title: Long-term deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance.
abstract: BACKGROUND
  Deterioration of quality of life in the long term has been suggested for celiac disease patients on a gluten-free diet.
  
  
  OBJECTIVE
  To determine long-term quality of life of celiac disease patients and to assess the benefits of gluten-free diet compliance.
  
  
  METHODS
  We prospectively evaluated 53 newly diagnosed adult celiac disease patients.
  
  
  METHODS
  The Short Form 36 Health Survey, the Gastrointestinal Symptoms Rating Scale and the Beck Depression Inventory were employed at the time of diagnosis, 1 year, and beyond 4 years (median: 53 months) on treatment.
  
  
  RESULTS
  At 1 year, a significant improvement from baseline in quality of life indicators was observed (p<0.001 to p<0.0001) with comparable scores to healthy subjects. At 4 years, the Short Form 36 Health Survey scores (p<0.002 to p<0.0002) and Beck Depression Inventory score (p<0.002) show significant deterioration compare with 1 year. Most scores remained significantly better than those at diagnosis (p<0.03 to p<0.0005). No changes were detected in the Gastrointestinal Symptoms Rating Scale scores. The long-term impairment of quality of life was attributable to the deterioration of most dimensions in patients who were not strictly compliant with the gluten-free diet (p<0.05 to p<0.001).
  
  
  CONCLUSIONS
  Long-term deterioration of quality of life outcomes after the first year of gluten-free diet was associated with the lack of strict compliance with the diet.
authors.affiliation: Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.
authors.forename: Fabio
authors.initials: F
authors.lastname: Nachman
authors.forename: Marcela Planzer
authors.initials: MP
authors.lastname: del Campo
authors.forename: Andrea
authors.initials: A
authors.lastname: González
authors.forename: Laura
authors.initials: L
authors.lastname: Corzo
authors.forename: Horacio
authors.initials: H
authors.lastname: Vázquez
authors.forename: Cristina
authors.initials: C
authors.lastname: Sfoggia
authors.forename: Edgardo
authors.initials: E
authors.lastname: Smecuol
authors.forename: María Inés Pinto
authors.initials: MI
authors.lastname: Sánchez
authors.forename: Sonia
authors.initials: S
authors.lastname: Niveloni
authors.forename: Emilia
authors.initials: E
authors.lastname: Sugai
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mauriño
authors.forename: Julio C
authors.initials: JC
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy / Q000523:psychology*; D055050:Diet, Gluten-Free; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult