Publication: Pediatrik çölyak hastalarında glutensiz diyet tedavisine uyumu etkileyen faktörlerin değerlendirilmesi
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Date
2022-08-01
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Abstract
Amaç: Çölyak hastalığının günümüzde bilinen tek tedavi şekli ömür boyu glutensiz diyet tedavisidir ve hastalığın
yönetimindeki en önemli sorun diyete uyumsuzluktur. Bu çalışmada, çocukluk çağında tanı almış çölyak hastalarında diyet
tedavisini etkileyen faktörlerin değerlendirilmesi amaçlanmıştır.
Bireyler ve Yöntem: Bu çalışmada, çölyak hastalığı tanısı almış ve en az bir yıldır takipli olan 8-18 yaş arasındaki rastgele
seçilmiş 92 hasta kesitsel olarak değerlendirilmiştir. Hastaların demografik ve klinik özellikleri, ailelerinin sosyal yapısı
ve glutensiz diyet hakkındaki bilgileri incelenmiştir. Hastaların diyete uyumu güncel serum anti-tTG IgA düzeylerine
bakılarak değerlendirilmiştir. Seroloji sonucuna göre hastalar, diyete uyumlu ve uyumsuz olarak 2 gruba ayrılmış ve veriler
karşılaştırılmıştır.
Bulgular: Çalışmaya dahil edilen 92 hastanın güncel yaş ortalaması 13.1±3.5 yıl’dır. Anti-tTG IgA düzeyi normal olan hasta
oranı %55.4 olarak saptanmıştır. Diyete uymayan hastalarda yaş ortalamasının daha yüksek (13.8±3.4 yıl; p<0.05) olduğu
bulunmuştur. Takip süresi iki yıldan az olan hastaların (%34.8) diyete uyum oranının en yüksek (%68) olduğu bulunmuştur.
Kardeş sayısının fazla olması ve kalabalık ev ortamı diyet uyumunu olumsuz etkileyen faktörler olarak tespit edilmiştir.
Cinsiyet, tanı yaşı, başvuru semptomları, komorbidite varlığı ve annenin eğitim düzeyi ile diyete uyum arasında ilişki
saptanmamıştır. Ebeveynlerin %55.4’ünün çapraz bulaşma konusunda bilgi sahibi olmadıkları tespit edilmiştir.
Sonuç: Çalışmanın sonuçlarına göre çocukluk döneminde çölyak hastalarında diyete uyumsuzluk oranı oldukça yüksektir.
Çalışmada, tanıdan sonra geçen süre ile diyet uyumu arasında ters ilişki saptanmıştır. Diyetin yaşam şekli olarak
benimsenmesi ve istikrarlı bir şekilde uygulanması ile hastalığa ait morbidite ile mortalitenin önlenmesi mümkündür.
Aim: Currently, the only known treatment for celiac disease is lifelong gluten-free diet (GFD) therapy, and the most important problem in the management of the disease is non-compliance with the diet. The aim of this study was to assess the factors affecting compliance to GFD therapy in pediatric celiac patients. Subjects and Method: 92 randomly selected celiac patients aged 8-18 years, followed in our clinic for at least one year, were evaluated cross-sectionally. The demographic and clinical characteristics of the patients, the social structure of their families and their knowledge of the GFD were examined. Dietary compliance was assessed by patients’ current serum anti-tTG IgA levels. According to the serology results, the patients were divided into 2 groups as adherent and non-adherent to the GFD and the data were compared. Results: The mean age of the 92 patients was 13.1±3.5 years. The rate of patients with normal anti-tTG IgA levels was 55.4%. The mean age was higher in patients who did not adhere to the GFD (13.8±3.4 years; p<0.05). The mean follow-up period was 5.2±3.9 years. Patients with a follow-up period of less than 2 years (34.8%) had the highest rate (68%) of adherence to diet. The high number of siblings, crowded home environment were the factors that negatively affected diet compliance. No relationship was found between gender, age at diagnosis, symptoms at presentation, presence of comorbidity, level of maternal education and dietary compliance. Knowledge about cross-contamination was not sufficient in 55.4% of the parents. Conclusion: In this study, dietary non-adherence was found to be quite high in pediatric celiac patients. There was an inverse relationship between time after diagnosis and adherence to diet. It is possible to prevent the morbidity and mortality of the disease by adopting the diet as a lifestyle, persuing it consistently
Aim: Currently, the only known treatment for celiac disease is lifelong gluten-free diet (GFD) therapy, and the most important problem in the management of the disease is non-compliance with the diet. The aim of this study was to assess the factors affecting compliance to GFD therapy in pediatric celiac patients. Subjects and Method: 92 randomly selected celiac patients aged 8-18 years, followed in our clinic for at least one year, were evaluated cross-sectionally. The demographic and clinical characteristics of the patients, the social structure of their families and their knowledge of the GFD were examined. Dietary compliance was assessed by patients’ current serum anti-tTG IgA levels. According to the serology results, the patients were divided into 2 groups as adherent and non-adherent to the GFD and the data were compared. Results: The mean age of the 92 patients was 13.1±3.5 years. The rate of patients with normal anti-tTG IgA levels was 55.4%. The mean age was higher in patients who did not adhere to the GFD (13.8±3.4 years; p<0.05). The mean follow-up period was 5.2±3.9 years. Patients with a follow-up period of less than 2 years (34.8%) had the highest rate (68%) of adherence to diet. The high number of siblings, crowded home environment were the factors that negatively affected diet compliance. No relationship was found between gender, age at diagnosis, symptoms at presentation, presence of comorbidity, level of maternal education and dietary compliance. Knowledge about cross-contamination was not sufficient in 55.4% of the parents. Conclusion: In this study, dietary non-adherence was found to be quite high in pediatric celiac patients. There was an inverse relationship between time after diagnosis and adherence to diet. It is possible to prevent the morbidity and mortality of the disease by adopting the diet as a lifestyle, persuing it consistently
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Keywords
Sağlık Bilimleri, Health Sciences, Klinik Tıp (MED), Clinical Medicine (MED), Celiac disease, diet compliance, gluten-free diet, pediatric, Çölyak hastalığı, diyet uyumu, glutensiz diyet, pediatrik
Citation
Şahin Akkelle B., Tutar E., Ertem Şahinoğlu D., "Pediatrik Çölyak Hastalarında Glutensiz Diyet Tedavisine Uyumu Etkileyen Faktörlerin Değerlendirilmesi", Beslenme ve Diyet Dergisi, cilt.50, sa.2, ss.48-55, 2022