms and GFD < 1 year are strongly associated with work impairment. Clinicians should be aware of and manage these issues.
关于乳糜泻（CD）患者旷工的数据很少。本研究旨在评估乳糜泻患者在采用无麸质饮食（GFD）时的工作时长损失、旷工原因，以及它们与生活质量（QOL）和心理疾病的关联。
2022年10月至2024年10月期间，成年GFD乳糜泻患者参加了一项意大利横断面研究。该调查包括工作效率和活动障碍量表（WPAI:CD）、乳糜泻特异性生活质量量表（CD-QOL）、贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI-Y）。进行多变量分析以确定与旷工独立相关的因素。
共纳入167例患者（121例女性，CD诊断时的平均年龄为32±13岁）。23/167（13.8%）的患者在过去30天内有工作时长损失（30天时平均旷工6.61小时）。旷工的原因包括门诊就诊（55.4%）、尽管采用GFD但症状持续（30.4%）以及GFD依从性问题（14.3%）。在为期30天的时间段内，旷工患者尽管采用GFD但仍有更多持续症状（95.7%对67.4%，p = 0.05），抑郁得分更高（BDI-II中位数得分12对6，p = 0.04），生活质量更低（CD-QOL中位数得分79.0对85.5，p = 0.015），相比于未损失工作时长的患者。多变量分析显示，采用GFD时间<1年（p = 0.001）以及尽管采用GFD但症状持续（p = 0.04）与30天时的旷工密切相关。
CD可显著损害工作活动。持续症状和采用GFD时间<1年与工作受损密切相关。临床医生应意识到并处理这些问题。
