Do Lipids Contribute to the Lack of Cardio-Protective Effect of Binge Drinking: Alcohol Consumption and Lipids in Three Eastern European Countries

Peasey, Anne; Bobák, Martin; Malyutina, Sofia; Pająk, Andrzej; Kubínová, Růžena; Pikhart, Hynek; Kurilovitch, Svetlana; Marmot, Michael

doi:10.1093/alcalc/agh161

Cited by 14 publications

(13 citation statements)

References 29 publications

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“…We showed that a significant inverse association with OR between low HDL-cholesterol concentrations and alcohol consumption which could be supported by several studies that alcohol consumption could increase HDL-cholesterol level and frequent drinkers were associated with increased levels of HDL-cholesterol [ 35 – 37 ].…”

Section: Discussionsupporting

confidence: 71%

The High Prevalence of Low HDL-Cholesterol Levels and Dyslipidemia in Rural Populations in Northwestern China

Dong

Ren

et al. 2015

PLoS ONE

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BackgroundDyslipidemia is a major health problem in China and an important modifiable cardiovascular disease (CVD) risk factor. This study aimed to describe the prevalence of dyslipidemia and low high density lipoprotein cholesterol (HDL-cholesterol) and associated risk factors among adults in rural northwest China.MethodsIn a cross-sectional analyses involving 2,980 adults aged >18 years, information on the demographics, cigarette smoking, alcohol consumption, education, and medical history was collected via face-to-face interviews. Blood samples were collected to determine total cholesterol (TC), low-density lipoprotein cholesterol (LDL-cholesterol), and HDL-cholesterol, and triglycerides (TG) levels.ResultsThe prevalence of high TC, high LDL-cholesterol, low HDL-cholesterol, and high TG were 1.0%, 0.6%, 60.9%, and 13.7%, respectively. TC, LDL-cholesterol, and TG increased with age in females. Elevated TC was more common in females than in males. The prevalence of low HDL-cholesterol was 67.6% in males and 55.4% in females. Current smokers, those with less education, those who were overweight or obese, and those with large waist circumference were more likely to have low HDL-cholesterol (p<0.05). Multivariable regression showed that male gender showed an association with low HDL-cholesterol (OR 2.10, 95%CI 1.68–2.61), age ≥60 years (OR 0.80, 95% CI 0.64–0.99), BMI (BMI = 24–27.9, OR 1.27, 95%CI 1.04–1.54, p = 0.02 and BMI≥28, OR 1.56, 95%CI 1.10–2.20, p = 0.01) and enlarged waist circumference (OR 2.10, 95%CI 1.51–2.92). Non-alcohol drinker was associated with low HDL-cholesterol levels (OR 0.72, 95%CI 0.53–0.99, p = 0.04).ConclusionsThis study found that the prevalence of low HDL-cholesterol was 67.6% and 55.4% for males and females. Male gender, non-alcohol drinker, BMI and central obesity were important risk factors for low HDL-cholesterol in Chinese adults.

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Section: Discussionsupporting

confidence: 71%

The High Prevalence of Low HDL-Cholesterol Levels and Dyslipidemia in Rural Populations in Northwestern China

Dong

Ren

et al. 2015

PLoS ONE

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“… 47–52 In fact, the highest HDL levels are observed in people with AUD. 53 It seems that despite a beneficial effect on HDL cholesterol even in chronic heavy alcohol consumers, other effects of chronic heavy alcohol consumption on heart disease risk might negate those beneficial effects, 54 55 resulting in an overall neutral or detrimental association found in our analysis. Further work on distinct biochemical pathways and differentiation of heart disease outcomes should be a priority in alcohol-heart research.…”

Section: Discussionmentioning

confidence: 65%

Chronic heavy drinking and ischaemic heart disease: a systematic review and meta-analysis

Roerecke

Rehm

2014

Open Heart

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Previous meta-analyses have reported either a protective, neutral or detrimental association from chronic heavy drinking in relation to ischaemic heart disease (IHD). We investigated the potential for systematic error because of study design. Using MOOSE guidelines, studies were identified through MEDLINE, EMBASE and Web of Science up to end of March, 2014. Epidemiological studies reporting on chronic heavy drinking and IHD risk in population studies and samples of people with alcohol use disorder (AUD) were included. Random-effects meta-analysis was used to pool eligible studies. The I2 statistic was used to assess heterogeneity across studies. In total, 34 observational studies with 110 570 chronic heavy drinkers and 3086 IHD events were identified. In population studies among men, the pooled risk for IHD incidence (fatal+non-fatal events) among chronic heavy drinkers (on average ≥60 g pure alcohol/day) in comparison to lifetime abstainers (n=11 studies) was relative risk (RR)=1.04 (95% CI 0.83 to 1.31, I2=54%). Few studies were available for women. In patients with AUD, the risk of IHD mortality in comparison to the general population was elevated with a RR=1.62 (95% CI 1.34 to 1.95, I2=81%) in men and RR=2.09 (95% CI 1.28 to 3.41, I2=67%) in women. There was a general lack of adjustment other than sex and age in studies among patients with AUD. There is no systematic evidence for a protective association from any type of chronic heavy drinking on IHD risk. Patients with AUD were at higher risk for IHD mortality, but better quality evidence is needed with regard to potential confounding.

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“…The increase in HDL cholesterol was also evident in experimental studies with regular heavy drinking (≥60 g/day every day) [ 77 – 82 ], and the highest levels of HDL cholesterol are found in people with AUD [ 21 ]. Despite elevated levels of HDL cholesterol even in regular heavy alcohol consumers [ 83 ], an increase in low-density lipoprotein (LDL) and other detrimental effects of episodic and chronic heavy alcohol consumption on heart disease risk seem to negate those beneficial effects, resulting in an overall neutral or detrimental association. The detrimental effect on blood pressure and arrhythmias [ 44 , 84 – 90 ] and atrial fibrillation [ 44 , 89 , 91 – 93 ], in particular from episodic and chronic heavy drinking, might play a role here, in combination with anti-atherosclerotic and anti-thrombotic processes.…”

Section: Resultsmentioning

confidence: 99%

Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers

Roerecke

Rehm

2014

BMC Med

269

233

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BackgroundAlcohol consumption is a major global risk factor for mortality and morbidity. Much discussion has revolved around the diverse findings on the complex relationship between alcohol consumption and the leading cause of death and disability, ischemic heart disease (IHD).MethodsWe conducted a systematic search of the literature up to August 2014 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify meta-analyses and observational studies examining the relationship between alcohol drinking, drinking patterns, and IHD risk, in comparison to lifetime abstainers. In a narrative review we have summarized the many meta-analyses published in the last 10 years, discussing the role of confounding and experimental evidence. We also conducted meta-analyses examining episodic heavy drinking among on average moderate drinkers.ResultsThe narrative review showed that the use of current abstainers as the reference group leads to systematic bias. With regard to average alcohol consumption in relation to lifetime abstainers, the relationship is clearly J-shaped, supported by short-term experimental evidence and similar associations within strata of potential confounders, except among smokers. Women experience slightly stronger beneficial associations and also a quicker upturn to a detrimental effect at lower levels of average alcohol consumption compared to men. There was no evidence that chronic or episodic heavy drinking confers a beneficial effect on IHD risk. People with alcohol use disorder have an elevated risk of IHD (1.5- to 2-fold). Results from our quantitative meta-analysis showed that drinkers with average intake of <30 g/day and no episodic heavy drinking had the lowest IHD risk (relative risk = 0.64, 95% confidence interval 0.53 to 0.71). Drinkers with episodic heavy drinking occasions had a risk similar to lifetime abstainers (relative risk = 1.12, 95% confidence interval 0.91 to 1.37).ConclusionsEpidemiological evidence for a beneficial effect of low alcohol consumption without heavy drinking episodes is strong, corroborated by experimental evidence. However, episodic and chronic heavy drinking do not provide any beneficial effect on IHD. Thus, average alcohol consumption is not sufficient to describe the risk relation between alcohol consumption and IHD. Alcohol policy should try to reduce heavy drinking patterns.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-014-0182-6) contains supplementary material, which is available to authorized users.

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Do Lipids Contribute to the Lack of Cardio-Protective Effect of Binge Drinking: Alcohol Consumption and Lipids in Three Eastern European Countries

Abstract: Blood lipids do not seem to explain the apparent lack of the cardio-protective effect of binge drinking reported in epidemiological studies.

Cited by 14 publications

References 29 publications

The High Prevalence of Low HDL-Cholesterol Levels and Dyslipidemia in Rural Populations in Northwestern China

The High Prevalence of Low HDL-Cholesterol Levels and Dyslipidemia in Rural Populations in Northwestern China

Chronic heavy drinking and ischaemic heart disease: a systematic review and meta-analysis

Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers

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