Predictors of reduced health-related quality of life in adults with coeliac disease

BACKGROUND: Data available on predictors of reduced health-related quality of life in coeliac disease are not consistent. AIM: To test predictors of reduced health-related quality of life, described in the literature, by a multivariate approach. METHODS: 1000 adult coeliacs of the German Coeliac Society completed a medical and a sociodemographic questionnaire, the Short-Form Health Survey (SF-36), the Coeliac Disease Questionnaire and the Hospital Anxiety and Depression Scale within a postal survey. Predictors of reduced health-related quality of life were tested for by logistic regression analysis. RESULTS: Physical comorbidities (beta = -0.41; OR = 0.66, P < 0.001) and mental disorder (beta = 0.88; OR = 2.4, P = 0.03) were associated with a reduced physical summary score of the SF-36. Mental disorder (beta = 2.5; OR = 11.9, P < 0.001), physical comorbidities (beta = -0.26; OR = 0.77, P = 0.004) and younger age at diagnosis (beta = -0.10; OR = 0.91, P = 0.05) predicted a reduced mental summary score of the SF-36. Mental disorder (beta = 0.90; OR = 2.5, P = 0.03), non-compliance with gluten-free diet (beta = 0.44; OR = 1.6, P = 0.009), active medical comorbidities (beta = -0.28; OR = 0.76, P = 0.007) and dissatisfaction with doctor-patient communication (beta = 0.55; OR = 1.7, P = 0.03) were associated with reduced Coeliac Disease Questionnaire scores. CONCLUSIONS: Reduced health-related quality of life in coeliac disease is associated not only with physical and mental comorbidities, but also with non-compliance with gluten-free diet and dissatisfaction with doctor-patient communication.