Fatigue in adult coeliac disease
Article first published online: 26 AUG 2005
Alimentary Pharmacology & Therapeutics
Volume 22, Issue 5, pages 489–494, September 2005
How to Cite
SINISCALCHI, M., IOVINO, P., TORTORA, R., FORESTIERO, S., SOMMA, A., CAPUANO, L., FRANZESE, M. D., SABBATINI, F. and CIACCI, C. (2005), Fatigue in adult coeliac disease. Alimentary Pharmacology & Therapeutics, 22: 489–494. doi: 10.1111/j.1365-2036.2005.02619.x
- Issue published online: 26 AUG 2005
- Article first published online: 26 AUG 2005
- Accepted for publication 5 July 2005
Background : Fatigue is reported by many adults at the moment of diagnosis of coeliac disease and during follow-up.
Aim : To evaluate the prevalence, characteristics and associations of fatigue in adult coeliac disease patients.
Methods : The investigated sample comprised adults from Campania, Italy. A total of 130 coeliac disease patients were consecutively recruited in both treated (59 on gluten-free diet) and untreated conditions (71 on normal diet). The control group was made up of 80 healthy controls. Coeliac disease patients and healthy controls underwent laboratory tests, a set of questionnaires for studying fatigue: visual analogue scale for fatigue, chronic fatigue syndrome questionnaire, fatigue severity scale and a modified version of the Zung self-rating depression scale.
Results : Coeliac disease patients showed a significantly lower body mass index than controls (P = 0.0001), lower serum iron (P = 0.04). The entire cohort of coeliac disease patients reported greater modified version of the Zung self-rating depression scale score (P = 0.001), greater visual analogue scale for fatigue score (P = 0.0001) and greater chronic fatigue syndrome questionnaire score (P = 0.0001) compared with healthy controls. Coeliac disease patients on a gluten-free diet had a significantly higher modified version of the Zung self-rating depression scale score than coeliacs on a normal diet (P = 0.001). The prevalence of pathological modified version of the Zung self-rating depression scale score was 17% in all coeliac disease patients and 0% in healthy controls. A significant correlation was found between modified version of the Zung self-rating depression scale score and fatigue scale scores in coeliacs on a normal diet. Presence/absence of gastrointestinal symptoms did not show any significant correlation with modified version of the Zung self-rating depression scale score and fatigue scale scores. In coeliacs on a gluten-free diet, modified version of the Zung self-rating depression scale and fatigue scales scores did not significantly differ from coeliacs on a normal diet and were not related to dietetic compliance.
Conclusion : In coeliacs, fatigue is a common finding, which ameliorates with the gluten-free diet and is strictly correlated to depression although coeliacs on a gluten-free diet showed more frequent and more severe depression symptoms than coeliacs on a normal diet.