Determinants of health-related quality of life in patients with celiac disease: a structural equation modeling

Abstract

Purpose We employed the structure equation modeling (SEM) for investigating the determinants of Helath-related quality of life (HRQOL) in Iranian patients with celiac disease (CD). Methods In the present cross-sectional study, a total of 170 patients with CD were recruited. The information regarding adherence to diet, symptom severity and HRQOL were collected using celiac disease adherence test (CDAT), gastrointestinal symptom rating scale (GSRS) and SF-36 questionnaire respectively. Association between various studied variables and HRQOL was assessed using SEM. The standardized regression weights was used to assess total, direct and indirect effects. The model fit was assessed to determine the “goodness of fit” between the hypothesized model. Results The mean age of participants was 37.57 ± 9.59 years. The results of SEM indicated that the overall fit of our model was acceptable. Adherence to the diet, GSRS score, occupation, and education level were significantly related to PCS of SF-36; and adherence to the diet, GSRS score, and education level were significantly correlated to MCS of SF-36. The analysis of indirect effect indicated that only adherence to diet indirectly via GSRS score was significantly associated with PCS and MCS of SF-36. There were significant differences between males and females regarding the relationship between education and adherence to diet (p<0.001) and education level and MCS of SF-36 (p=0.03). Conclusion In adult patients with celiac disease, HRQoL was affected by age, education level, adherence to GFD, and GSRS score. Additionally, occupation and disease duration were associated with HRQoL only in women and men respectively.