Less, but not gone-gluten-free diet effects on fatigue in celiac disease: a prospective controlled study.
Study Goal
The researchers aimed to investigate the prevalence, severity, and associated factors of fatigue in celiac disease patients at diagnosis and after 1 year on a gluten-free diet.
Results Summary
Fatigue significantly decreased after 12 months on a gluten-free diet, as measured by multiple fatigue scales, though fatigue levels remained higher than in healthy controls. Higher fatigue scores were linked to depression and pain but not to disease activity or nutritional deficiencies.
Population
78 patients with serologically and histologically verified celiac disease, matched with 78 healthy controls by age and sex.
Effective Dosage
Not specified
Duration
12 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten-free diet | decrease | Fatigue | patients with celiac disease | - | reduced | #1 |
gluten-free diet | decrease | Fatigue Severity Scale (FSS) score | patients with celiac disease | from 3.8 (IQR: 2.2 to 4.8) to 1.9 (IQR: 1.4 to 3.5) | changed | #2 |
gluten-free diet | decrease | Fatigue Visual Analog Scale (fVAS) score | patients with celiac disease | from 44.5 (IQR: 18.8 to 66.0) to 15.5 (IQR: 7.8 to 43.3) | changed | #3 |
gluten-free diet | decrease | inverted Vitality subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36vs) score | patients with celiac disease | from 65 (IQR: 40 to 75) to 35 (IQR: 25 to 55) | changed | #4 |
gluten-free diet | decrease | Fatigue prevalence | patients with celiac disease | - | declined | #5 |
- | increase | Fatigue scores | patients with celiac disease | - | were significantly higher | #6 |
- | neutral | Higher fatigue scores | patients with celiac disease | - | were associated with | #7 |
- | no change | Higher fatigue scores | patients with celiac disease | - | were not associated with | #8 |
INTRODUCTION: Fatigue is a frequent complaint in patients with celiac disease. A gluten-free diet is the only established treatment for celiac disease, but how this diet influences fatigue is uncertain. We aimed to investigate fatigue prevalence, severity, and associated factors in patients with celiac disease, at diagnosis and at 1 year after commencing a gluten-free diet. METHODS: 78 patients with serologically and histologically verified celiac disease, 78 age- and sex-matched healthy subjects. Primary endpoints were Fatigue Visual Analog Scale (fVAS), Fatigue Severity Scale (FSS), and inverted Vitality subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36vs). Clinically relevant fatigue was defined as: FSS score ≥ 4, fVAS score ≥ 50 mm, or inverted SF-36vs score ≥ 65. Higher scores represented more fatigue. RESULTS: Fatigue was reduced after a 12-month gluten-free diet. Median scores changed from 3.8 (interquartile range [IQR]: 2.2 to 4.8) to 1.9 (IQR: 1.4 to 3.5) for FSS, from 44.5 (IQR: 18.8 to 66.0) to 15.5 (IQR: 7.8 to 43.3) for fVAS, and from 65 (IQR: 40 to 75) to 35 (IQR: 25 to 55) for inverted SF-36vs (p < 0.001 for all). Fatigue prevalence also declined after treatment. However, scores were significantly higher in patients compared to control subjects. Higher fatigue scores were associated with depression and pain, but not with signs of disease activity or nutritional deficiency. CONCLUSION: At diagnosis, patients with celiac disease frequently had severe fatigue. Fatigue declined after a gluten-free diet, but it remained higher than that observed in healthy subjects. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, Identifier NCT01551563.