Abstract P354: Elevated Adiponectin And Tnf-alpha Levels Are Markers For Gluten And Lectin Sensitivity

Abstract

Adiponectin is a protein hormone secreted by adipose cells and is thought to be a precursor for the inflammatory cytokine TNF-alpha. Although low levels of Adiponectin are associated with visceral adiposity and high levels with weight loss, there is a strong association of elevated Adiponectin and TNF-alpha levels in thin women with dementia, osteopenia, and/or coronary artery disease. This paradox led us to consider that these biomarkers correlated to sensitivity to the plant defense proteins: gluten and other lectins. We studied serial Adiponectin and TNF-alpha levels every 3 months in 1,000 pts, M:F ratio 1:1 in response to a lectin and gluten elimination diet (The Matrix Diet). All samples were sent to a core lab (Singulex, Alameda, CA). The diet consisted of avoidance of grains, sprouted grains, pseudo-grains, beans and legumes, soy, peanuts, cashews, nightshades, melons and squashes, and non-Southern European cow milk products (Casein A1), and grain and/or bean fed animals. Eight hundred pts (80%) related some history of autoimmune disease (AID) personally or among family members, including Hashimotos thyroiditis, IBS, arthritis, RA, Lupus, Crohns, colitis, GERD, CAD, Type 1 DM. Adiponectin levels were elevated in all 800 pts with family hx or personal history of AID (16.6-83 ug/ml)(nl<16.5). TNF-alpha levels were elevated in 760/800pts with AID hx (95%) (>3.0 pg/mL). In contrast, Adiponectin was normal in 200 remaining pts without AID history (<16.5 ug/ml), while TNF-alpha was normal in 100/200 (50%) of pts without AID. When the lectin and gluten free diet was instituted, all TNF-alpha levels became normal in all 1,000 pts (<3.0 pg/mL), within 6 months and remained normal, if the diet was followed, for up to one year of study. However, despite normal TNF-alpha levels, Adiponectin levels remained elevated in 790/800 pts with AID hx. Late lack of adherence to the diet occurred in 56/1,000 pts (6%) (as determined by questionnaire) resulted in re-elevation of TNF-alpha in 56/56 pts (100%). We conclude that elevated Adiponectin is a marker for lectin and gluten sensitivity, while TNF-alpha can be used as a marker for gluten/lectin exposure in sensitive individuals. These findings probably explain the Adiponectin paradox. TNF-alpha levels appear to be useful as a marker of response to a lectin/gluten limited diet, and as a marker for degree of adherence to such a diet.