Consequential effect of gluten-free diet on health-related quality of life in celiac populace-a meta-analysis

Abstract

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.