Consequential Effect of Gluten-Free Diet on Health-Related Quality of Life in Celiac Populace-A Meta-Analysis

2020 ◽  
Vol 8 (3) ◽  
pp. 1025-1036
Author(s):  
Shivani Rustagi ◽  
Saumya Choudhary ◽  
Sheeba Khan ◽  
Tanu Jain

Globally, celiac disease (CD) affects around 1-2% of the population. Gluten elimination becomes the cornerstone treatment and is also being followed by non-celiac as a healthy dietary habit. However, there is lack of sustainable evidence to understand this view. Adherence to gluten-free diet (GFD) rendered a few to reduced quality of life. Hence, a meta-analysis has been performed to determine interaction of GFD and Health-related Quality of Life (HRQoL). NCBI/MEDLINE, PubMed, Cochrane Library, Google Scholar and Science Direct were combed from date of inception to October 30, 2018 for studies assessing the effect of GFD using validated questionnaires on HRQoL a) between healthy controls and celiac patients b) dietary adherence to GFD in celiac subjects. Random effect model was used for meta-analysis. Twenty-five studies comprising 5148 CD subjects fit in the inclusion criteria. GFD had moderate significant association with HRQoL, for PGWB odds ratio’s (OR) 0.613 [95% CI, 0.449-0.837], SF-36 Mental Component Score (MCS) 0.026 [95% CI, 0.011-0.060], Physical Component Score (PCS) 0.066 95% [CI, 0.032-0.138]. Partial adherence to GFD had lower quality of life when compared to strictly adherent patients for OR’s SF-36 MCS 5.080 [95% CI, 1.885- 13.692], PCS 3.204 [95% CI, 1.579- 6.503] and CDQoL 2.439 [95%CI (1.724- 3.450)]. The results implied moderate significant association between GFD and HRQoL and better compliance leads to favourable HRQoL.

Lupus ◽  
2019 ◽  
Vol 28 (3) ◽  
pp. 371-382 ◽  
Author(s):  
M Gu ◽  
Q Cheng ◽  
X Wang ◽  
F Yuan ◽  
NB Sam ◽  
...  

Objective To evaluate the impact of systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) assessed with SF-36 and explore factors associated with HRQoL in SLE patients. Methods A random-effect meta-analysis was performed to calculate extracted data. Sensitivity and subgroup analyses were performed to distinguish sources of heterogeneity. Results A total of 36 articles were finally included in this meta-analysis, including 6510 patients. The pooled mean scores of SF-36 physical component summary and mental component summary were 46.10 (95% confidence interval (CI): 43.09–49.10) and 50.37 (95% CI: 47.78–52.87), respectively. Spearman's correlation analysis found that mean age, proportion of female participants, and publication decades were negatively associated with some of the SF-36 domains. Sample size and SLEDAI were positively associated with some of the SF-36 domains. Patients with SLE have lower HRQoL in comparison to the general population. Conclusions SLE has a significant impact on HRQoL, which proves that the necessity of improving HRQoL in SLE patients cannot be ignored. Measuring HRQoL should be considered as an indispensable part of the overall evaluation of health conditions of SLE patients.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S094-S095
Author(s):  
W J Sandborn ◽  
D S Rowbotham ◽  
R W L Leong ◽  
C Han ◽  
Y Zhou ◽  
...  

Abstract Background The UNIFI maintenance study evaluated the safety and efficacy of subcutaneous (SC) ustekinumab (UST) in patients with moderately–severely active UC who had responded to IV UST induction. Previously, we reported that health-related quality of life (HRQoL) improvements achieved after UST induction were maintained through Week 44 with UST maintenance. Here, we evaluated HRQoL through Week 92 in patients who continued UST maintenance in the long-term extension (LTE). Methods Patients who completed the maintenance study were eligible to continue their maintenance treatment regimen (placebo [PBO], UST90mg q12w, or UST90mg q8w) in the LTE if the investigator thought they could benefit from continued treatment. PBO patients discontinued from the LTE after the maintenance study was unblinded. Per investigator discretion, patients could receive a single dose adjustment (UST q12w to q8w or UST q8w to q8w [sham dose adjustment]) starting at Week 56. The Inflammatory Bowel Disease Questionnaire (IBDQ) is a 32-item questionnaire with a total score ranging from 32 to 224. Higher scores indicate better HRQoL, a score ≥170 indicates remission, and a change ≥16 was defined as clinically meaningful. General health was assessed using SF-36. A change ≥5 points in physical and mental component scores was defined as clinically meaningful. In this analysis, patients who dose adjusted were considered treatment failures. Results Most patients who received UST in the LTE maintained the improvements in IBDQ and SF-36 that were achieved after induction (Tables 1 and 2) through Week 92. Overall, 158 of 284 patients (55.6%) who received UST were in IBDQ remission at Week 92, and 114 of 169 patients (67.5%) who were in IBDQ remission at maintenance baseline were in IBDQ remission at Week 92. Of the 284 patients, 179 (63.0%) achieved a ≥16-point improvement in IBDQ score from induction baseline to Week 92. Of 250 patients who achieved a ≥16-point improvement from induction baseline to maintenance baseline, 154(61.6%) maintained a ≥16-point improvement at both Weeks 44 and 92. For SF-36, 142 of 284 patients (50.0%) had a ≥5-point improvement from induction baseline to Week 92 in the physical component score, while 128 of 284 (45.1%) had a ≥5-point improvement in the mental component score. Conclusion The majority of patients who were treated with UST in the LTE generally maintained improvements in IBDQ and SF-36 scores that were achieved after IV induction.


Obesity ◽  
2013 ◽  
Vol 21 (3) ◽  
pp. E322-E327 ◽  
Author(s):  
Zia Ul-Haq ◽  
Daniel F. Mackay ◽  
Elisabeth Fenwick ◽  
Jill P. Pell

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