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

Abstract

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.

Serum alkylresorcinols as biomarkers of dietary gluten exposure in coeliac disease

“…A number of studies have demonstrated the strong association between plasma alkylresorcinols and alkylresorcinol intake in a variety of populations, and the overwhelmingly main source of alkylresorcinols in the diet is from the gluten‐containing cereals wheat and rye, with minor contributions from barley and quinoa . We have also found that plasma alkylresorcinols are moderately correlated with self‐reported gluten intake in an intervention setting . Thus, although there was no measurement of gluten intake in the study population, the alkylresorcinol measurements serve as a good proxy for intake of gluten‐containing cereals.…”

“…34 We have also found that plasma alkylresorcinols are moderately correlated with self-reported gluten intake in an intervention setting. 46 Thus, although there was no measurement of gluten intake in the study population, the alkylresorcinol measurements serve as a good proxy for intake of gluten-containing cereals. In the case of healthy controls measured in this study (Figure 1), very low concentrations are just as possible as for people following a gluten-free diet, reflecting that their recent diet has not contained either wheat or rye.…”

“…In this study, one treated CD patient had a high alkylresorcinol concentration and was found to have high amounts of the even‐numbered alkyl‐chain homologues, likely reflecting quinoa intake. In an intervention study, we have established decision‐tree methodology that allowed the determination of compliance to a gluten‐free diet including quinoa, based on both total plasma alkylresorcinols and one of the unique quinoa alkylresorcinol homologues . With further analysis of serum alkylresorcinols in patients with CD and control subjects with well characterised dietary data, it will be possible to implement such decision‐tree methodology to aid in the rapid determination of likely variations from a GFD.…”

Percepción de estar haciendo bien la dieta sin gluten y adherencia al tratamiento en pacientes pediátricos con enfermedad celíaca

“…Sin duda, es necesario mejorar las capacidades de medir la ingesta de gluten del paciente celíaco a largo plazo. Las mediciones de gluten en heces y/u orina parecen una opción interesante en este aspecto, pero los resultados actualmente disponibles están lejos aún de permitir plantearlas formalmente como una opción de seguimiento en la EC (31)(32)(33)(34)(35) . En este punto es relevante considerar que si hay dudas de si un paciente tiene anticuerpos elevados por que no adhiere a la DLG o porque no responde al tratamiento, una nueva biopsia duodenal sería de utilidad, lo mismo que un estudio genético que muestre ausencia de los haplotipos de riesgo.…”

IgA and IgG Antitransglutaminase 2 Antibodies in the Diagnosis of Celiac Disease

“…Surveillance of this diet during follow up is difficult because there is no objective way to measure actual gluten ingestion; this is especially so during the transition period of adolescence [4]. None of the existing techniques are completely reliable, including measurements of blood autoantibodies, interviews, questionnaires or the more recently described measurement of 33-mer peptide in feces/urine [5,6] or alkylresorcinols in urine [7], which await validation. At present and both for diagnosis and gluten-free diet control during follow up, measuring blood autoantibodies mainly against transglutaminase 2 (TTG) is the most recommended test worldwide.…”