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Russian Journal of Gastroenterology, Hepatology, Coloproctology

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Quality of Life in Children and Adolescents with Celiac Disease in the Russian Federation: Results of the Cross-Sectional Multicenter Study

https://doi.org/10.22416/1382-4376-2026-36-3-60-73

Abstract

Introduction. Assessing the quality of life of patients with various chronic diseases, including celiac disease, is an important component of scientific research, determining the rationale and effectiveness of treatment and rehabilitation strategies. Few studies have examined the quality of life of children with celiac disease on a gluten-free diet. Furthermore, all of these studies utilized a variety of questionnaires.

Aim: to study the quality of life of children and adolescents with celiac disease on a gluten-free diet using a validated Russian-language version of the CD-QOL questionnaire.

Materials and methods. A cross-sectional study surveyed 599 children and adolescents with celiac disease (aged 2–22 years) using a validated Russian-language version of the CD-QOL questionnaire; the impact of diet on social functioning was also assessed. Comparisons were made using Student’s t-test (Welch’s test was used if homogeneity of variances was not met). For age groups, one-way analysis of variance (ANOVA) was used, with a preliminary check for homogeneity of variances using Levene’s test; in case of homogeneity, Tukey’s post-hoc test was performed. In cases of deviations from normality, the nonparametric Mann — Whitney test was used to compare independent groups. Multiple linear regression was used to assess the influence of factors on indicator levels; associations between variables were additionally assessed using the Pearson or Spearman correlation. The significance level was p < 0.05.

Results. The mean subscale scores for 599 respondents were: “social-emotional limitations” — 3.39 (SD = 0.96),“anxiety/fear for health” — 3.16 (SD = 1.07). A moderately strong positive correlation was found between the subscales  (r = 0.649; p < 0.001). No gender differences were found (p = 0.956 and p = 0.970 for both subscales). In the analysis by age groups, a statistical trend was observed for the “limitations” component (ANOVA: F(3,590) = 2.63; p = 0.053). For the  anxiety component, with confirmed homogeneity of variances using Levene’s test, significant between-group differences were revealed (ANOVA: F(3,590) = 8.84; p < 0.001). Tukey’s post-hoc comparisons revealed higher values in younger groups compared to adolescents and adults. Linear regression showed that anxiety was most strongly associated  with the severity of socioemotional limitations (β = 0.636; p < 0.001) with an independent negative effect of age (β ≈ –0.24;  p < 0.01). The model explained 44.4 % of the variance (R2 = 0.444); VIF < 1.1. Psychometric analysis confirmed the two-factor structure with high internal consistency of the subscales (α = 0.904 and α = 0.874).

Conclusions. The quality of life of children and adolescents with celiac disease on a gluten-free diet is characterized by moderate "restriction burden" and associated anxiety. Anxiety is higher in younger age groups; no gender differences were found. The priority of medical and social support is to reduce daily limitations through organizational and environmental measures (in educational and leisure contexts, when eating out), supplemented by psychoeducational support for families, especially in younger age groups. According to the study, such measures are associated with reduced anxiety and improved daily functioning.

About the Authors

A. I. Khavkin
Research Clinical Institute of Childhood of the Moscow Region; Belgorod State National Research University
Russian Federation

Anatoly I. Khavkin* — Dr. Sci. (Med.), Professor, Head of the Moscow Regional Center for Pediatric Gastroenterology and Hepatology named after A.V. Mazurin; Professor of the Department of Pediatrics of the Medical Institute

115093, Moscow, Bolshaya Serpukhovskaya str., 62


A. A. Lee
National Association “GlutenFree Living”
Russian Federation

Anastasia A. Lee — Expert

192174, Saint Petersburg, Obukhovskoy Oborony ave., 199


I. A. Bavykina
N.N. Burdenko Voronezh State Medical University
Russian Federation

Irina A. Bavykina — Dr. Sci. (Med.), Associate Professor of the Department of Faculty and Palliative Pediatrics

394036, Voronezh, Studencheskaya str., 10


E. A. Balakireva
Belgorod State National Research University
Russian Federation

Elena A. Balakireva — Dr. Sci. (Med.), Docent, Head of the De- partment of Pediatrics

308015, Belgorod, Pobedy str., 85


T. T. Boraeva
North-Ossetia State Medical Academy
Russian Federation

Tatyana T. Boraeva — Dr. Sci. (Med.), Professor, Head of the De- partment of Children’s Diseases No. 1

 


А. Kh. Vetrova
Children’s Polyclinic No. 3; Ministry of Health of the Chechen Republic
Russian Federation

Anastasia Kh. Vetrova — Pediatrician

364061, Grozny, Chekhova str., 4


S. V. Grechaniy
St. Petersburg State Pediatric Medical University
Russian Federation

Severin V. Grechaniy — Dr. Sci. (Med.), Docent, Head of the Department of Psychiatry and Narcology

194100, Saint Petersburg, Litovskaya str., 2


J. Dolinšek
University of Maribor
Slovenia

Jernej Dolinšek — Dr. Sci. (Med.), Head of the Pediatric Gastroenterology Unit of the University Medical Center

2000, Slovenia, Maribor, Slomškov trg., 15


M. G. Dzgoeva
North-Ossetia State Medical Academy
Russian Federation

Madina G. Dzgoeva — Dr. Sci. (Med), Docent, Vice-Rector for Research

362019, Vladikavkaz, Pushkinskaya str., 40


Yu. A. Dmitrieva
Children’s City Clinical Hospital named after Z.A. Bashlyaeva of the Moscow Department of Healthcare; Russian Medical Academy of Continuous Professional Education
Russian Federation

Yulia A. Dmitrieva — Cand. Sci. (Med.), Head of the Celiac Disease Centre

125373, Moscow, Geroev Panfilovtsev str., 28


R. A. Zhetishev
Kabardino-Balkarian State University named after H.M. Berbekov
Russian Federation

Rashid A. Zhetishev — Dr. Sci. (Med.), Professor, Head of the Department of Pediatric Diseases, Obstetrics and Gynecology

360004, Nalchik, Chernyshevskogo str., 173


K. D. Zavrazhnaya
Research Clinical Institute of Childhood of the Moscow Region
Russian Federation

Kristina D. Zavrazhnaya — Pediatric Gastroenterologist, Postgraduate

115093, Moscow, Bolshaya Serpukhovskaya str., 62


A. L. Zaryankina
Gomel State Medical University
Belarus

Alla I. Zaryankina — Cand. Sci. (Med.), Docent, Head of the Department of Pediatrics with the Course for Continuing Medical Education and Professional Development

246000, Gomel, Lange str., 5


A. A. Zvyagin
N.N. Burdenko Voronezh State Medical University
Russian Federation

Aleksandr A. Zvyagin — Dr. Sci. (Med.), Professor, Professor of the Department of Propedeutics of Children’s Diseases and Outpatient Pediatrics

394036, Voronezh, Studencheskaya str., 10


O. A. Kagirova
Ministry of Health of the Chechen Republic
Russian Federation

Olesia A. Kagirova — Head of the Department of Childhood

364061, Grozny, Chekhova str., 4


A. A. Kamalova
Kazan State Medical University; Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan
Russian Federation

Aelita A. Kamalova — Dr. Sci. (Med.), Professor of the De- partment of Hospital Pediatrics; Pediatrician of the Diagnostic Department

420012, Kazan, Butlerova str., 49

 


L. Ya. Klimov
Stavropol State Medical University
Russian Federation

Leonid Ya. Klimov — Dr. Sci. (Med.), Professor, Head of the Department of Faculty Pediatrics

355017, Stavropol, Mira str., 310


E. I. Kondratyeva
Research Clinical Institute of Childhood of the Moscow Region; Research Centre of Medical Genetics
Russian Federation

Elena I. Kondratyeva — Dr. Sci. (Med.), Professor, Deputy Director for Scientific Work; Head of the Clinical and Research Department of Cystic Fibrosis

115522, Moscow, Moskvorechye str., 1


E. V. Krylova
Novosibirsk State Medical University
Russian Federation

Evgenia V. Krylova — Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology

630091, Novosibirsk, Krasny ave., 52


E. V. Loshkova
Research Centre of Medical Genetics; Siberian State Medical University
Russian Federation

Elena V. Loshkova — Dr. Sci. (Med.), Leading Researcher; Associate Professor of the Department of Pediatrics

634050, Tomsk, Moskovsky Trakt, 2


A. V. Nalyotov
M. Gorky Donetsk State Medical University
Russian Federation

Andrew V. Nalyotov — Dr. Sci. (Med.), Professor, Head of the Department of Pediatrics No. 2; Chief Pediatric Gastroenterologist of the Ministry of Health of the Donetsk People’s Republic

283003, Donetsk, Ilyicha ave., 16


V. N. Panfilova
Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University
Russian Federation

Victoria N. Panfilova — Dr. Sci. (Med.), Associate Professor at the Department of Pediatrics of the Institute of PostGraduate Education; Chief Pediatric Gastroenterologist of the Krasnoyarsk Territory

660022, Krasnoyarsk, Partizana Zheleznyaka str., 1


D. V. Pechkurov
Samara State Medical University
Russian Federation

Dmitry V. Pechkurov — Dr. Sci. (Med.), Professor, Head of the Department of Children’s Diseases

443099, Samara, Chapaevskaya str., 89


M. O. Revnova
St. Petersburg State Pediatric Medical University
Russian Federation

Maria O. Revnova — Dr. Sci. (Med.), Professor, Head of the Department of Outpatient Pediatrics named after Academician A.F. Tur

194100, Saint Petersburg, Litovskaya str., 2, build. ‘Zh’


I. E. Romanovskaya
National Association “Gluten-Free Living”
Russian Federation

Irena E. Romanovskaya — Cand. Sci. (Philol.), Docent, President

192174, Saint Petersburg, Obukhovskoy Oborony ave., 199


L. E. Safronova
Regional Children’s Clinical Hospital
Russian Federation

Lyubov E. Safronova — Cand. Sci. (Med.), Deputy Chief Physician for Organisational and Methodical Work; Chief Freelance Pediatric Gastroenterologist of the Sverdlovsk Region

620149, Yekaterinburg, Serafimy Deryabinoy str., 32


A. N. Sultanova
Novosibirsk State Medical University
Russian Federation

Aklima N. Sultanova — Dr. Sci. (Med.), Professor of the Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology

630091, Novosibirsk, Krasny ave., 52


A. A. Tyazheva
Samara State Medical University
Russian Federation

Alyona A. Tyazheva — Cand. Sci. (Med.), Associate Professor of the Department of Children’s Diseases

443099, Samara, Chapaevskaya str., 89


G. V. Fedotova
Regional Children’s Clinical Hospital; Urals State Medical University
Russian Federation

Galina V. Fedotova — Cand. Sci. (Med.), Gastroenterologist; Associate Professor of the Department of Hospital Pediatrics

620028, Yekaterinburg, Repina str., 3


D. S. Fugol
Altai State Medical University
Russian Federation

Denis S. Fugol — Cand. Sci. (Med.), Associate Professor of the Department of Propedeutics of Children’s Diseases

656038, Barnaul, Lenina ave., 40


E. A. Yablokova
Research Clinical Institute of Childhood of the Moscow Region; I.M. Sechenov First Moscow State Medical University (Sechenov University).
Russian Federation

Ekaterina A. Yablokova — Cand. Sci. (Med.), Leading Researcher at the Pediatrics Department; Associate Professor of the Department of Children’s Diseases of the N.F. Filatov Clinical Institute of Children’s Health

115093, Moscow, Bolshaya Serpukhovskaya str., 62


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Review

For citations:

Khavkin A.I., Lee A.A., Bavykina I.A., Balakireva E.A., Boraeva T.T., Vetrova А.Kh., Grechaniy S.V., Dolinšek J., Dzgoeva M.G., Dmitrieva Yu.A., Zhetishev R.A., Zavrazhnaya K.D., Zaryankina A.L., Zvyagin A.A., Kagirova O.A., Kamalova A.A., Klimov L.Ya., Kondratyeva E.I., Krylova E.V., Loshkova E.V., Nalyotov A.V., Panfilova V.N., Pechkurov D.V., Revnova M.O., Romanovskaya I.E., Safronova L.E., Sultanova A.N., Tyazheva A.A., Fedotova G.V., Fugol D.S., Yablokova E.A. Quality of Life in Children and Adolescents with Celiac Disease in the Russian Federation: Results of the Cross-Sectional Multicenter Study. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2026;36(3):60-73. https://doi.org/10.22416/1382-4376-2026-36-3-60-73

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ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)

Tatiana L. Lapina - MD, PhD, associate professor, Department of Internal Diseases Propedeutics,
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
119146,  Moscow, PO box 31
e-mail: editorial@gastro-j.ru, tatlapina@gmail.com
tel.: +79031926919

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