title: Characteristics and factors related to quality of life in Mexican Mestizo patients with celiac disease.
abstract: BACKGROUND
  Celiac disease (CD) is a global health problem and its prevalence is underestimated, especially in Latin American populations. Our aim was to evaluate the clinical features, psychological factors, and health-related quality of life (QoL), before and after diagnosis, in a representative sample of adult Mexican Mestizo patients presenting with CD.
  
  
  METHODS
  A cross-sectional analysis was conducted on patients seen at two tertiary referral centers in Mexico. QoL before and after CD diagnosis was evaluated using the EuroQoL 5D, the Hospital Anxiety and Depression Scale (HADS), and the disease-specific Celiac Symptom Index (CSI) questionnaires.
  
  
  RESULTS
  We included 80 patients (80% were women, with a mean age of 48.6 ± 14.1 years). The most common symptoms were diarrhea (86%), bloating (77.5%), and abdominal pain (71.3%). Mean symptom duration was 10.33 ± 6.3 years. Fifty-one patients (63.8%) had a previous diagnosis of irritable bowel syndrome (IBS) and 23 (28.8%) had one of functional dyspepsia. Questionnaire respondents rated their health status at 50% before diagnosis (0 = worst imaginable state, 100 = best imaginable state) and there was a significant improvement of 26% after diagnosis. Thirty-nine percent of the patients had a CSI score > 45 and they were the ones that had been previously diagnosed most often with IBS (p = 0.13) or dyspepsia (p = .036).
  
  
  CONCLUSIONS
  At the time of diagnosis, Mexican Mestizo patients with CD had poor QoL. Long-standing symptoms and a previous diagnosis of functional disorders were associated with worse QoL. As in other populations, our results support the need for a detailed examination of cost-effective strategies for increasing CD awareness in clinical practice.
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico. karen_14_89@hotmail.com.
authors.forename: Karen Lizzete
authors.initials: KL
authors.lastname: Ramírez-Cervantes
authors.affiliation: Digestive Physiology and Gastrointestinal Motility Laboratory, Medical and Biologic Research Institute, Universidad Veracruzana, Veracruz, Mexico. joremes@uv.mx.|National System of Level 1 Researchers, Veracruz, Mexico. joremes@uv.mx.|Facultad de Medicina, Miguel Alemán Valdés, Veracruz, Mexico. joremes@uv.mx.
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.affiliation: Facultad de Medicina, Miguel Alemán Valdés, Veracruz, Mexico. nutriclinica@hotmail.com.
authors.forename: María
authors.initials: M
authors.lastname: Del Pilar Milke-García
authors.affiliation: Department of Nutrition Administration, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico. romero61@prodigy.net.mx.
authors.forename: Viridiana
authors.initials: V
authors.lastname: Romero
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico. luis.uscangad@gmail.com.
authors.forename: Luis F
authors.initials: LF
authors.lastname: Uscanga
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000523:psychology; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000209:etiology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007198:Indians, North American; D043183:Irritable Bowel Syndrome / Q000175:diagnosis; D008297:Male; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D044465:White People; D055815:Young Adult