Plasma Alkylresorcinols Reflect Gluten Intake and Distinguish between Gluten-Rich and Gluten-Poor Diets in a Population at Risk of Metabolic Syndrome

• Published in: The Journal of nutrition Vol. 146; no. 10; pp. 1991 - 1998
• Main Authors: Lind, Mads V, Madsen, Mia L, Rumessen, Jüri J, Vestergaard, Henrik, Gøbel, Rikke J, Hansen, Torben, Lauritzen, Lotte, Pedersen, Oluf B, Kristensen, Mette, Ross, Alastair B
• Format: Journal Article
• Language: English
• Published: United States American Institute of Nutrition 01.10.2016
• Subjects: adolescents; Adult; adults; Aged; at-risk; biomarkers; Biomarkers - blood; Blood Glucose - metabolism; Blood Pressure; Body Mass Index; celiac disease; Celiac Disease - blood; Celiac Disease - diet therapy; cereal-grains; Cholesterol, HDL - blood; Cholesterol, LDL - blood; coeliac disease; Cross-Over Studies; Cross-Sectional Studies; Denmark; detection; Diet; Diet, Gluten-Free; electrochemical; Energy Intake; Female; Gluten; gluten sensitivity; gluten-related disorders; Glutens - administration & dosage; Glutens - blood; Humans; Linear Models; Lipids; liquid-chromatography; Male; Metabolic disorders; Metabolic Syndrome - blood; Middle Aged; Patient Compliance; Plasma; prevalence; Resorcinols - blood; Risk Factors; rye intake; Self Report; Triglycerides - blood; Waist Circumference; whole-grain wheat; Young Adult; coeliac disease; gluten sensitivity; gluten-free diet; biomarkers; gluten intolerance; celiac disease; gluten-related disorders
• ISSN: 0022-3166; 1541-6100; 1541-6100
• DOI: 10.3945/jn.116.236398

Many patients with celiac disease experience difficulties in adherence to a gluten-free diet. Methods for testing compliance to a gluten-free diet are costly and cumbersome. Thus, a simple biomarker of gluten intake is needed in a clinical setting and will be useful for epidemiologic studies investigating wider effects of gluten intake. The aim was to evaluate plasma total alkylresorcinol concentrations as a measure of gluten intake. In this randomized, controlled, crossover intervention study in 52 Danish adults with features of the metabolic syndrome, we compared 8 wk of a gluten-rich and gluten-poor diet separated by a washout period of ≥6 wk. We measured fasting plasma concentrations of alkylresorcinols to determine if they reflected differences in gluten intake as a secondary outcome of the original study. In addition, we investigated in 118 Danish adults the cross-sectional association between self-reported gluten intake and plasma alkylresorcinols in the same and a similar study at baseline. We used mixed-model ANCOVA for examining treatment effects, a classification tree to determine compliance to the gluten-poor diet, and linear regression models for examining baseline correlation between plasma alkylresorcinol concentrations and gluten intake. Plasma total alkylresorcinols decreased more during the gluten-poor period (geometric mean: -124.8 nmol/L; 95% CI: -156.5, -93.0 nmol/L) than in the gluten-rich period (geometric mean: -31.8 nmol/L; 95% CI: -63.1, -0.4 nmol/L) (P < 0.001). On the basis of the plasma alkylresorcinol profile, we built a classification tree to objectively determine compliance and found an overall participant misclassification error of 3.9%. In the cross-sectional study we found a 5.6% (95% CI: 2.4%, 8.9%) increase in plasma total alkylresorcinols per 1-g increase in reported gluten intake (P < 0.001). We propose the use of plasma alkylresorcinols to monitor compliance to a gluten-free diet as well as to help investigations into the possible effects of gluten in the wider population. This trial was registered at www.clinicaltrials.gov as NCT017119913 and NCT01731366.