Ankara'da Yaşayan 19-65 Yaş Arası Çölyak Hastalarının Beslenme Durumlarının Yaşam Kalitesi Üzerine Etkisi

Abstract

Adherence to gluten free diet is strongly associated with the health related quality of life and clinical signs in celiac disease. This study was designed to assess the nutritional status of patients with celiac disease, to evaluate the effects of dietary compliance and nutritional status on patients’ health related quality of life. Forty three male and a hundred and sixteen female celiac patients who are between 19-65 years of age with no additional health problems, no nutritional support within the last year, no smoking and no regular alcohol consumption, were recruited to the study. A questionnaire which included general characteristics, medical history, body weight change and symptoms was applied to the patients. Celiac Disease Healthrelated Quality of Life Questionnaire (CDQ) is used to evaluate the quality of life. The intake of nutrients of patients was determined by 3 days dietary recall. The physical activity levels (PAL) were assessed by 24-h physical activity recall. Anthropometric and body composition measurements were made on the same day. Statistical analysis were done using SPSS 19 software. The mean age of the patients was 32.74 ± 9.04 years, 50,9% of patients were married and 55.3% of patients were college graduates. Nausea (%83), fatigue (%74.8), abdominal pain (%57.2), diarrhea (%47.8) have been found as the most common symptoms in all patients. Study population was found to adhere 66.7% to a gluten-free diet. Married participants were more adherent than unmarried participants (p<0.05). Age at diagnosis also found to be correlated with adherence (p<0.05). The dietary energy intakes of the patients have met 78.8±24.47% of the age and gender specific dietary recommended levels. Contributions of carbohydrates, proteins and fats to the total dietary energy intake have been found to be 47.5±9.73%, 13.1±3.36% and 39.3±9.27%, respectively. The ratios of meeting the recommended levels of thiamine (%64.74 ± 27.65), niacin (%73.22 ± 31.89), folic acid (%62.24 ± 24.53), calcium (%60.56 ± 20.18), iron (%63.90 ± 30.17) and zinc (%63.31 ± 41.81) were found to be low when compared with other nutrients. Especially emotional and social quality of life scores decreased significantly at elder age (p<0.05). Total quality of life score was also decrease with aging (p<0.05). Compliance with the dietary treatment was associated with the health related quality of life. The mean health related quality life score of adhered patient was significantly higher than nonadhered patients (p<0.05). Patients who intake gluten more frequently than 3-4 times per week have significantly lower health related quality of life score than patients who do not consume gluten (p<0.05). Gastrointestinal quality of life score shows positive perfect correlation with daily energy requirement (r = 0.768, p = 0.000). Celiac disease requires lifelong treatment. Therefore, assessment of patients’ quality of life and compliance to gluten-free diet, is important.