Systematic Review With Meta-analysis of the Health-related Quality of Life in Children With Celiac Disease

Objectives:The aim of this article is to systematically review and meta-analyze the published data on the comparison of the health-related quality of life (HRQOL) in children and adolescents with celiac disease (CD) and healthy children. Moreover, the meta-analysis was performed to compare the parent proxy-report and child self-report of HRQOL.Methods:The databases of PubMed, Embase, Scopus, and Cochrane library were searched from inception to April 2019 to identify observational studies that evaluated the HRQOL in children with CD. Studies comparing the HRQOL in celiac patients and healthy children, and also comparing the parent's proxy-report and child self-report of HRQOL were included. Comprehensive meta-analysis software was used for statistical analysis.Results:Through our systematic search, 26 articles met our predefined inclusion criteria. The result of our meta-analysis on studies using the PedsQL questionnaire showed that the total score of HRQOL was not significantly different between celiac patients and healthy controls (SMD (95% confidence interval; CI]: -0.11[-0.45 to 0.23], P=0.52). The result of our meta-analysis showed that the parents reported the child's diet and communication scores lower than that of children. Only 4 out of 11 studies showed a significant correlation between HRQOL and gluten-free diet (GFD) compliance and 2 of 4 studies showed a significant negative association between HRQOL and age at diagnosis.Conclusions:The results of the present study showed that there was no significant difference between children with CD and healthy controls regarding HRQOL. Moreover, the parental perception of their children's HRQOL was lower than the children's perception.