Skip to main content
Top
Published in: Digestive Diseases and Sciences 10/2021

01-10-2021 | Gastritis | Original Article

Impaired Quality of Life in Patients with Autoimmune Atrophic Gastritis

Authors: Emanuela Miceli, Natascia Brondino, Marco Vincenzo Lenti, Michele Di Stefano, Martina Staiani, Francesca Zugnoni, Martina Pisati, Costanza Caccia Dominioni, Gino Roberto Corazza, Pierluigi Politi, Antonio Di Sabatino

Published in: Digestive Diseases and Sciences | Issue 10/2021

Login to get access

Abstract

Background

Autoimmune atrophic gastritis (AAG) leads to vitamin B12 deficiency that may manifest with neuropsychiatric disorders, such as emotional instability, cognitive deficits, depression, and personality changes.

Aims

To evaluate the quality of life (QoL) in patients with AAG and the interplay between QoL, psychopathological symptoms, and demographic factors.

Methods

This is an observational, cross-sectional study including 102 patients with AAG (mean age 62 ± 13 years), 100 with functional gastrointestinal disorders (mean age 38.3 ± 17 years), 100 with other chronic organic gastrointestinal diseases (mean age 50.9 ± 21.4 years), and 100 healthy controls (mean age 37.5 ± 18.9 years). The 36-Item Short Form Health Survey questionnaire (SF-36) and the General Health Questionnaire-12 were administered. The results of the scales were compared among the study groups. Linear regression analyses were fitted to identify independent predictors of QoL in AAG patients.

Results

QoL was significantly different among the four groups in all subdomains. In particular, the AAG group was significantly (P < 0.01) more impaired than the functional gastrointestinal disorder group in the physical functioning and it was significantly more impaired than the control group in all the quality of life subdomains with exception of vitality. Vitamin B12 serum level was a significant (P < 0.04) independent predictor of physical functioning.

Conclusions

Patients with AAG have a decreased QoL compared to healthy controls, but in line with that of patients with organic gastrointestinal disorders. Physical component is responsible for worsening QoL. Vitamin B12 supplementation may positively affect patient’s perception of body functioning.
Literature
1.
go back to reference Lenti MV, Rugge M, Lahner E, et al. Autoimmune gastritis. Nat Rev Dis Primers. 2020;6:56.CrossRef Lenti MV, Rugge M, Lahner E, et al. Autoimmune gastritis. Nat Rev Dis Primers. 2020;6:56.CrossRef
2.
go back to reference Lahner E, Zagari RM, Zullo A, et al. Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]. Dig Liver Dis. 2019;51:1621–1632.CrossRef Lahner E, Zagari RM, Zullo A, et al. Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]. Dig Liver Dis. 2019;51:1621–1632.CrossRef
3.
go back to reference Di Sabatino A, Lenti MV, Giuffrida P, Vanoli A, Corazza GR. New insights into immune mechanisms underlying autoimmune diseases of the gastrointestinal tract. Autoimmun Rev. 2015;14:1161–1169.CrossRef Di Sabatino A, Lenti MV, Giuffrida P, Vanoli A, Corazza GR. New insights into immune mechanisms underlying autoimmune diseases of the gastrointestinal tract. Autoimmun Rev. 2015;14:1161–1169.CrossRef
4.
go back to reference Miceli E, Vanoli A, Lenti MV, et al. Natural history of autoimmune atrophic gastritis: a prospective, single centre, long-term experience. Aliment Pharmacol Ther. 2019;50:1172–1180.CrossRef Miceli E, Vanoli A, Lenti MV, et al. Natural history of autoimmune atrophic gastritis: a prospective, single centre, long-term experience. Aliment Pharmacol Ther. 2019;50:1172–1180.CrossRef
5.
go back to reference Miceli E, Lenti MV, Padula D, et al. Common features of patients with autoimmune atrophic gastritis. Clin Gastroenterol Hepatol. 2012;10:812–814.CrossRef Miceli E, Lenti MV, Padula D, et al. Common features of patients with autoimmune atrophic gastritis. Clin Gastroenterol Hepatol. 2012;10:812–814.CrossRef
6.
go back to reference Lenti MV, Miceli E, Cococcia S, et al. Determinants of diagnostic delay in autoimmune atrophic gastritis. Aliment Pharmacol Ther. 2019;50:167–175.CrossRef Lenti MV, Miceli E, Cococcia S, et al. Determinants of diagnostic delay in autoimmune atrophic gastritis. Aliment Pharmacol Ther. 2019;50:167–175.CrossRef
7.
go back to reference Vanoli A, La Rosa S, Miceli E, et al. Prognostic evaluations tailored to specific gastric neuroendocrine neoplasms: analysis of 200 cases with extended follow-up. Neuroendocrinology. 2018;107:114–126.CrossRef Vanoli A, La Rosa S, Miceli E, et al. Prognostic evaluations tailored to specific gastric neuroendocrine neoplasms: analysis of 200 cases with extended follow-up. Neuroendocrinology. 2018;107:114–126.CrossRef
8.
go back to reference Briani C, Dalla Torre C, Citton V, et al. Cobalamin deficiency: clinical picture and radiological findings. Nutrients. 2013;5:4521–4539.CrossRef Briani C, Dalla Torre C, Citton V, et al. Cobalamin deficiency: clinical picture and radiological findings. Nutrients. 2013;5:4521–4539.CrossRef
9.
go back to reference Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2010;28:107–170.CrossRef Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2010;28:107–170.CrossRef
10.
go back to reference Morita S, Miwa H, Kihira T, Kondo T. Cerebellar ataxia and leukoencephalopathy associated with cobalamin deficiency. J Neurol Sci. 2003;216:183–184.CrossRef Morita S, Miwa H, Kihira T, Kondo T. Cerebellar ataxia and leukoencephalopathy associated with cobalamin deficiency. J Neurol Sci. 2003;216:183–184.CrossRef
11.
go back to reference Puri V, Chaudhry N, Gulati P. Syringomyelia-like manifestation of subacute combined degeneration. J Clin Neurosci. 2004;11:672–675.CrossRef Puri V, Chaudhry N, Gulati P. Syringomyelia-like manifestation of subacute combined degeneration. J Clin Neurosci. 2004;11:672–675.CrossRef
12.
go back to reference Zhang N, Li RH, Ma L, et al. Subacute combined degeneration, pernicious anemia and gastric neuroendocrine tumor occured simultaneously caused by autoimmune gastritis. Front Neurosci. 2019;13:1.CrossRef Zhang N, Li RH, Ma L, et al. Subacute combined degeneration, pernicious anemia and gastric neuroendocrine tumor occured simultaneously caused by autoimmune gastritis. Front Neurosci. 2019;13:1.CrossRef
13.
go back to reference Berry N, Sagar R, Tripathi BM. Catatonia and other psychiatric symptoms with vitamin B12 deficiency. Acta Psychiatr Scand. 2003;108:156–159.CrossRef Berry N, Sagar R, Tripathi BM. Catatonia and other psychiatric symptoms with vitamin B12 deficiency. Acta Psychiatr Scand. 2003;108:156–159.CrossRef
14.
go back to reference Rannelli L, Watterson R, Pandya R, Leung AA. Vitamin B12 deficiency with combined hematological and neuropsychiatric derangements: a case report. J Med Case Rep. 2014;8:277.CrossRef Rannelli L, Watterson R, Pandya R, Leung AA. Vitamin B12 deficiency with combined hematological and neuropsychiatric derangements: a case report. J Med Case Rep. 2014;8:277.CrossRef
15.
go back to reference Kapoor A, Baig M, Tunio SA, Memon AS, Karmani H. Neuropsychiatric and neurological problems among Vitamin B12 deficient young vegetarians. Neurosciences (Riyadh). 2017;22:228–232.CrossRef Kapoor A, Baig M, Tunio SA, Memon AS, Karmani H. Neuropsychiatric and neurological problems among Vitamin B12 deficient young vegetarians. Neurosciences (Riyadh). 2017;22:228–232.CrossRef
16.
go back to reference Stapersma L, van den Brink G, van der Ende J, et al. Illness perceptions and depression are associated with health-related quality of life in youth with inflammatory bowel disease. Int J Behav Med. 2019;26:415–426.CrossRef Stapersma L, van den Brink G, van der Ende J, et al. Illness perceptions and depression are associated with health-related quality of life in youth with inflammatory bowel disease. Int J Behav Med. 2019;26:415–426.CrossRef
17.
go back to reference Violato M, Gray A. The impact of diagnosis on health-related quality of life in people with coeliac disease: a UK population-based longitudinal perspective. BMC Gastroenterol. 2019;19:68.CrossRef Violato M, Gray A. The impact of diagnosis on health-related quality of life in people with coeliac disease: a UK population-based longitudinal perspective. BMC Gastroenterol. 2019;19:68.CrossRef
18.
go back to reference Tenca A, Massironi S, Pugliese D, et al. Gastro-esophageal reflux and antisecretory drugs use among patients with chronic autoimmune atrophic gastritis: a study with pH-impedance monitoring. Neurogastroenterol Motil. 2016;28:274–280.CrossRef Tenca A, Massironi S, Pugliese D, et al. Gastro-esophageal reflux and antisecretory drugs use among patients with chronic autoimmune atrophic gastritis: a study with pH-impedance monitoring. Neurogastroenterol Motil. 2016;28:274–280.CrossRef
19.
go back to reference Miceli E, Padula D, Lenti MV, et al. A laboratory score in the diagnosis of autoimmune atrophic gastritis: a prospective study. J Clin Gastroenterol. 2015;49:e1–e5.CrossRef Miceli E, Padula D, Lenti MV, et al. A laboratory score in the diagnosis of autoimmune atrophic gastritis: a prospective study. J Clin Gastroenterol. 2015;49:e1–e5.CrossRef
20.
go back to reference Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993;306:1440–1444.CrossRef Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993;306:1440–1444.CrossRef
21.
go back to reference Laas E, Zacharopoulou C, Montanari G, et al. External validation of the SF-36 quality-of-life questionnaire in Italian and Brazilian populations to select patients with colorectal endometriosis for surgery. J Minim Invasive Gynecol. 2015;22:378–383.CrossRef Laas E, Zacharopoulou C, Montanari G, et al. External validation of the SF-36 quality-of-life questionnaire in Italian and Brazilian populations to select patients with colorectal endometriosis for surgery. J Minim Invasive Gynecol. 2015;22:378–383.CrossRef
22.
go back to reference Yarlas A, Bayliss M, Cappelleri JC, et al. Psychometric validation of the SF-36((R)) Health Survey in ulcerative colitis: results from a systematic literature review. Qual Life Res. 2018;27:273–290.CrossRef Yarlas A, Bayliss M, Cappelleri JC, et al. Psychometric validation of the SF-36((R)) Health Survey in ulcerative colitis: results from a systematic literature review. Qual Life Res. 2018;27:273–290.CrossRef
23.
go back to reference Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M. PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine (Phila Pa 1976). 2017;42:921–929.CrossRef Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M. PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine (Phila Pa 1976). 2017;42:921–929.CrossRef
24.
go back to reference Apolone G, Mosconi P. The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–1036.CrossRef Apolone G, Mosconi P. The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–1036.CrossRef
25.
go back to reference Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191–197.CrossRef Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191–197.CrossRef
26.
go back to reference Piccinelli M, Bisoffi G, Bon MG, Cunico L, Tansella M. Validity and test-retest reliability of the Italian version of the 12-item General Health Questionnaire in general practice: a comparison between three scoring methods. Compr Psychiatry. 1993;34:198–205.CrossRef Piccinelli M, Bisoffi G, Bon MG, Cunico L, Tansella M. Validity and test-retest reliability of the Italian version of the 12-item General Health Questionnaire in general practice: a comparison between three scoring methods. Compr Psychiatry. 1993;34:198–205.CrossRef
27.
go back to reference Lundin A, Hallgren M, Theobald H, Hellgren C, Torgen M. Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population. Public Health. 2016;136:66–74.CrossRef Lundin A, Hallgren M, Theobald H, Hellgren C, Torgen M. Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population. Public Health. 2016;136:66–74.CrossRef
28.
go back to reference Petkovska MS, Bojadziev MI, Stefanovska VV. Reliability, validity and factor structure of the 12-item General Health questionnaire among general population. Open Access Maced J Med Sci. 2015;3:478–483.CrossRef Petkovska MS, Bojadziev MI, Stefanovska VV. Reliability, validity and factor structure of the 12-item General Health questionnaire among general population. Open Access Maced J Med Sci. 2015;3:478–483.CrossRef
29.
go back to reference Aguado J, Campbell A, Ascaso C, Navarro P, Garcia-Esteve L, Luciano JV. Examining the factor structure and discriminant validity of the 12-item General Health Questionnaire (GHQ-12) among Spanish postpartum women. Assessment. 2012;19:517–525.CrossRef Aguado J, Campbell A, Ascaso C, Navarro P, Garcia-Esteve L, Luciano JV. Examining the factor structure and discriminant validity of the 12-item General Health Questionnaire (GHQ-12) among Spanish postpartum women. Assessment. 2012;19:517–525.CrossRef
30.
go back to reference Baksheev GN, Robinson J, Cosgrave EM, Baker K, Yung AR. Validity of the 12-item General Health Questionnaire (GHQ-12) in detecting depressive and anxiety disorders among high school students. Psychiatry Res. 2011;187:291–296.CrossRef Baksheev GN, Robinson J, Cosgrave EM, Baker K, Yung AR. Validity of the 12-item General Health Questionnaire (GHQ-12) in detecting depressive and anxiety disorders among high school students. Psychiatry Res. 2011;187:291–296.CrossRef
31.
go back to reference Sanchez-Lopez Mdel P, Dresch V. The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema. 2008;20:839–843.PubMed Sanchez-Lopez Mdel P, Dresch V. The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema. 2008;20:839–843.PubMed
32.
go back to reference Panes J, Vermeire S, Lindsay JO, et al. Tofacitinib in patients with ulcerative colitis: health-related quality of life in phase 3 randomised controlled induction and maintenance studies. J Crohns Colitis. 2019;13:139–140.CrossRef Panes J, Vermeire S, Lindsay JO, et al. Tofacitinib in patients with ulcerative colitis: health-related quality of life in phase 3 randomised controlled induction and maintenance studies. J Crohns Colitis. 2019;13:139–140.CrossRef
33.
go back to reference Yarlas A, D’Haens G, Willian MK, Teynor M. Health-related quality of life and work-related outcomes for patients with mild-to-moderate ulcerative colitis and remission status following short-term and long-term treatment with multimatrix mesalamine: a prospective, open-label study. Inflamm Bowel Dis. 2018;24:450–463.CrossRef Yarlas A, D’Haens G, Willian MK, Teynor M. Health-related quality of life and work-related outcomes for patients with mild-to-moderate ulcerative colitis and remission status following short-term and long-term treatment with multimatrix mesalamine: a prospective, open-label study. Inflamm Bowel Dis. 2018;24:450–463.CrossRef
34.
go back to reference Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol. 2009;15:5121–5128.CrossRef Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol. 2009;15:5121–5128.CrossRef
35.
go back to reference Mykletun A, Jacka F, Williams L, et al. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC Gastroenterol. 2010;10:88.CrossRef Mykletun A, Jacka F, Williams L, et al. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC Gastroenterol. 2010;10:88.CrossRef
36.
go back to reference Toh BH. Pathophysiology and laboratory diagnosis of pernicious anemia. Immunol Res. 2017;65:326–330.CrossRef Toh BH. Pathophysiology and laboratory diagnosis of pernicious anemia. Immunol Res. 2017;65:326–330.CrossRef
Metadata
Title
Impaired Quality of Life in Patients with Autoimmune Atrophic Gastritis
Authors
Emanuela Miceli
Natascia Brondino
Marco Vincenzo Lenti
Michele Di Stefano
Martina Staiani
Francesca Zugnoni
Martina Pisati
Costanza Caccia Dominioni
Gino Roberto Corazza
Pierluigi Politi
Antonio Di Sabatino
Publication date
01-10-2021
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 10/2021
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-020-06656-x

Other articles of this Issue 10/2021

Digestive Diseases and Sciences 10/2021 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.