title: Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain.
abstract: BACKGROUND
  Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population.
  
  
  METHODS
  An observational, transversal study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors.
  
  
  RESULTS
  We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores.
  
  
  CONCLUSIONS
  The HRQL of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.
authors.affiliation: Emergency Services, Hospital General Universitario, ESPAÑA.
authors.forename: Julián
authors.initials: J
authors.lastname: Rodríguez Almagro
authors.affiliation: Nurse midwife teaching Unit, Hospital General Mancha Centro, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández Martínez
authors.affiliation: Deparment of Gastroenterology, Hospital General de Tomelloso, España.
authors.forename: Alfredo José
authors.initials: AJ
authors.lastname: Lucendo
authors.affiliation: Special Unit for the Treatment of Crohn´s Disease , Hospital Universitari Vall d'Hebron, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Casellas
authors.affiliation: Nursing Department, School of Health Sciences. Universidad de Alicante.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Solano Ruiz
authors.affiliation: Nursing Department, School of Health Sciences. Universidad de Alicante.
authors.forename: José
authors.initials: J
authors.lastname: Siles González
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy / Q000523:psychology*; D003430:Cross-Sectional Studies; D055050:Diet, Gluten-Free; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011153:Population; D011788:Quality of Life; D012737:Sex Factors; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult