TOPLINE:

Patients with celiac disease (CeD) reported worse fatigue and overall health, faced challenges in daily activities, and used more healthcare, with more negative experiences with providers than matched peers without the disease.

METHODOLOGY:

• In CeD, maintaining a gluten-free diet is often expensive and linked to nutritional gaps, stigma, and social isolation. Prior studies examining physical and psychiatric impacts of the disease were largely single-center or claims-based analyses with limited patient-reported data.
• Investigators retrieved data from the large All of Us Research Program cohort, comparing physical disability and healthcare interactions between individuals with genetically validated CeD and control individuals without the condition, matched by age, sex, and genetic ancestry.
• Analyses evaluated survey responses across five categories through October 1, 2023: basics, lifestyle, overall health, social factors of health, and healthcare access and utilization.

TAKEAWAY:

• The final analysis included 1816 patients with CeD and 9080 matched control individuals. More individuals with than without CeD reported being White (91.1% vs 86.9%); having advanced degrees (35.0% vs 27.0%) and higher annual household incomes (≥ $150,000: 18.8% vs 15.4%); and being retired or unable to work (38.3% vs 33.5%).
• Patients with CeD reported higher fatigue severity than control individuals (P < .0001), with more reporting severe fatigue (12.0% vs 8.4%). They were less likely to rate their general (P < .0001) and physical health (P = .0018) as excellent and more likely to rate it as fair or poor, and less often reported being able to carry out everyday activities completely (61.5% vs 65.0%; P = .007).
• Patients with CeD reported more frequent physician and specialist visits, including a higher proportion reporting 13 or more specialist visits annually (6.6% vs 4.3%), and were less likely to report consistently respectful and attentive interactions with healthcare providers.
• In multivariable analyses, fatigue and a higher level of education were positively associated with CeD (P < .0001 for both), whereas a higher smoking frequency and daily alcohol intake were associated with lower odds of CeD (P ≤ .0001).

IN PRACTICE:

“As [CeD] places a significant burden on affected individuals in the domains of fatigue, disability, and healthcare interactions, future efforts should focus on the development of personalized and equitable care strategies for individuals with CeD,” the authors wrote.

SOURCE:

The study was led by Bettina Anil, MS, University of Texas Southwestern Medical Center in Dallas. It was published online in the Journal of Clinical Gastroenterology.

LIMITATIONS:

CeD was not confirmed by serology or intestinal biopsy. The study lacked data on adherence to gluten-free diets, and on mucosal healing. Researchers could not fully assess factors contributing to fatigue, such as sleep disturbance, due to inconsistent data.

DISCLOSURES:

One author reported receiving support from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and the Disease-Oriented Clinical Scholars Program at the University of Texas Southwestern Medical Center. The research program used as the source of data (All of Us) received support from multiple sources, including the National Institutes of Health, Federally Qualified Health Centers, and Participant Technology Systems Center.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.