Influence of Facial Flushing on Pre- or Type 2 Diabetes Risk according to Alcohol Consumption in Korean Male

Abstract

Background: This study aims to examine the association between alcohol consumption and the risk of pre-or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI). Methods: This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre-or T2DM. Results: In both the normal-weight group (BMI <23 kg/m 2 ) and the overweight group (BMI ≥23 kg/m 2 and <25 kg/ m 2 ), the flushers had a higher risk of pre-or T2DM (odds ratio, 95% confidence interval) when consuming more than 8 drinks of alcohol per week than the non-drinkers (normal-weight group: 3.43, 1.06-11.07; overweight group: 4.94, 1.56-15.67). But in the non-flushers among the normal-weight group and the overweight group, there was no significant difference compared to non-drinkers regarding the risk of pre-or T2DM. Obese flushers had a significantly higher risk of pre-or T2DM when consuming more than 4 drinks of alcohol per week than the non-drinkers (>4 and ≤8 drinks: 2.64, 1.10-6.36; >8 drinks: 2.42, 1.11-5.27). However, obese non-flushers had only a significant higher risk of pre-or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39-5.30) Conclusion: These results suggest that obese flushers have an increased risk of developing pre-or T2DM even with less alcohol consumption.

Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing

“…According to research by Kim et al [23], the risk of prediabetes or T2DM was significantly increased among non-flushers if they consumed >8 drinks/wk (OR, 2.08; 95% CI, 1.32 to 3.26) after adjusting for age, BMI, total cholesterol levels, smoking, exercise, and dietary habits in 1,030 Korean men (158 non-drinkers, 364 flushers, and 508 non-flushers). A stratified analysis based on BMI demonstrated that only the obese group (BMI ≥25 kg/m 2 ) of non-flushers exhibited a significantly higher risk of prediabetes or T2DM when their average weekly alcohol consumption was >4 drinks (4–8 drinks: OR, 2.72; 95% CI, 1.39 to 5.30; >8 drinks: OR, 2.42; 95% CI, 1.11 to 5.27).…”

“…In a study by Kim et al [23], flushers with a weekly alcohol consumption of >4 drinks showed an increased risk of prediabetes or T2DM (4–8 drinks: OR, 1.93; 95% CI, 1.06 to 3.53; >8 drinks: OR, 2.73; 95% CI, 1.58 to 4.69). Furthermore, when stratified by BMI, normal weight (BMI <23 kg/m 2 ) and overweight (BMI ≥23 kg/m 2 , <25 kg/m 2 ) groups showed an increased risk of prediabetes or T2DM if they consumed >8 drinks/wk (normal weight flushers: OR, 3.43; 95% CI, 1.06 to 11.07; overweight flushers: OR, 4.94; 95% CI, 1.56 to 15.67).…”

Relationship between Alcohol Consumption and Testosterone Deficiency according to Facial Flushes among Middle-Aged and Older Korean Men

“…14) Inactive ALDH2 induces the accumulation of acetaldehyde in the body, which expands facial blood vessels and causes facial flushing. This inability to metabolize alcohol increases the risk of hypertension, 15) metabolic syndrome, 16,17) and diabetes mellitus 18,19) in Koreans.…”

Alcohol and Testosterone Deficiency in People Who Experience Facial Flushes

“…For this reason, it is possible that the average level of testosterone was low, and the risk of testosterone deficiency increased only in the group that experienced flushing at a relatively low eight standard drinks per week in this study, compared to other studies [ 8 ]. Some studies have reported that Koreans who develop a drinking flush have higher risks of hypertension [ 9 ], metabolic syndrome [ 10 , 11 ], diabetes mellitus [ 12 , 13 ], and have high rheumatoid factors [ 14 ] and intraocular pressure [ 15 ] even if they do not drink excessively. The authors recommended that the drinkers who experienced flushing should limit their alcohol intake to eight or less standard drinks per week [ 8 ].…”