Korean J Health Promot.  2021 Dec;21(4):167-174. 10.15384/kjhp.2021.21.4.167.

The Mediating Role of Smoking and Body Mass Index on the Relationship between Alcohol Consumption and Blood Triglyceride Levels among Korean Adults: The 7th Korean National Health and Nutrition Examination Survey

Affiliations
  • 1Department of Family Medicine, Daegu Veterans Hospital, Daegu, Korea

Abstract

Background
Although there are many studies of association between alcohol consumption and hypertriglyceridemia with categorized variables, it is insufficient to study association between quantity of alcohol consumption and triglyceride levels as continuous variables. Therefore, this study investigates direct effect of alcohol consumption on triglyceride levels. Additionally, this study examines indirect effects through smoking and body mass index (BMI).
Methods
This study uses data from the 7th Korean National Health and Nutrition Examination Survey. Among the participants, 5,867 adults ≥20 years of age are enrolled. To test the association between quantity of alcohol consumption and triglyceride levels and indirect effects through smoking and BMI, this study conducts multi-regression analysis by SPSS PROCESS macro.
Results
The results are as follows. First, alcohol consumption has positive(+) effects on smoking, BMI, and triglyceride levels significantly. Second, smoking and BMI have a positive(+) effect on triglyceride levels significantly. Third, alcohol consumption has positive(+) effects on triglyceride levels through smoking and BMI indirectly.
Conclusions
Alcohol consumption has a direct effect on triglyceride levels, also has indirect effects through smoking and BMI positively.

Keyword

Alcohol consumption; Triglyceride; Smoking; Body mass index

Reference

1. Studer M, Briel M, Leimenstoll B, Glass TR, Bucher HC. Effect of different antilipidemic agents and diets on mortality: a systematic review. Arch Intern Med. 2005; 165(7):725–30.
Article
2. Jun M, Foote C, Lv J, Neal B, Patel A, Nicholls SJ, et al. Effects of fibrates on cardiovascular outcomes: a systematic review and meta-analysis. Lancet. 2010; 375(9729):1875–84.
Article
3. Alan J, Nazir S, Roger SB, Seth SM. Hypertriglyceridemia management according to the 2018 AHA/ACC Guideline. J Am Coll Cardiol. 2019; Jan. 11. [Epub].
4. Wan J, He W, Zhu Y, Zhu Y, Zeng H, Liu P, et al. Stratified analysis and clinical significance of elevated serum triglyceride levels in early acute pancreatitis: a retrospective study. Lipids Health Dis. 2017; 16(1):124.
Article
5. Nawaz H, Koutroumpakis E, Easler J, Slivka A, Whitcomb DC, Singh VP, et al. Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis. Am J Gastroenterol. 2015; 110(10):1497–503.
Article
6. Yuan G, Al-Shali KZ, Hegele RA. Hypertriglyceridemia: its etiology, effects and treatment. CMAJ. 2007; 176(8):1113–20.
Article
7. Kabagambe EK, Ordovas JM, Tsai MY, Borecki IB, Hopkins PN, Glasser SP, et al. Smoking, inflammatory patterns and postprandial hypertriglyceridemia. Atherosclerosis. 2009; 203(2):633–9.
Article
8. Friedman GD, Tekawa I, Klatsky AL, Sidney S, Armstrong MA. Alcohol drinking and cigarette smoking: an exploration of the association in middle-aged men and women. Drug Alcohol Depend. 1991; 27(3):283–90.
Article
9. Suter PM, Häsler E, Vetter W. Effects of alcohol on energy metabolism and body weight regulation: is alcohol a risk factor for obesity? Nutr Rev. 1997; 55(5):157–71.
Article
10. Kim KJ, Jung H, Park KT, Kim MT, Oh TG, Lee SH, et al. Relation between healthy drinking habits and metabolic syndrome. Korean J Fam Pract. 2015; 5(3):361–7.
11. Jung CH, Park JS, Lee WY, Kim SW. Effects of smoking, alcohol, exercise, level of education, and family history on the metabolic syndrome in Korean adults. Korean J Med. 2002; 63(6):649–59.
12. Cohen J. The cost of dichotomization. Appl Psychol Meas. 1983; 7(3):249–53.
Article
13. MacCallum RC, Zhang S, Preacher KJ, Rucker DD. On the practice of dichotomization of quantitative variables. Psychol Methods. 2002; 7(1):19–40.
Article
14. Lee HK. Misunderstanding and truth of moderation, moderated mediation and mediated moderation. KASTM. 2016; 31(3):213–48.
15. Maxwell SE, Delaney HD. Bivariate median splits and spurious statistical significance. Psychological Bulletin. 1993; 113(1):181–90.
Article
16. Bissonnette V, Ickes W, Bernstein I, Knowles E. Personality moderating variables: a warning about statistical artifact and a comparison of analytic techniques. J Pers. 1990; 58(3):567–87.
Article
17. Irwin JR, McClelland GH. Misleading heuristics and moderated multiple regression models. J Mark Res. 2001; 38(1):100–9.
Article
18. Siler SQ, Neese RA, Hellerstein MK. De novo lipogenesis, lipid kinetics, and whole-body lipid balances in humans after acute alcohol consumption. Am J Clin Nutr. 1999; 70(5):928–36.
Article
19. Steiner JL, Lang CH. Alcohol, adipose tissue and lipid dysregulation. Biomolecules. 2017; 7(1):16.
Article
20. You M, Arteel GE. Effect of ethanol on lipid metabolism. J Hepatol. 2019; 70(2):237–48.
Article
21. Nguyen KH, Lee JH, Nyomba BL. Ethanol causes endoplasmic reticulum stress and impairment of insulin secretion in pancreatic β-cells. Alcohol. 2012; 46(1):89–99.
Article
22. Suter PM, Maire R, Vetter W. Alcohol consumption: a risk factor for abdominal fat accumulation in men. Addict Biol. 1997; 2(1):101–3.
Article
23. Shiffman S, Balabanis M. Do drinking and smoking go together? Alcohol Health Res World. 1996; 20(2):107–10.
24. Epstein AM, Sher TG, Young MA, King AC. Tobacco chippers show robust increases in smoking urge after alcohol consumption. Psychopharmacology (Berl). 2007; 190(3):321–9.
Article
25. Funk D, Marinelli PW, Lê AD. Biological processes underlying co-use of alcohol and nicotine: neuronal mechanisms, cross-tolerance, and genetic factors. Alcohol Res Health. 2006; 29(3):186–92.
26. Cryer PE, Haymond MW, Santiago JV, Shah SD. Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events. N Engl J Med. 1976; 295(11):573–7.
Article
27. Hofstetter A, Schutz Y, Jéquier E, Wahren J. Increased 24-hour energy expenditure in cigarette smokers. N Engl J Med. 1986; 614:79–82.
Article
28. Andrew FH. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. 2nd ed. New York: Guilford Press;2018. p. 116.
29. Westerterp-Plantenga MS, Verwegen CR. The appetizing effect of an apéritif in overweight and normal-weight humans. Am J Clin Nutr. 1999; 69(2):205–12.
Article
30. Feingold KR. Obesity and dyslipidemia. [Updated 2020 Nov 2]. In: Feingold KR, Anawalt B, Boyce A, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.;2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305895/.
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