The effects of different alcoholic drinks on lipids, insulin and haemostatic and inflammatory markers in older men

Summary

Light to moderate drinking is associated with lower risk of coronary heart (CHD) than non-drinkers. We have examined the relationships between total alcohol intake and type of alcoholic beverage and several potential biological mechanisms.

We carried out the study in 3158 men aged 60-79 years drawn from general practices in 24 British towns with no history of myocardial infarction, stroke or diabetes and who were not on warfarin. Total alcohol consumption showed a significant positive dose-response relationship with high density lipoprotein cholesterol (HDL-C), coagulation factor IX, haematocrit, blood viscosity, and tissue plasminogen (t-PA) antigen, and an inverse dose-response relationship with insulin, fibrinogen, von Willebrand factor (vWF) and triglycerides after adjustment for possible confounders. Total alcohol consumption showed weak associations with plasma viscosity and fibrin D-dimer, and no association with factors VII, VIII, or C-reactive protein (CRP). Wine was specifically associated with lower CRP, plasma viscosity, factor VIII and triglycerides.

The findings are consistent with the suggestion that HDL-C in particular but also insulin and haemostatic factors may contribute to the beneficial effect of light to moderate drinking on risk of CHD.Wine has effects that may confer greater protection than other alcoholic beverages.

Keywords

Alcohol intake - haemostasis - insulin - lipids

• References

• 1 Di Castelnuovo A, Rotondo S, Iacoviello L. et al. Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation 2002; 105: 2836-44.
• 2 Rimm EB, Klatsky AL, Grobbee D. et al. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine or spirits?. BMJ 1996; 312: 731-5.
• 3 Rimm EB, Williams P, Fosher K. et al. A biologic basis for moderate alcohol consumption and lower coronary heart disease risk: a meta-analysis of effects on lipids and haemostatic factors. BMJ 1999; 319: 1523-28.
• 4 Gaziano JM, Buring JE, Breslow JL. et al. Moderate alcohol intake, increased levels of high density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993; 329: 1829-34.
• 5 Pyorala M, Mietennen H, Laakso M. et al. Hyperinsulinaemia predicts coronary heart disease risk in healthy middle-aged men: the 22 year follow-up results of the Helsinki Policemen Study. Circulation 1998; 98: 398-404.
• 6 Lowe GDO, Yarnell JWG, Sweetnam PM. et al. Fibrin D-dimer, tissue plasminogen activator, plasminogen activator inhibitor, and the risk of major ischaemic heart disease in the Caerphilly study. Thromb Haemost 1998; 79: 129-33.
• 7 Danesh J, Collins R, Appleby P. et al. Association of fibrinogen, C-reactive protein, albumin or leukocyte count with coronary heart disease. Meta-analyses of prospective studies. JAMA 1998; 279: 1477-82.
• 8 Danesh J, Collins R, Peto R. et al. Haematocrit, viscosity, erythrocyte sedimentation rate; meta-analysis of prospective studies of coronary heart disease. Eur Heart J 2000; 21: 512-20.
• 9 Rumley A, Lowe GDO, Sweetnam PM. et al. Factor VIII, von Willebrand factor and the risk of major ischaemic heart disease in the Caerphilly Study. Br J Haematol 1999; 105: 110-6.
• 10 Kiechl S, Willeit J, Poewe W. et al. Insulin sensitivity and regular alcohol consumption: large prospective, cross sectional population study (Bruneck Study). BMJ 1996; 313: 1040-4.
• 11 Lazarus R, Sparrow D, Weiss ST. Alcohol intake and insulin levels: The Normative Aging Study. Am J Epidemiol 1997; 145: 909-16.
• 12 Yarnell JWG, Sweetnam PM, Rumley A. et al. Lifestyle and hemostatic risk factors for ischaemic heart disease. Arterioscler Thromb Vasc Biol 2000; 20: 271-9.
• 13 Mukamal KJ, Jadhav PP, D’Agostino RB. et al. Alcohol consumption and hemostatic factors: analysis of the Framingham Offspring Cohort. Circulation 2001; 104: 1367-73.
• 14 Mennen I L, Balkau B, Vol S. et al. Fibrinogen: a possible link between alcohol consumption and cardiovascular disease?. Arterioscler Thromb Vasc Biol 1999; 19: 887-92.
• 15 Marques-Vidal P, Montaye M, Haas B. et al. Relationships between alcoholic beverages and cardiovascular risk factor levels in middle-aged men, the Prime Study. Atherosclerosis 2001; 157: 431-40.
• 16 Renaud S, De Lorgerill M. Wine, alcohol and the French paradox for coronary heart disease. Lancet 1992; 339: 1523-5.
• 17 Shaper AG, Pocock SJ, Walker M. et al. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. BMJ 1981; 283: 179-86.
• 18 Lowe GDO, Rumley A, Norrie J. et al. Blood rheology, cardiovascular risk factors, and cardiovascular disease: the West of Scotland Coronary Prevention Study. Thromb Haemost 2000; 84: 553-8.
• 19 Siedel J, Hagele EO, Ziegenhorn J. et al. Reagent for the enzymatic determination of serum total cholesterol with improved lipolytic efficiency. Clin Chem 1983; 29: 1075-80.
• 20 Sugishi H, Uji Y, Okabe H. et al. Direct measurement of high-density lipoprotein cholesterol in serum with polyethylene glycol modified enzymes and sulphated alpha cyclodextrin. Clin Chem 1995; 41: 717-23.
• 21 Andersen L, Dinesen B, Jorgensen PN. et al. Enzyme immunoassay for intact human insulin in serum or plasma. Clin Chem 1993; 39: 578-82.
• 22 Emberson J, Whincup PH, Walker M. et al. Biochemical measures in a population based study: the effect of fasting duration and time of day. Ann Clin Biochem 2002; 39: 493-501.
• 23 Wannamethee SG, Lowe GDO, Whincup PH. et al. Physical activity and hemostatic and inflammatory variables in elderly men. Circulation 2002; 105: 1785-90.
• 24 Wannamethee SG, Shaper AG, Walker M. Alcohol and coronary heart disease: a perspective from the British Regional heart Study. Int J Epidemiol 1994; 23: 482-94.
• 25 Gaziano JM, Hennekens CH, Godfried I S. et al. Type of alcoholic beverage and risk of myocardial infarction. Am J Cardiol 1999; 83: 52-7.
• 26 Kao WHL, Puddey IB, Boland LL. et al. Alcohol consumption and the risk of type 2 diabetes: Atherosclerosis Risk in Communities Study. Am J Epidemiol 2001; 154: 748-57.
• 27 Imhof A, Froehlich M, Brenner H. et al. Effect of alcohol consumption on systemic markers of inflammation. Lancet 2001; 357: 763-7.
• 28 Mannucci PM. Von Willebrand Factor – a marker of endothelial damage?. Arterioscler Thromb Vasc Biol 1998; 18: 1359-62.
• 29 Lowe GDO. Factor IX and thrombosis. Br J Haematol 2001; 115: 507-13.
• 30 Ridker PM, Hennekens CH, Stampfer MJ. et al. Prospective study of endogenous tissue plasminogen activator and risk of stroke. Lancet 1994; 343: 940-3.
• 31 Johansson L, Jansson JH, Boman K. et al. t-PA-PAI-1 complex as a risk factor for the development of a first stroke. Stroke 2000; 31: 26-32.
• 32 Ridker PM, Vaughan DE, Stampfer MJ. et al. Association of moderate alcohol consumption and plasma concentration of endogenous tissue type plasminogen activator. JAMA 1994; 272: 929-33.
• 33 Goldberg IR, Mosca L, Piano MR. et al. AHA Science Advisory: Wine and your heart. Circulation 2001; 103: 472-5.
• 34 Tjonneland A, Gronbaek M, Stripp C. et al. Wine intake and diet in a random sample of 48763 Danish men and women. Am J Clin Nutr 1999; 69: 49-54.
• 35 Barefoot JC, Gronbaek M, Feaganes JR. et al. Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study. Am J Clin Nutr 2002; 76: 466-72.
• 36 Wannamethee SG, Shaper AG. Type of alcoholic drink and risk of major coronary heart disease events and all cause mortality. Am J Public Health 1999; 89: 685-90.