A Prospective Population-Based Study of Alcohol Use and Non-Insulin-Dependent Diabetes Mellitus

Holbrook, Troy L.; Barrett‐Connor, Elizabeth; Wingard, Deborah L.

doi:10.1093/oxfordjournals.aje.a115733

Cited by 161 publications

(133 citation statements)

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“…Hu et al (2001) reported a large cohort study of 84,941 female nurses from 1980 to 1996, in which abstinence from alcohol use was associated with a significantly increased risk of diabetes. In contrast, other studies (Holbrook et al 1990) have shown an increased risk of diabetes among a proportion of subjects in the top alcohol consumption category. In Japanese men, Tsumura et al (1999) reported that heavy drinking is associated with an increased risk of type 2 diabetes, while moderate drinking is associated with a decreased risk of type 2 diabetes, showing a U-shaped relationship.…”

Section: Introductioncontrasting

confidence: 56%

Association of alcohol dehydrogenase 2*1 allele with liver damage and insulin concentration in the Japanese

Suzuki

Ando²,

Ohsawa

et al. 2005

J Hum Genet

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The Japanese have a polymorphism in the alcohol dehydrogenase 2 gene (ADH2). The alleles of ADH2 (ADH2*1 and ADH2*2) encode more active and less active forms for ethanol metabolism, respectively. We examined whether liver damage and the insulinglucose axis vary according to ADH2 genotype in the Japanese. The 2,232 subjects (1,126 men and 1,106 women) were recruited from a population-based prospective cohort study. Clinical evaluations including alcohol consumption, percentage of alcohol drinkers, plasma glucose, HbA1c, insulin, AST, ALT, c-GTP, and prevalence of diabetes were compared among the ADH2 genotypes. The percentage of drinkers, alcohol consumption, AST, ALT, and c-GTP were higher in group ADH2*1/1 than in group ADH2*1/2 or ADH2*2/2 (all P<0.05). Hence, ADH2*1/1 is associated with excess alcohol intake and liver disorders. However, the prevalence of diabetes did not differ among the three groups. For the glucose-insulin axis, we examined subjects who did not receive insulin therapy or oral anti-diabetes medication. While amounts of alcohol consumed and glucose levels were nearly the same between ADH*1/2 and ADH2*2/2, insulin concentrations were lower in ADH2*2/1 than in ADH2*2/2 (P<0.05 in men). This finding suggests that the ADH2*1 allele is associated with a lower insulin concentration when alcohol intake is light or moderate. It also suggests that the genetic effect of ADH2*1 plays an important role in alcohol drinking behavior and in the occurrence of liver injury, but the effect is so mild that it does not influence the glucose-insulin axis or prevalence of diabetes.

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Section: Introductioncontrasting

confidence: 56%

Association of alcohol dehydrogenase 2*1 allele with liver damage and insulin concentration in the Japanese

Suzuki

Ando²,

Ohsawa

et al. 2005

J Hum Genet

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“…Several possible pathogenic pathways may relate alcohol consumption to chronic kidney failure. Alcohol consumption may increase the risk of kidney failure by initiating and/or promoting atherogenic risk factors, such as high blood pressure (31,32), hyperuricemia (33), insulin resistance (34), and diabetes (35). The finding in our study that adjustment for hypertension and diabetes strengthened rather than weakened odds ratios for ESRD associated with alcohol consumption may reflect a secondary reduction of alcohol intake by many patients who have received a diagnosis of hypertension or diabetes.…”

Section: Alcohol Consumption As a Risk Factor For Esrdmentioning

confidence: 51%

Risk of End-stage Renal Disease Associated with Alcohol Consumption

Perneger

Whelton

Puddey

et al. 1999

American Journal of Epidemiology

113

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Alcohol consumption has been linked to kidney disorders in selected patient groups, but whether it contributes to the burden of end-stage renal disease (ESRD) in the general population is unknown. The authors conducted a population-based case-control study to assess the relation between alcohol consumption and risk of ESRD. The study took place in Maryland, Virginia, West Virginia, and Washington, DC, in 1991. Participants were 716 patients who had started treatment for ESRD and 361 control subjects of similar age (20-64 years) selected by random digit dialing. The main risk factor of interest was self-reported consumption of alcoholic beverages (frequency of drinking days and number of drinks consumed per drinking day). In univariate analysis, consumption of alcohol exhibited a J-shaped association with risk of ESRD. The J shape disappeared after exclusion of persons who had ever consumed home-distilled whiskey ("moonshine") and adjustment for age, race, sex, income, history of hypertension, history of diabetes mellitus, use of acetaminophen, use of opiates, and cigarette smoking; however, the odds ratio for ESRD remained significantly increased (odds ratio = 4.0; 95% confidence interval: 1.2, 13.0) among persons who consumed an average of >2 alcoholic drinks per day. The corresponding population attributable risk was 9 percent. Thus, consumption of more than two alcoholic drinks per day, on average, was associated with an increased risk of kidney failure in the general population. A lower intake of alcohol did not appear to be harmful. Because these results are based on self-reports in a case-control study, they should be seen as preliminary. Am J Epidemiol 1999;150:1275-81. alcohol drinking; ethanol; kidney failure, chronic Prevention of end-stage renal disease (ESRD) requires knowledge of modifiable risk factors responsible for initiation and promotion of renal insufficiency (1). Modifiable risk factors for kidney failure that have been identified in population-based studies include high blood pressure (2), diabetes mellitus (3), exposure to occupational nephrotoxins (4), and chronic use of analgesics (5). However, known risk factors explain only a limited part of the overall incidence of ESRD.Alcohol consumption is a plausible risk factor for ESRD. Historically, alcoholism or intemperance was suspected of causing kidney failure by Richard Bright

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“…In contrast, for the women in the Rancho Bernardo study there was no evidence that alcohol use increased the risk of type 2 diabetes (17). In both the Nurses Health study (11) and the ARIC study (18), the association between alcohol consumption and diabetes risk appeared inverse for women (18).…”

mentioning

confidence: 86%

“…In the prospective Rancho Bernardo Study involving 220 men, those in the highest tertile of drinking (i.e., Ͼ25 g alcohol/day) had a significantly higher risk of developing type 2 diabetes compared with the lighter drinkers (17). Even after adjustment for age, BMI, and smoking, alcohol intake was significantly higher in the men who went on to develop type 2 diabetes.…”

Section: Statisticsmentioning

confidence: 98%

“…Two of these studies (11,13) were hampered due to the very limited number of subjects with moderate to heavy intake (i.e., Ͼ20 g/day, equivalent to more than two standard drinks per day). In the prospective Rancho Bernardo Study (17), the upper tertile of drinkers consumed Ͼ25 g alcohol/day, whereas in the Atherosclerosis Risk in Communities (ARIC) Study (18), Ͼ8% of the male population consumed Ͼ36 g alcohol/day. Data from both these studies suggest that levels of alcohol consumption in these men were associated with an increased risk for the development of type 2 diabetes.…”

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confidence: 99%

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The Effect of Alcohol Intake on Insulin Sensitivity in Men

et al. 2003

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OBJECTIVE -Population data suggest that alcohol consumption may influence the risk of diabetes in a biphasic manner, but this has not been tested by any controlled interventions. The object of this study was to determine whether reducing alcohol intake in moderate-to-heavy drinkers (40 -110 g/day) results in improvement in insulin sensitivity. RESEARCH DESIGN AND METHODS-A 4-week run-in period where subjects maintained their usual drinking pattern was followed by randomization to a two-way cross-over intervention study. In each of two 4-week treatment interventions, subjects either substituted their usual alcohol intake with a 0.9% alcohol beer or maintained their usual alcohol intake. At the end of each 4-week period, insulin sensitivity as determined by the low-dose insulin glucose infusion test and the homeostasis model assessment (HOMA) score, and biomarkers of alcohol consumption (␥-glutamyl transpeptidase [␥-GT] and HDL cholesterol) were measured.RESULTS -A total of 16 healthy men aged 51.0 Ϯ 2.7 (mean Ϯ SEM) years with a BMI of 26.4 Ϯ 0.61 kg/m 2 completed the study. There was a large reduction in alcohol intake (72.4 Ϯ 5.0 vs. 7.9 Ϯ 1.6 g/day, P Ͻ 0.001) and significant reductions in ␥-GT (geometric mean .2], P Ͻ 0.01) and HDL cholesterol (1.36 Ϯ 0.07 vs. 1.13 Ϯ 0.07 mmol/l, P Ͻ 0.001). There was no effect of alcohol on insulin sensitivity index (ISI), fasting insulin, glucose, or HOMA score.CONCLUSIONS -A substantial reduction in alcohol intake from 7.2 to 0.8 standard drinks per day in healthy men did not change insulin sensitivity as measured by ISI or HOMA score. Diabetes Care 26:608 -612, 2003P resently, it is difficult to simply define overall effects of alcohol on the insulin-glucose axis. Acutely, alcohol impairs insulin sensitivity in shortterm experiments using insulin-glucose clamp techniques (1-5). In contrast, evidence from cross-sectional populationbased studies suggests an association between chronic alcohol exposure and improvement in insulin sensitivity (6), but such studies are rendered inherently weak by the potential for confounding by other variables affecting insulin sensitivity, especially adiposity (7-10). Although there have been no prospective studies evaluating the effect of long-term alcohol use on insulin sensitivity, per se, there have been a number of studies investigating whether there is any association between alcohol use at baseline and subsequent incidence of type 2 diabetes. Many of these studies found that light (ϳ3-18 g/day) (11-13) to moderate (18 -49 g/day) (14 -16) alcohol use was associated with a reduced risk for the development of diabetes. Two of these studies (11,13) were hampered due to the very limited number of subjects with moderate to heavy intake (i.e., Ͼ20 g/day, equivalent to more than two standard drinks per day). In the prospective Rancho Bernardo Study (17), the upper tertile of drinkers consumed Ͼ25 g alcohol/day, whereas in the Atherosclerosis Risk in Communities (ARIC) Study (18), Ͼ8% of the male population consumed Ͼ36 g alcohol/day. Data from...

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A Prospective Population-Based Study of Alcohol Use and Non-Insulin-Dependent Diabetes Mellitus

Cited by 161 publications

References 0 publications

Association of alcohol dehydrogenase 2*1 allele with liver damage and insulin concentration in the Japanese

Association of alcohol dehydrogenase 2*1 allele with liver damage and insulin concentration in the Japanese

Risk of End-stage Renal Disease Associated with Alcohol Consumption

The Effect of Alcohol Intake on Insulin Sensitivity in Men

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