Which factors are associated with a better quality of life for patients with celiac disease ? Results of a survey of 787 cases ; Quels sont les facteurs associés à une meilleure qualité de vie chez les patients avec maladie cœliaque ? Résultats d’une enquête portant sur 787 cas

Introduction : the quality of life of patients treated for celiac disease (CD) can be impaired both by the symptoms of the disease and the constraints of the gluten-free diet (GFD). The factors influencing the quality of life of this population remain poorly understood. The purpose of this study was to explore the factors associated with a better quality of life. Methods : in January 2016 an online questionnaire of 43 questions was sent by email to the members of AFDIAG, the french association of gluten intolerance. The French Celiac Disease Questionnaire (F-CDQ), validated score of 28 questions, was used to measure the patients' quality of life which was graded from 0 to 100 (the lowest value corresponding to the worst quality of life). Other collected data were socio-demographic characteristics, information about celiac disease, purchase and consumption habits of gluten-free products, and a self-evaluation (ranging from 0 to 10) of gluten-free diet compliance. Patients over 15 years of age, members of AFDIAG, with a confirmed diagnosis of celiac disease (serology and/or duodenal biopsy) and who had completed the entire questionnaire were included. Results: out of 4000 AFDIAG members, 907 patients answered the questionnaire, 787 of which met the inclusion criteria (638 women, (81,1 %); median age : 49). 475 (60,4 %) lived in urban areas and 556 (70,7 %) had a self-assessed compliance to GFD > 8/10. The median F-CDQ was 71 (extremes : 59 – 82). The factors significantly associated with a better quality of life in multivariate analysis were: duration of GFD (+0,47 [0,21; 0,72] points of F-CDQ per additional year of GFD, p<0,001) ; good compliance with the GDF (+6,8 [1,73 ; 11,9] points for patients with a self-assessed compliance > 8/10 compared to those ≤ 5/10, p < 0,001) ; age at diagnosis (+0,30 [0,06 ; 0,54] point for every additional year at diagnosis, p=0,014); socio-professional category (+3,14 [0,19 ; 6,09] points for executives compared to employees, p=0,032); frequency of follow up (+8,17 ...