Diabetes Metab J.  2019 Oct;43(5):615-626. 10.4093/dmj.2018.0128.

Association between Change in Alcohol Consumption and Metabolic Syndrome: Analysis from the Health Examinees Study

• Choi S
• Kim K
• Lee JK
• Choi JY
• Shin A
• Park SK
• Kang D
• Park SM

• KMID: 2460955
• DOI: http://doi.org/10.4093/dmj.2018.0128

Abstract

BACKGROUND
The association between change in alcohol intake and metabolic syndrome is unclear.
METHODS
This retrospective cohort consisted of 41,368 males and females from the Health Examinees-GEM study. Participants were divided into non-drinkers (0.0 g/day), light drinkers (male: 0.1 to 19.9 g/day; female: 0.1 to 9.9 g/day), moderate drinkers (male: 20.0 to 39.9 g/day; female: 10.0 to 19.9 g/day), and heavy drinkers (male: ≥40.0 g/day; female: ≥20.0 g/day) for each of the initial and follow-up health examinations. Logistic regression analysis was used to determine the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for developing metabolic syndrome according to the change in alcohol consumption between the initial and follow-up health examinations. Adjusted mean values for the change in waist circumference, fasting serum glucose (FSG), blood pressure, triglycerides, and high density lipoprotein cholesterol (HDL-C) levels were determined according to the change in alcohol consumption by linear regression analysis.
RESULTS
Compared to persistent light drinkers, those who increased alcohol intake to heavy levels had elevated risk of metabolic syndrome (aOR, 1.45; 95% CI, 1.09 to 1.92). In contrast, heavy drinkers who became light drinkers had reduced risk of metabolic syndrome (aOR, 0.61; 95% CI, 0.44 to 0.84) compared to persistent heavy drinkers. Increased alcohol consumption was associated with elevated adjusted mean values for waist circumference, FSG, blood pressure, triglycerides, and HDL-C levels (all P<0.05). Reduction in alcohol intake was associated with decreased waist circumference, FSG, blood pressure, triglycerides, and HDL-C levels among initial heavy drinkers (all P<0.05).
CONCLUSION
Heavy drinkers who reduce alcohol consumption could benefit from reduced risk of metabolic syndrome.

Keyword

Alcohol drinking; Dyslipidemias; Hypertension; Metabolic syndrome; Obesity

MeSH Terms

Alcohol Drinking*
Blood Glucose
Blood Pressure
Cholesterol, HDL
Cohort Studies
Dyslipidemias
Fasting
Female
Follow-Up Studies
Humans
Hypertension
Linear Models
Logistic Models
Male
Obesity
Odds Ratio
Retrospective Studies
Triglycerides
Waist Circumference
Cholesterol, HDL
Triglycerides

Figure

• 

  Fig. 1 Association between change in alcohol consumption and change in waist circumference or fasting serum glucose. Adjusted mean values of change in (A) waist circumference or (B) fasting serum glucose were calculated for initial non-drinkers, light drinkers, moderate drinkers, and heavy drinkers according to follow-up alcohol consumption: non-drinkers (0.0 g/day), light drinkers (0.1 to 19.9 g/day for males, 0.1 to 9.9 g/day for females), moderate drinkers (20.0 to 39.9 g/day for males, 10.0 to 19.9 g/day for females), heavy drinkers (≥40.0 g/day for males, ≥20.0 g/day for females). Adjusted mean values determined by linear regression analysis after adjustments for age, sex, household income, education level, physical activity, smoking, total energy intake, body mass index (excluded for analyses on change in waist circumference), past history of cardiovascular disease, family history of hypertension, diabetes, and dyslipidemia, and follow-up duration. Groups without change in alcohol consumption were considered reference groups (e.g., initial non-drinkers to follow-up non-drinkers). P values for statistical significance: aP<0.05, bP<0.01, cP<0.001.

• 

  Fig. 2 Association between change in alcohol consumption and change systolic or diastolic blood pressure. Adjusted mean values of change in (A) systolic or (B) diastolic blood pressure were calculated for initial non-drinkers, light drinkers, moderate drinkers, and heavy drinkers according to follow-up alcohol consumption: non-drinkers (0.0 g/day), light drinkers (0.1 to 19.9 g/day for males, 0.1 to 9.9 g/day for females), moderate drinkers (20.0 to 39.9 g/day for males, 10.0 to 19.9 g/day for females), heavy drinkers (≥40.0 g/day for males, ≥20.0 g/day for females). Adjusted mean values determined by linear regression analysis after adjustments for age, sex, household income, education level, physical activity, smoking, total energy intake, body mass index, past history of cardiovascular disease, family history of hypertension, diabetes, and dyslipidemia, and follow-up duration. Groups without change in alcohol consumption were considered reference groups (e.g., initial non-drinkers to follow-up non-drinkers). P values for statistical significance: aP<0.05, bP<0.01, cP<0.001.

• 

  Fig. 3 Association between change in alcohol consumption and change triglycerides or high density lipoprotein cholesterol (HDL-C). Adjusted mean values of change in (A) triglycerides or (B) HDL-C were calculated for initial non-drinkers, light drinkers, moderate drinkers, and heavy drinkers according to follow-up alcohol consumption: non-drinkers (0.0 g/day), light drinkers (0.1 to 19.9 g/day for males, 0.1 to 9.9 g/day for females), moderate drinkers (20.0 to 39.9 g/day for males, 10.0–19.9 g/day for females), heavy drinkers (≥40.0 g/day for males, ≥20.0 g/day for females). Adjusted mean values determined by linear regression analysis after adjustments for age, sex, household income, education level, physical activity, smoking, total energy intake, body mass index, past history of cardiovascular disease, family history of hypertension, diabetes, and dyslipidemia, and follow-up duration. Groups without change in alcohol consumption were considered reference groups (e.g., initial non-drinkers to follow-up non-drinkers). P values for statistical significance: aP<0.05, bP<0.01, cP<0.001.

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