|Huang, Shue - Pennsylvania State University|
|Li, Junjuan - Kailuan Hospital|
|Shearer, Gregory - Pennsylvania State University|
|Lichtenstein, Alice - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Zheng, Xiaoming - Kailuan Hospital|
|Wu, Yuntao - Kailuan Hospital|
|Jin, Cheng - Kailuan Hospital|
|Wu, Shouling - Kailuan Hospital|
|Gao, Xiang - Pennsylvania State University|
Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/31/2017
Publication Date: 3/1/2017
Citation: Huang, S., Li, J., Shearer, G.C., Lichtenstein, A.H., Zheng, X., Wu, Y., Jin, C., Wu, S., Gao, X. 2017. Longitudinal study of alcohol consumption and high-density lipoprotein concentrations: A community-based study. American Journal of Clinical Nutrition. https://doi.org/10.3945/ajcn.116.144832.
Interpretive Summary: Observational studies have consistently reported that individuals who consumed moderate amounts of alcohol are at lower risk for developing heart disease compared to nondrinkers or heavy drinkers. Higher high density lipoprotein-cholesterol (HDL-C) concentrations are associated with lower risk of developing heart disease. Unlike the U-shaped dose-response relationship between alcohol intake and heart disease risk, greater alcohol consumption has been associated with higher HDL-C concentrations in a dose-response manner. However, thus far the data are limited to cross-sectional observational studies. The long-term impact of long-term alcohol intake on HDL-C concentrations remains to be elucidated. To address this issue we used data from a large Chinese cohort (80,081 adults, mean age 49 y) composed of individuals who were free of heart disease and cancer at the time of recruitment and did not use cholesterol-lowering drugs. The results indicate there is an umbrella-shaped relation between alcohol intake and HDL-C concentrations over a 6-year period. The smallest decreases over time were observed in those individuals consuming low to moderate amounts of alcohol compared to nondrinkers and heavy drinkers. These findings support the possible beneficial effect of moderate alcohol on heart health. Additional prospective studies are still needed to confirm this finding
Technical Abstract: Background: In cross-sectional studies and short-term clinical trials, it has been suggested that there is a positive dose-response relation between alcohol consumption and HDL concentrations. However, prospective data have been limited. Objective: We sought to determine the association between total alcohol intake, the type of alcohol-containing beverage, and the 6-y (2006-2012) longitudinal change in HDL-cholesterol concentrations in a community-based cohort. Design: A total of 71,379 Chinese adults (mean age: 50 y) who were free of cardiovascular diseases and cancer and did not use cholesterol-lowering agents during follow-up were included in the study. Alcohol intake was assessed via a questionnaire in 2006 (baseline), and participants were classified into the following categories of alcohol consumption: never, past, light (women: 0-0.4 servings/d; men: 0-0.9 servings/d), moderate (women: 0.5-1.0 servings/d; men: 1-2 servings/d), and heavy (women: >1.0 servings/d; men: >2 servings/d). HDL-cholesterol concentrations were measured in 2006, 2008, 2010, and 2012. We used generalized estimating equation models to examine the associations between baseline alcohol intake and the change in HDL-cholesterol concentrations with adjustment for age, sex, smoking, physical activity, obesity, hypertension, diabetes, liver function, and C-reactive protein concentrations. Results: An umbrella-shaped association was observed between total alcohol consumption and changes in HDL-cholesterol concentrations. Compared with never drinkers, past, light, moderate, and heavy drinkers experienced slower decreases in HDL cholesterol of 0.012 mmol x L-1 x y-1 (95% CI: 0.008, 0.016 mmol x L-1 x y-1), 0.013 mmol x L-1 x y-1 (95% CI: 0.010, 0.016 mmol x L-1 x y-1), 0.017 mmol x L-1 x y-1 (95% CI: 0.009, 0.025 mmol x L-1 x y-1), and 0.008 mmol x L-1 x y-1 (95% CI: 0.005, 0.011 mmol x L-1 x y-1), respectively (P < 0.0001 for all), after adjustment for potential confounders. Moderate alcohol consumption was associated with the slowest increase in total-cholesterol:HDL-cholesterol and triglyceride:HDL-cholesterol ratios. We observed a similar association between hard-liquor consumption and the HDL-cholesterol change. In contrast, greater beer consumption was associated with slower HDL-cholesterol decreases in a dose-response manner. Conclusion: Moderate alcohol consumption was associated with slower HDL-cholesterol decreases; however, the type of alcoholic beverage had differential effects on the change in the HDL-cholesterol concentration.