Low prevalence of the metabolic syndrome in wine drinkers--is it the alcohol beverage or the lifestyle?

The Relationship between Dietary Flavonols Intake and Metabolic Syndrome in Polish Adults

Metabolic syndrome (MetS) is a cluster of metabolic disorders primarily caused by central obesity, which results in chronic inflammation leading to hypertension, diabetes and atherogenic dyslipidemia. Inflammation underlying MetS could be the target for dietary flavonols as they present antioxidative properties. The aim of this paper was to analyze the differences in habitual intake of selected flavonols (quercetin, kaempferol, isorhamnetin and myricetin) between MetS patients and healthy participants, and its relationship with MetS advancement. Ninety participants were enrolled in this study. The one-year flavonol intake was assessed with a dedicated food frequency questionnaire. The patients with MetS consumed significantly less quercetin (p = 0.01), kaempferol (p = 0.04), isorhamnetin (p < 0.001), total flavonols (p = 0.01), tomatoes (p = 0.001) and wine (p = 0.01) daily. Further analysis revealed a moderate inverse correlation between quercetin (p = 0.001), kaempferol (p = 0.01), isorhamnetin (p < 0.001), total flavonols (p = 0.001) and tomato consumption (p = 0.004) and MetS stage. The analysis of laboratory parameters showed that dietary intake of flavonols was not correlated with lipid profile, glucose level or renal function. On the basis of this observation, a potential protective effect of dietary flavonols, mainly from tomatoes, against MetS could be suggested. However, when referring to MetS components, flavonols probably mainly impact central obesity and blood pressure, without a significant impact on conventional lipid-profile parameters and glucose level.

Wine and Health-New Evidence

Health benefits of moderate wine consumption have been studied during the past decades, first in observational studies and more recently, in experimental settings and randomized controlled studies. Suggested biological pathways include antioxidant, lipid regulating, and anti-inflammatory effects. Both the alcoholic and polyphenolic components of wine are believed to contribute to these beneficial effects. Although several of these studies demonstrated protective associations between moderate drinking and cardiovascular disease, atherosclerosis, hypertension, certain types of cancer, type 2 diabetes, neurological disorders, and the metabolic syndrome, no conclusive recommendations exist regarding moderate wine consumption. Yet, it is suggested that the physician and patient should discuss alcohol use. In the CASCADE (CArdiovaSCulAr Diabetes & Ethanol) trial, 224 abstainers with type 2 diabetes were randomized to consume red wine, white wine or mineral water for two years. Here, we summarize our previous findings, offer new evidence concerning the differential effects of wine consumption among men and women, and further suggest that initiating moderate alcohol consumption among well-controlled persons with type 2 diabetes is apparently safe, in regard to changes in heart rate variability and carotid plaque formation.

Adolescent wine consumption is inversely associated with long-term weight gain: results from follow-up of 20 or 22 years

Background

Several studies have suggested a link between the type of alcoholic beverage consumption and body weight. However, results from longitudinal studies have been inconsistent, and the association between adolescent alcohol consumption long-term weight gain has generally not been examined.

Methods

The study was based on data from 720 Danish adolescents aged between 15 to 19 years at baseline from the Danish Youth and Sports Study (YSS). Self-reported alcohol use, height, weight, smoking, social economic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985, and in the follow up survey which was conducted in 2005. Multiple linear regression analyses were used to examine the association between alcohol consumption in adolescence and subsequent weight gain later in midlife.

Results

There was no significant association between total alcohol consumption during adolescence and change in BMI into midlife (P = 0.079) (β − 0.14; 95% CI -0.28, 0.005). Wine consumption was found to be inversely associated to subsequent BMI gain (P = 0.001) (β − 0.46; 95% CI -0.82, − 0.09) while the results were not significant for beer and spirit. The relationship did not differ by gender, but smoking status was found to modify the relationship, and the inverse association between alcohol and BMI gain was seen only among non-smokers (P = 0.01) (β − 0.24; 95% CI -0.41, − 0.06) while no association was found among smokers. Neither adolescent nor attained socioeconomic status in adulthood modified the relationship between alcohol intake and subsequent BMI gain.

Conclusion

Among non-smoking adolescents, consumption of alcohol, and in particular wine, seems to be associated with less weight gain until midlife.

Trial registration

The YSS cohort was retrospectively registered on August 2017. (Study ID number: NCT03244150).

Electronic supplementary material

The online version of this article (10.1186/s12937-019-0478-7) contains supplementary material, which is available to authorized users.

Association between Alcohol Consumption and Body Mass Index in University Students

Objective: The aim of this study was to determine the correlation between alcohol consumption and body mass index in university students in Eastern Thailand. Methods: Undergraduate students (19-23 years, n = 396) were randomly surveyed via questionnaires, which included general information, alcohol consumption, and unhealthy food consumption. Average daily alcohol consumption was then calculated from grams of ethanol consumed per day. A subject, who has body mass index (BMI) more than 23 kg/m², was defined as excessive weight. Difference between genders of each variable was compared using independent t-test. Mean of each variable between groups was compared using analysis of variance (ANOVA). The correlation between average daily alcohol consumption and BMI, unhealthy consumption and BMI were analyzed by applying Pearson correlation coefficient. Results: 229 university students consumed alcohol (58%). After 229 subjects were divided into three categories, the average daily alcohol consumption of the overweight group was significantly higher than the underweight and normal weight groups in women; meanwhile, unhealthy food consumption frequencies was not different between groups. Average daily alcohol consumption levels for overweight group were 74.17 and 73.45 g/day in men and women, respectively. Furthermore, higher daily alcohol consumption was independently associated with higher BMI (95% confidence interval [CI] R = 0.161: p = 0.015; men R = 0.120: p = 0.236; women R = 0.214: p = 0.015). Conclusion: There was a positive relationship between alcohol consumption and BMI in university students in Eastern Thailand. This study supports that the daily alcohol consumption is a risk factor for excessive weight and gender may contribute to the correlation.

Can Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease Co-Exist?

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) by definition would require exclusion of significant alcohol intake. Present study was aimed to assess the prevalence of various components of metabolic syndrome (MS) in patients with alcoholic cirrhosis (AC) and to study the affect of its presence on the severity of liver disease, testing the hypothesis if alcoholic liver disease (ALD) and NAFLD could co-exist.

METHODS

In a retrospective analysis of 16 months data, 81 patients with AC were analysed for the prevalence of MS. The diagnosis of AC was based on the history of alcohol intake, clinical examination, serum biochemistry, hematological parameters, exclusion of other causes of chronic liver disease, imaging and upper gastrointestinal endoscopy. Severity of liver disease was assessed by Child-Turcott-Pugh (CTP) score. MS was assessed as per the ATP III criteria and the affect of MS on CTP score was evaluated.

RESULTS

All 81 patients with AC were male [mean age 50.9 ± 9.5, mean CTP score 8.38 ± 1.66]. But for three patients (3.7%) all other 78 patients (96.3%) with AC had at least one component of MS. Forty-three (53.0%) patients had full blown MS with three or more components of MS. Sixty-one (75.30%) patients were either overweight [22 (27.1%)] or obese [39 (48.1%)], with a mean BMI of 25.35 ± 3.86 kg/m². Type II DM was present in 40 (25%) and 28 (34.5%) patients were hypertensive. Twenty-two (27.2%) patients had hypertriglyceridemia and 52 (64.2%) had low HDL. Eleven (13.6%) patients had Child's A cirrhosis, 46 (56.8%) had Child's B and 24 (29.6%) patients had Child's C cirrhosis. Even though not significant statistically, patients with Child's C cirrhosis (17, 70.83%) had higher presence of MS in comparison to Child's A (7, 63.6%) and B (19, 41.3%) cirrhosis.

CONCLUSION

MS is common in patients with AC. Presence of MS may be contributing towards severity of liver disease in these patients indirectly suggesting the co-existence of ALD and NAFLD.

Association Between Alcohol Consumption and Metabolic Syndrome in a Community-Based Cohort of Korean Adults

Background

The relationship between alcohol consumption and metabolic syndrome (MetS) remains controversial. This study investigated the relationship between alcohol consumption and MetS components and prevalence.

Material/Methods

We analyzed 10 037 subjects (3076 MetS and 6961 non-MetS) in a community-based cohort.

MetS was defined according to the ATP III Guidelines. Subjects were divided according to amount of alcohol consumption; non-drinker, very light (0.1–5.0 g/day), light (5.1–15.0 g/day), moderate (15.1–30.0 g/day), and heavy drinker (>30 g/day). Multiple logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The analyses were performed in men and women separately. SPSS statistical software was used for analyses.

Results

The prevalence of MetS in both males and females was associated with alcohol drinking status (p<0.0001). Amount of alcohol consumption (0.1–5.0 g/day) was significantly associated with lower prevalence of MetS in both genders compared to non-drinkers. Amount of alcohol consumption (>30.0 g/day) did not show a significant association with prevalence of MetS. However, alcohol consumption (>30.0 g/day) showed an association with glucose and HDL cholesterol among the components of MetS.

Conclusions

Our results indicate that alcohol drinking (0.1–5.0 g/day) contributed to decrease prevalence of MetS and components, including triglyceride and HDL cholesterol.

Incremental Predictive Value of Serum AST-to-ALT Ratio for Incident Metabolic Syndrome: The ARIRANG Study

Aims

The ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study.

Material and Methods

The population-based cohort study included 2276 adults (903 men and 1373 women) aged 40–70 years, who participated from 2005–2008 (baseline) without metabolic syndrome and were followed up from 2008–2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods.

Results

During an average follow-up period of 2.6-years, 395 individuals (17.4%) developed metabolic syndrome. In a multivariable adjusted model, the odds ratio (95% confidence interval) for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 (0.422–0.853). The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve (AUC) for predicting new cases of metabolic syndrome (0.715 vs. 0.732, P = 0.004). The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 (95% CI: 0.124–0.337, P<0.001), and the integrated discrimination improvement was 0.0094 (95% CI: 0.0046–0.0143, P<0.001).

Conclusions

The AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.

Habitual Alcohol Consumption and Metabolic Syndrome in Patients with Sleep Disordered Breathing

To investigate the associations between amount of habitual alcohol consumption (HAC) and prevalence of metabolic syndrome (MetS), sleep, and sleep-disordered breathing (SDB). We enrolled 683 untreated SDB male patients (age: 54.4 ± 7.80 y, apnea-hypopnea index (AHI): 29.0 ± 21.53/h). HAC was assessed as the average number of drinks consumed per week during the past 12 months. Anthropometric and biochemical markers were used to diagnose MetS. Clinical data and MetS components were compared according to the reported amounts of HAC (no drinking, light drinking <13, heavy drinking ≥13 drinks/week). As reported, 78.9% of the participants (n = 539) were regular drinkers; 33.7% (n = 230) were habitually heavy drinkers (mean: 30.7 drinks/week), and 45.2% (n = 309) were light drinkers (5.1 drinks/week). The overall prevalence of MetS was 36.9% (n = 252) and was most common in heavy drinkers (40.5%). Compared to non-drinkers and light drinkers, heavy drinkers had the greatest body mass index (BMI) and waist circumference. Central obesity, hypertension, and hyperglycemia were most prevalent in heavy drinkers. Sleep quality and severity of SDB were the worst in heavy drinkers. After adjusting for age, AHI, and BMI, heavy drinkers had a 1.71 times greater risk of MetS when compared with non-drinkers, and light and heavy drinkers had a 2.06 and 2.11 times higher risk of severe SDB than non-drinkers. HAC may increase the prevalence of MetS and deteriorate sleep in relation to amount of alcohol intake. Even light drinkers had more than twice higher risk of severe SDB than non-drinkers.

Metabolic syndrome, glucose tolerance categories and the cardiovascular risk in Spanish population

We examined the prevalence of metabolic syndrome (MetS), glucose tolerance categories and risk factors of cardiovascular-disease (CVD) in the general Spanish population. We studied 3844 randomly sampled subjects (46% males) aged 35-74 years. Glucose tolerance categories were defined according to the 2003 ADA and MetS according to the Harmonized Consensus Criteria with waist circumference (WC) cut-off-points previously reported in Spanish population (≥94.5/≥89.5cm for males/females). The prevalences of normoglycemia (NG), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG and IGT considered together (IFG/IGT), and diabetes mellitus (DM) were 67.6/16.6/5.0/3.3, and 7.5%, respectively. The overall prevalence of MetS was 31.2%. In subjects with NG, IFG, IGT, IFG/IGT, and DM the MetS prevalence's were 16.3/57.1/31.5/66.1, and 74.4% (p<0.001), respectively. MetS was more common in males, older subjects, smokers, and/or individuals with obesity, IFG, IFG/IGT, DM, or insulin resistance (HOMA-IR ≥3.8). MetS was less prevalent in individuals with low alcohol intake and/or high education level. Regarding the risk level of CVD estimated by Framingham and SCORE risk charts, IGT had higher estimated CVD-risk than IFG and IFG/IGT. The presence of MetS increases the risk 4.85 times by Framingham and 2.43 times by SCORE. Prevalence of prediabetes (IFG/IGT) and MetS were 25% and 31.2% respectively. Prevalence of MetS has not changed in the past decade in Spanish females, but has slightly increased in males. We found that subjects with IGT showed a higher risk of CVD than IFG and IFG/IGT according to the Framingham and SCORE. MetS increased the CVD-risk previously estimated by Framingham and SCORE.

Modifiable Lifestyle Behaviors Are Associated With Metabolic Syndrome in a Taiwanese Population

PURPOSE

To explore associations between metabolic syndrome and modifiable lifestyle behaviors among the adult population in Taiwan.

DESIGN

This cross-sectional study analyzed data from a nationally representative sample that participated in the 2005-2008 Nutrition and Health Survey in Taiwan. The sample (2,337 participants older than 19 years) provided data on demographic characteristics, modifiable lifestyle behaviors, anthropometric measurements, and blood chemistry panel.

METHODS

These data were analyzed by descriptive statistics, univariate logistic regression, and multivariate logistic regression to determine factors associated with metabolic syndrome.

FINDINGS

Metabolic syndrome had a prevalence of 25.2%, and this prevalence increased with age. In univariate regression analysis, metabolic syndrome was associated with age, living with family members, educational level, and modifiable lifestyle behaviors (smoking, drinking, betel quid chewing, and physical activity). Individuals with a smoking history and currently chewing betel quid had the highest risk for metabolic syndrome.

CONCLUSIONS

The risk for metabolic syndrome might be reduced by public health campaigns to encourage people to quit smoking cigarettes and chewing betel quid. Implementing more modifiable lifestyle behaviors in daily life will decrease metabolic syndrome in Taiwan.

CLINICAL RELEVANCE

Considering that betel quid chewing and tobacco smoking interact to adversely affect metabolic syndrome risk, public health campaigns against both behaviors seem to be a cost-effective and efficient health promotion strategy to reduce the prevalence rate of metabolic syndrome.

Light alcohol consumption plays a protective role against non-alcoholic fatty liver disease in Japanese men with metabolic syndrome

BACKGROUND & AIMS

Although excess alcohol consumption has been believed to cause liver injury, light alcohol consumption (LAC) has been reported to play a protective role against fatty liver in recent studies. However, the association between non-alcoholic fatty liver disease (NAFLD) and LAC in men with metabolic syndrome (MS) is unclear. The aim of this study was to examine the association between NAFLD and LAC in men with MS.

METHODS

Subjects were 1055 men with MS who underwent a regular health check-up and drank less 20 g/day of alcohol. A distinction was made between non-drinkers and light drinkers and the association between NAFLD and LAC in men with MS was elucidated. NAFLD was referred as fatty liver with alanine aminotransferase (ALT) levels ≧31 IU/L in this study.

RESULTS

Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and the prevalence of NAFLD were significantly lower in light drinkers than in non-drinkers. Logistic regression analysis showed body mass index (BMI), waist circumference (WC), uric acid (UA), haemoglobin A1c (HbA1c), visceral fat type MS and LAC (odds ratios: 0.654; 95% confidence intervals: 0.473-0.906; <0.05) were significant predictors of the prevalence of NAFLD.

CONCLUSION

The prevalence of NAFLD in light drinkers was significantly lower than in non-drinkers, and supporting previous reports studying the general population, LAC is one of the significant predictors of a decreased prevalence of NAFLD in men with MS.

Binge drinking and its relation to metabolic syndrome in korean adult men

Background

It is reported that heavy drinking increases the risk of metabolic syndrome. But there have been few studies on the relationship between the intensity of drinking and metabolic syndrome when drinking the same amount of alcohol. This study aimed to assess the relationship between the frequency of binge drinking and metabolic syndrome in Korean adult men.

Methods

From the database of the 4th and 5th Korea National Health and Nutrition Examination Survey conducted in 2007-2010, data of 8,305 adult men (≥19 years of age) was included in this analysis. Cross-sectional relationship between the frequency of binge drinking and metabolic syndrome was investigated adjusting for pure alcohol consumed per day.

Results

Adjusting for various confounders including pure alcohol consumed per day, the adjusted odds ratio for metabolic syndrome in those in higher frequency (more than 1/wk) binge drinking group was 1.62 (95% confidence interval, 1.30 to 2.03; P for trend = <0.001) compared to those in the non-binge drinking group. Through analysis of the relationship between pure alcohol consumed per day and metabolic syndrome, it was found that pure alcohol consumed per day had a positive relation to metabolic syndrome in the higher frequency binge drinking group (P for trend = 0.041). The relationship was inverse in the non-binge drinking group (P for trend = 0.002).

Conclusion

Our study found a positive relationship between frequency of binge drinking and metabolic syndrome in adult men. And the effect of drinking on metabolic syndrome may depend on the frequency of binge drinking. Further studies are required to confirm this association.

Wine, Food and Health

Wine has historically been associated with religious rights, used as a salubrious beverage, employed as a medication as well as a medicinal solvent, and consumed as a food accompaniment. It is the latter that is most intimately associated in the minds of most modern consumers. Despite this, there is little flavor commonality on which pairing could be based. The first section of the chapter examines this feature, and wine’s primary role as a palate cleanser and food condiment. The synergistic role of food and wine in suppressing each other’s least pleasant attributes is also explained. The final section deals with the latest evidence relating to the many beneficial health effects of moderate wine consumption, shortfalls in the data, headache induction, dental erosion, and conditions under which wine intake is contraindicated.

The Association between Type of Work and Insulin Resistance and the Metabolic Syndrome in Middle-Aged Korean Men: Results from the Korean National Health and Nutrition Examination Survey IV (2007~2009)

Purpose

Type of work might be related to insulin resistance and the metabolic syndrome (MetS). However, scant data are available. We performed this study to investigate whether the prevalence of MetS and insulin resistance differed according to occupation in middle-aged men.

Materials and Methods

In all, 2,348 men in their 40s~50s who had participated in the Korean National Health and Nutrition Examination Survey IV were included and were classified into two groups according to the type of work (manual worker vs. non-manual worker). Diagnosis of MetS required satisfying three or more of the National Cholesterol Education Program-Adult Treatment Panel III criteria. Fasting insulin, the glucose/insulin ratio (G/I ratio), and the homeostasis model assessment of insulin resistance (HOMA-IR) were used to estimate the insulin resistance. We used the Mann-Whitney test, χ² tests, multiple linear regression test, and logistic regression analyses to examine the relationships.

Results

Age was significantly higher in the manual worker group. Body mass index was significantly lower in the manual worker group. Rates of current smoking and frequent drinking were higher in the manual worker group. In terms of surrogate markers of insulin resistance, the age-adjusted mean of fasting insulin, G/I ratio, and HOMA-IR indicated that lower insulin resistance was significantly related to manual work. After adjusting for age and other confounding factors, non-manual workers had a higher risk of the MetS than manual workers. The odds ratio in relation to MetS was significantly lower in the manual workers.

Conclusions

MetS and impaired insulin resistance are significantly related to non-manual work in middle-aged Korean men.

Metabolic syndrome, adiponectin, and cardiovascular risk in Spain (the Segovia study): impact of consensus societies criteria

BACKGROUND

We aimed to investigate the prevalence of metabolic syndrome in rural and urban areas in the province of Segovia, Spain, and its relationship to lifestyle habits, cardiovascular risk, and serum adiponectin concentrations.

METHODS

The study had a cross-sectional design and included 888 individual residents in the province of Segovia, Autonomous Community of Castilla-León.

RESULTS

The age/sex standardized prevalence of the metabolic syndrome was by: (1) American Heart Association/National Heart Lung and Blood Institute criteria (AHA/NHLBI), 17%; (2) International Diabetes Federation (IDF), 24.3%; and (3) Consensus Societies/Joint Interim Statement (CS), 27.8%. A high correlation was found between the different criteria. No formal education [odds ratio (OR) 6.9 (2.4-20.2)] and primary education [6.7 (2.8-15.9)] were independently associated with metabolic syndrome. An inverse association with metabolic syndrome was found for subjects doing a high level of exercise during work [0.4 (0.2-0.7)] as well as those who were mild drinkers [alcohol intake of less than 15 grams/daily, 0.4 (0.3-0.8)]. Among subjects with low estimated cardiovascular risk, adiponectin levels are higher in those who do not meet criteria of metabolic syndrome. A total of 29.7% of subjects meeting CS criteria had >20% 10-year predicted risk of cardiovascular disease (CVD) by the Framingham risk score criteria [4.5 (2.4-8.5)].

CONCLUSIONS

Our results show: (1) A higher estimated prevalence of metabolic syndrome according to IDF and CS criteria. (2) Low educational level was independently associated with metabolic syndrome. A high level of physical activity and a daily alcohol intake of less than 15 grams/day were inversely associated with metabolic syndrome. (3) Metabolic syndrome increases the predicted CVD risk. (4) Adiponectin levels are not inversely related to insulin resistance in subjects with high cardiovascular risk and metabolic syndrome.

Metabolic syndrome in alcohol-dependent men: a cross-sectional study

BACKGROUND

In the context to mental illness metabolic syndrome (MS) has gained significant attention in the last decade. The present research aimed to study the prevalence of MS and its correlates among the alcohol-dependent men at a deaddiction center in Northern India.

MATERIALS AND METHODS

A cross-sectional analysis was done for consecutive male subjects who met the diagnosis of alcohol-dependence syndrome currently using alcohol according to the International Clinical Diagnostic criteria- tenth revision mental and behavioral disorder- Clinical description and diagnostic guidelines criteria (ICD-10). The subjects were evaluated for alcohol consumption and the components of MS as per the International Diabetic Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III).

RESULTS

A total of 200 male subjects were studied: 100 subjects meeting ICD-10 criteria for alcohol dependence currently using alcohol; 50 each of genetically related controls and nongenetically related healthy controls. As per the IDF (with ethnicity specific modifications for waist circumference) and NCEP ATP- III definitions, respectively, MS was found to be less prevalent in alcohol-dependent subjects (27% and 18%) in comparison the healthy controls (30% and 20%).

CONCLUSION

Findings of the study suggest that irrespective of the amount the current alcohol intake is associated with a lower prevalence of MS and a favorable effect on serum high density lipoproteins and waist circumference. However, the cross-sectional nature of our study does not allow any definitive causal inference.

Prospective study of alcohol consumption and the incidence of the metabolic syndrome in US men

Few studies have evaluated the effects of alcohol consumption on the incidence of the metabolic syndrome (MetS). Therefore, the objective of the present study was to examine the association between alcohol consumption and incident MetS in a population of US men. This is a prospective study of 7483 Caucasian men, who were free of the MetS and CVD at baseline. Information was collected on alcohol consumption, health status and fitness level at an initial clinical examination. Additional health information and determination of incident cases of the MetS were obtained at follow-up clinical examinations between 1979 and 2005. Compared with non-drinkers, the multivariate hazard ratios of the MetS for light (1–3 drinks/week), moderate (4–7 drinks/week), moderate–heavy (8–13 drinks/week) and heavy ( ≥ 14 drinks/week) drinkers were 0·81 (95 % CI 0·68, 0·95), 0·68 (95 % CI 0·57, 0·80), 0·70 (95 % CI 0·59, 0·83) and 0·78 (95 % CI 0·66, 0·91), respectively. This association was seen across age groups, in men with one or more pre-existing MetS risk factors, and those with BMI ≥ 25 kg/m2, and in all alcohol beverage types at most levels of alcohol consumption. An inverse dose–response association between alcohol consumption and low HDL concentrations was observed, while significant associations were observed between high fasting glucose concentrations and moderate, moderate–heavy and heavy levels of alcohol consumption. Alcohol consumption was not significantly associated with central obesity, hypertriacylglycerolaemia or hypertension. All levels of alcohol consumption provided significant inverse associations with incidence of the MetS. In particular, this effect was observed in overweight and/or obese individuals, in those who had pre-existing risk factors for the MetS, and extended across all types of alcoholic beverages consumed.

Metabolic syndrome among substance dependent men: A study from north India

BACKGROUND

Substance abuse, alcohol in particular, is associated with increased risk of diabetes and metabolic syndrome (MS). The relationship between the substance abuse and MS is complex and the literature is sparse.

OBJECTIVES

The present research was aimed to study the prevalence and predictors of MS among outpatients with substance dependence.

MATERIALS AND METHODS

Patients with substance dependence were recruited from a deaddiction center in North India, who attended outpatient clinic from 1(st) January, 2010-31(st) December, 2010. MS was assessed using International Diabetes Federation (IDF) criteria.

RESULTS

Out of 250 subjects, 34 (13.6%) of the subjects met the IDF criteria for MS and highest being in alcohol group (21.6%). The commonest abnormality was increased triglycerides (TG; 54%) and increased waist circumference (36.8%). Age, body weight, body mass index, and obesity were significant predictor of MS.

CONCLUSION

MS was highest in subjects with alcohol dependence with the commonest abnormality of TG and blood pressure. Hence, routine screening is advisable in this population to address emerging MS.

Low fasting serum insulin in Japanese alcohol consumers does not imply improved coronary risk factors

OBJECTIVE

The effects of alcohol consumption on coronary risk factors (CRFs) and insulin resistance (IR) have seemed equivocal in previous studies. This study aimed to clarify the implications of low fasting blood insulin observed in alcohol consumers as related to CRFs and IR.

METHODS

A cross-sectional observation in 2133 middle-aged healthy Japanese men for associations of increases in alcohol consumption, fasting serum insulin concentration and serum gammaglutamyltransferase (GGT) activity with the major CRFs of high systolic blood pressure (SBP), fasting serum glucose, triglycerides (TG), total- and LDL-cholesterol (tCh&LDLc) and low serum HDL-cholesterol (HDLc).

RESULTS

Increased alcohol consumption was related to higher SBP, serum GGT, glucose and HDLc, and lower serum LDLc and insulin. Although high serum insulin was significantly related to all of the CRFs in all nondrinkers, moderate drinkers consuming up to 59 ml of alcohol per day and excessive drinkers consuming more, the means of SBP, serum glucose and HDLc were significantly higher and serum LDLc was lower in drinkers than in nondrinkers at any level of serum insulin, indicating that the good and bad profiles of CRFs in alcohol consumers are independent of their low fasting serum insulin. High serum GGT related to increased alcohol consumption and/or body weight was significantly associated with high serum insulin and all of the CRFs in all categories of alcohol consumption.

CONCLUSIONS

Low fasting serum insulin observed in drinkers does not imply improved CRFs, and thus may not imply improved IR. High serum GGT may reflect increased IR in both drinkers and nondrinkers.

Alcohol Consumption, Beverage Preference, and Diet in Middle-Aged Men from the STANISLAS Study

The question about differences in dietary patterns associated with beer, wine, and spirits is still unresolved. We used diet data from 423 middle-aged males of the STANISLAS Study. Using adjusted values for covariates, we observed a negative significant association between increasing alcohol intakes and the consumption of milk, yogurt, and fresh/uncured cheese, sugar and confectionery, vegetables and fruits, and a significant positive relationship with cheese, meat and organs, pork-butcher's meat, and potatoes. In addition, the first dietary pattern identified by factor analysis (characterized a more prudent diet) was inversely related to alcohol intakes. Conversely, when analyzing daily consumption of specific food groups and diet patterns according to beverage preference (wine, beer, and spirits), no significant difference was observed. In conclusion, in this sample of middle-aged French males, there was a linear trend between increasing alcohol intakes and worsening of quality of diet, while no difference was observed according to beverage preference.

Gender-specific relationships between alcohol drinking patterns and metabolic syndrome: the Korea National Health and Nutrition Examination Survey 2008

OBJECTIVE

To examine gender-specific relationships between alcohol drinking patterns (average drinking frequency, typical drinking quantity and frequency of binge drinking) and the prevalence of metabolic syndrome (MetS) and its components in the Korean population.

DESIGN

Cross-sectional study using complex sampling design analyses.

SETTING

The Korea National Health and Nutrition Examination Survey IV, which was conducted in 2008.

SUBJECTS

Current drinkers (n 3793, 1963 men and 1830 women).

RESULTS

After adjusting for confounders (age, educational level, income, physical activity, smoking, energy intake and drinking frequency in the analysis for drinking quantity), the associations of drinking quantity and frequency of binge drinking with the prevalence of MetS were gender-specific. Seven or more drinks for men and ≥ 3 drinks for women per typical occasion and binge drinking ≥ 1 time/week for both sexes resulted in significantly higher odds for the prevalence of MetS compared with men and women who had 1 or 2 drinks and no instances of binge drinking. The association of drinking quantity and the criteria of MetS was stronger for men with high blood pressure and abdominal obesity, whereas it was stronger for women with high glucose. Binge drinking frequency was dose-dependently associated with high TAG, high glucose, high blood pressure and abdominal obesity in men, and with high glucose and high blood pressure in women. Interestingly, average drinking frequency was not associated with the prevalence of MetS in either sex.

CONCLUSIONS

Higher drinking quantity and frequent binge drinking are indicators of a higher prevalence of MetS, and the association strength is thought to be gender-specific.

Protective effect of alcohol consumption for fatty liver but not metabolic syndrome

AIM: To investigate the effect of alcohol on the metabolic syndrome (MS) and fatty liver in Japanese men and women.

METHODS: A cross-sectional study was conducted in a medical health checkup program at a general hospital. This study involved 18 571 Japanese men and women, 18-88 years of age, with a mean body mass index of 22.6 kg/m². A standardized questionnaire was administered. The total amount of alcohol consumed per week was calculated, and categorized into four grades. Fatty liver was examined by ultrasound modified criteria of the revised National Cholesterol Education Program Adult Treatment Panel III and the new International Diabetes Federation.

RESULTS: The prevalence of fatty liver decreased in men and women with light to moderate alcohol consumption, whereas the prevalence of MS was not so changed. The prevalence of fatty liver of any grade in men was lower than that in those with no or minimal alcohol consumption. In women with light to moderate alcohol consumption, prevalence of fatty liver was lower than that in women with no or minimal alcohol consumption. By logistic regression analysis, the odds ratio (OR) for MS in women with light alcohol consumption was decreased to < 1.0, but this change was not clear in men. The OR for fatty liver was clearly < 1.0 in men with any level of alcohol consumption and in women with light to moderate consumption.

CONCLUSION: Light to moderate alcohol consumption has a favorable effect for fatty liver, but not for MS in Japanese men and women.

Elevated serum γ-glutamyltransferase predicts the development of impaired glucose metabolism in middle-aged and elderly Chinese

The aim of this article is to prospectively investigate the association of the liver enzyme γ-glutamyltransferase (GGT) with the development of diabetes and impaired glucose regulation (IGR) in a Chinese population. Seven hundred and sixty normoglycaemic subjects aged 40 years or older randomly selected from an urban community of Shanghai received a baseline investigation in May 2005. The participants were invited to receive a standard 75-g oral glucose tolerance test (OGTT) in November 2008. Incident diabetes and IGR were determined according to the 1999 WHO criteria. Serum GGT levels were significantly associated with incident diabetes or combined diabetes and IGR prospectively. After extensive adjustment, the diabetes risk was significantly increased with incrementing serum GGT quartiles (P value for trend = 0.0027). As compared with the lowest quartile of GGT, the highest quartile had an adjusted hazard ratio of 1.30 (95% CI 1.03-1.65) for developing combined diabetes and IGR. Furthermore, a high serum GGT level at baseline was independently associated with an increase in the index of homeostasis model assessment of insulin resistance (HOMA-IR) at follow-up. Serum GGT concentration, even within its normal range, is a risk marker for developing impaired glucose metabolism in middle-aged and elderly Chinese.

Single administration effects of ethanol on the distribution of white blood cells in rats

Acute single administration effects of ethanol on the distribution of total white blood cells (WBCs), neutrophil, basophil, eosinophil, monocyte and lymphocytes were studied in rats. Acute single administration effects of ethanol on the number of red blood cells (RBCs), hemoglobin concentration and hematocrit were also examined. Male 8-week-old Sprague Dawley rats were randomly divided into the ethanol-administered (ETA) group and the control (CON) group. Two parts of an experiment, 1) 1st experiment : (ethanol dose : 1.0 g/kg body weight), and 2) 2nd experiment : (ethanol dose : 2.0 g/kg body weight) were carried out in rats. The rats were starved to 19:00, and deprived of diet for 12 hr and water for 1 hr before the single administration of ethanol. 1.0 or 2.0 g/kg body weight of ethanol (in 20% (w/w) ethanol) was orally administered to ETA group rats via a stainless stomach tube. In the CON group rats, 0.9% NaCl solution was orally given with the solution volume being equal, in the same manner. Single administration of 1.0 or 2.0 g/kg body weight of ethanol did not change the number of RBCs, hemoglobin concentration and hematocrit. Single administration of 1.0 g/kg body weight of ethanol did not also change the number of WBCs. However, administration of 2.0 g/kg body weight of ethanol increased significantly the number of neutrophil, basophil, monocyte and total WBCs without changing the number of eosinophil and lymphocytes. These results suggest that single administration of 2.0 g/kg body weight of ethanol to rats increased markedly the number of the natural immunity cells without changing the number of acquired cells.

Cross-sectional and longitudinal association of serum alanine aminotransaminase and γ-glutamyltransferase with metabolic syndrome in middle-aged and elderly Chinese people

BACKGROUND

Although associations of the liver enzymes alanine aminotransaminase (ALT) and γ-glutamyltransferase (GGT) with metabolic syndrome (MetS) are well recognized, whether they are independent of insulin resistance and which enzyme is more effective are yet to be clarified.

METHODS

A total of 5404 subjects aged ≥ 40 years were recruited from two urban communities in Shanghai for cross-sectional analyses. A subgroup of 681 participants without MetS at baseline was included in the longitudinal analyses. Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR), and the modified National Cholesterol Education Program Adult Treatment Panel III criteria were adopted to diagnose MetS.

RESULTS

Both GGT and ALT were strongly and positively associated with MetS risks in simple and multivariate analyses. Further adjustment for HOMA-IR and ALT did not change the association of GGT and MetS materially, whereas adjustment for HOMA-IR and GGT substantially attenuated the ALT-MetS association. In longitudinal analyses, risks of developing MetS were increased across GGT quartiles in a dose-dependent manner after extensive adjustments (odds ratios were 1.00, 1.38, 1.62, and 2.29 for GGT, quartile 1 through quartile 4; P for trend = 0.01). In contrast, ALT was no longer associated with MetS development after final adjustment for GGT (P for trend = 0.09).

CONCLUSIONS

Our study confirmed significant and independent associations of GGT and ALT with MetS in adult Chinese people. Moreover, GGT might be more effective for indicating the future development of MetS.

Alcohol drinking, the metabolic syndrome and diabetes in a population with high mean alcohol consumption

AIMS

To investigate the relationship of alcohol consumption with the metabolic syndrome and diabetes in a population-based study with high mean alcohol consumption. Few data exist on these conditions in high-risk drinkers.

METHODS

In 6172 adults aged 35-75 years, alcohol consumption was categorized as 0, 1-6, 7-13, 14-20, 21-27, 28-34 and ≥ 35 drinks/week or as non-drinkers (0), low-risk (1-13), medium-to-high-risk (14-34) and very-high-risk (≥ 35) drinkers. Alcohol consumption was objectively confirmed by biochemical tests. In multivariate analysis, we assessed the relationship of alcohol consumption with adjusted prevalence of the metabolic syndrome, diabetes and insulin resistance, determined with the homeostasis model assessment of insulin resistance (HOMA-IR).

RESULTS

Seventy-three per cent of participants consumed alcohol, 16% were medium-to-high-risk drinkers and 2% very-high-risk drinkers. In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. Adjusted prevalence of the metabolic syndrome was 24% in non-drinkers, 19% in low-risk (P<0.001 vs. non-drinkers), 20% in medium-to-high-risk and 29% in very-high-risk drinkers (P=0.005 vs. low-risk). Adjusted prevalence of diabetes was 6.0% in non-drinkers, 3.6% in low-risk (P<0.001 vs. non-drinkers), 3.8% in medium-to-high-risk and 6.7% in very-high-risk drinkers (P=0.046 vs. low-risk). Adjusted HOMA-IR was 2.47 in non-drinkers, 2.14 in low-risk (P<0.001 vs. non-drinkers), 2.27 in medium-to-high-risk and 2.53 in very-high-risk drinkers (P=0.04 vs. low-risk). These relationships did not differ according to beverage types.

CONCLUSIONS

Alcohol has a U-shaped relationship with the metabolic syndrome, diabetes and HOMA-IR, without differences between beverage types.

Population-based study in Lithuania: lifestyle factors and risk of metabolic syndrome

The aim of this study was to assess the relationship between lifestyle characteristics and the probability of metabolic syndrome in the Lithuanian middle-aged population of Kaunas city. Study sample was comprised of 1403 individuals aged 35–64 years. Metabolic syndrome was defined by International Diabetes Federation definition. Lifestyle habits were evaluated using frequency questionnaires. The prevalence of metabolic syndrome was identified in 29.7% of men and 35.1% of women. In men only alcohol intake increased the risk of metabolic syndrome: wine intake daily or several times a week increased the risk of metabolic syndrome in men aged 35–49 years by 3.8-fold whereas intake of spirits once a week or more often increased the risk of metabolic syndrome in men aged 50–64 years by 2.8-fold. In women aged 50–64 years beer intake daily or several times a week (OR=11.9; p=0.015) and some unhealthy nutrition habits — intake of cakes 4 times a week or more often (OR=5.49; p=0.005) and slather spread butter on bread (OR=2.09; p=0.028) increased the odds of metabolic syndrome. Our findings indicated that frequent intake of wine and spirits increased the risk of metabolic syndrome in men; frequent intake of beer, cakes, slather spread butter on bread and low education level increased the risk of metabolic syndrome in women.

Association between alcohol intake amount and prevalence of metabolic syndrome in Korean rural male population

Moderate alcohol consumption is known to be associated with a reduced risk of cardiovascular disease and mortality. However, few studies reported that long-term alcohol drinking may increase the prevalence of central obesity, and cardiovascular disease. We examined the association between metabolic syndrome, nutritional factors and alcohol intake amount in Korean male rural population. We performed a cross-sectional analysis on data from Korean Rural Genomic Cohort (KRGC) study. We used multiple logistic regression analysis to estimate the adjusted odds ratio of metabolic syndrome according to alcohol intake amount categories (never, 0-16 g/day, 16-40 g/day, and >40 g/day). The age adjusted odds ratio for the prevalence of metabolic syndrome was significantly increased in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group (1.33; C.I., 1.11-1.59). These results were similar in the high energy intake group, but not in the low energy intake group. Waist circumference, blood pressure, and serum triglyceride levels were significantly higher in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group. These results suggest that large alcohol consumption is associated with metabolic syndrome and may be a modifiable risk factor of metabolic syndrome especially in subjects with high calorie intake.

Associations between alcohol drinking and multiple risk factors for atherosclerosis in smokers and nonsmokers

This study investigated relationships between alcohol intake and multiple risk factors for atherosclerosis in smokers and nonsmokers. Men aged 35 to 54 years (n = 27 005) were divided into 6 groups by ethanol intake. The prevalence of multiple (>or=3 or >or=4) risk factors, including obesity, high blood pressure, high total cholesterol, triglyceride and fasting blood glucose, and low high-density lipoprotein (HDL) cholesterol, was compared among the groups in smokers and nonsmokers. Smokers and nonsmokers showed U- and J-shaped relationships, respectively, between alcohol intake and prevalence of multiple risk factors. Odds ratios of drinkers versus nondrinkers for multiple risk factors were significantly low in very light, light, moderate, and heavy drinkers in smokers and were significantly low in light and moderate drinkers but not in very low and heavy drinkers in nonsmokers. There is a U- or J-shaped relationship between alcohol consumption and multiple risk factors for atherosclerosis, and this relationship is modified by smoking.

Beverage consumption and adult weight management: A review

Total energy consumption among United States adults has increased in recent decades, and energy-containing beverages are a significant contributor to this increase. Because beverages are less satiating than solid foods, consumption of energy-containing beverages may increase energy intake and lead to weight gain; trends in food and beverage consumption coinciding with increases in overweight and obesity support this possibility. The purpose of this review is to present what is known about the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol). Existing evidence, albeit limited, suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet.

Effects of light-to-moderate alcohol consumption on steatosis and steatohepatitis in severely obese patients

OBJECTIVES

The effect of light-to-moderate alcohol consumption (LMAC) in nonalcoholic fatty liver disease (NAFLD) remains a controversial subject. The aim of this study was to evaluate the relationship between LMAC and the severity of NAFLD in morbidly obese patients.

METHODS

We studied 132 patients undergoing liver biopsy during bariatric surgery. The patients were divided into three groups: G1: alcohol intake greater than 20 g/day and less than 40 g/day; G2: alcohol intake less than 20 g/day; G3: no alcohol intake. Insulin resistance was defined by the Homeostasis Model Assessment (>3). NAFLD was classified according to the Matteoni types: type I: steatosis alone; type II: steatosis with inflammation; types III-IV: steatosis with ballooning and/or fibrosis.

RESULTS

The mean age was 37.3+/-11 years. Sixty-three percent were females and body mass index was 43.9+/-5.6 kg/m. G1, G2, and G3 included 19, 56, and 57 patients, respectively. Histological diagnoses classified by levels of alcohol were: G1: 10.5% normal liver, 89.5% type III or IV; G2: 10.7% normal liver, 1.8% type I or II, and 87.5% grade III or IV; G3: 10.5% normal liver, 3.5% type I or II, and 86% type III or IV (one had cirrhosis). The presence of IR was similar in moderate and no alcohol consumption (81.3 and 78.7%) but significantly less in the light consumption group (54%, P<0.05).

CONCLUSION

The results suggest that LMAC may have a protection effect against IR in severely obese patients. However, it had no impact on the severity of activity and stage of liver disease.

Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? Disentangling the effects of social adversity

BACKGROUND

Studies concerning whether exposure to low levels of maternal alcohol consumption during fetal development is related to child inattention and hyperactivity symptoms have shown conflicting results. We examine the contribution of covariates related to social adversity to resolve some inconsistencies in the extant research by conducting parallel analyses of three cohorts with varying alcohol consumption and attitudes towards alcohol use.

METHODS

We compare three population-based pregnancy-offspring cohorts within the Nordic Network on ADHD from Denmark and Finland. Prenatal data were gathered via self-report during pregnancy and birth outcomes were abstracted from medical charts. A total of 21,678 reports concerning inattention and hyperactivity symptoms in children were available from the Strengths and Difficulties Questionnaire or the Rutter Scale completed by parents and/or teachers.

RESULTS

Drinking patterns differed cross-nationally. Women who had at least some social adversity (young, low education, or being single) were more likely to drink than those better off in the Finnish cohort, but the opposite was true for the Danish cohorts. Prenatal alcohol exposure was not related to risk for a high inattention-hyperactivity symptom score in children across cohorts after adjustment for covariates. In contrast, maternal smoking and social adversity during pregnancy were independently and consistently associated with an increase in risk of child symptoms.

CONCLUSIONS

Low doses of alcohol consumption during pregnancy were not related to child inattention/hyperactivity symptoms once social adversity and smoking were taken into account.

Psychosocial Status and Health Related Quality of Life in Relation to the Metabolic Syndrome in a Swedish Middle-Aged Population

Background: The Metabolic Syndrome (MS) is a combination of risk factors related to increased risk of cardiovascular disease. Psychosocial factors and stress have been suggested to be important determinants.

Aim: To analyse how psychosocial factors, perceived stress and health related quality of life are related to MS, and assess if observed associations are dependent of life-style.

Methods: A cross-sectional study of a random sample of 502 men and 505 women aged 45–69, from southeast Sweden, including fasting blood samples, blood pressure, anthropometrics, self-reported data of life-style, psychosocial status and health related quality of life (SF-36). Linear regression models were adjusted for age and, in a second step, also for life-style.

Results: Men and women with MS reported lower levels of physical activity, lower scores on physical and social dimensions of SF-36, and women with MS reported stronger effect of social change compared to those without MS ( p < 0.05), but we found no differences for mental health or perceived stress. The major part of observed associations was lost after adjustment for effects of life-style.

Conclusion: Our data speak against a direct effect of social stress on MS via psychological strain but suggest an indirect pathway via a sedentary life-style.

Alcohol consumption and the prevalence of metabolic syndrome: a meta-analysis of observational studies

BACKGROUND

In the past two decades, the metabolic syndrome has given rise to much clinical and research interest. The broad overlap of alcohol consumption with different components of metabolic syndrome makes alcohol-metabolic syndrome relationship a controversial topic.

OBJECTIVES

To support the evidence available about the relationship between alcohol consumption and metabolic syndrome as a comprehensive clinical entity, as well as to identify the gender-specific dose-response, by performing a meta-analysis based on information from published data.

METHODS

Manual and computer searches in different bibliographic databases were performed to identify the relevant scientific publications, on the relation between alcohol consumption and metabolic syndrome. Alcohol intake was converted into a same unit (g/day) and then categorized using standard classification in order to provide relevant comparisons. Fixed and random effects models were used to aggregate individual odds ratios and to derive pooled estimates and 95% confidence intervals.

RESULTS

Fourteen relevant publications were identified on the relation between alcohol consumption and the prevalence of metabolic syndrome. 7 studies were included in the meta-analysis. The results showed that alcohol consumption of less than 40 g/day in men and 20 g/day in women significantly reduced the prevalence of metabolic syndrome.

CONCLUSION

"Responsible alcohol intake" appears to be associated with a reduced prevalence of metabolic syndrome. Favorable metabolic effect seemed to be restricted to alcohol consumption of less than 20 g/day among women, and of less than 40 g/day among men. These findings support the actual recommendations regarding alcohol consumption among apparently healthy people.

Prospective study of alcohol consumption and metabolic syndrome

BACKGROUND

Alcohol consumption is related to the prevalent metabolic syndrome. Few studies have evaluated the effects of alcohol consumption on the development of metabolic syndrome.

OBJECTIVE

We examined the association between alcohol consumption and incident metabolic syndrome.

DESIGN

This was a prospective cohort study of 3833 male and female Koreans aged 40-69 y and free of the metabolic syndrome at baseline. Information on alcohol consumption was obtained periodically from interviewer-administered questionnaires. Incident cases of the metabolic syndrome were identified by biennial health examinations during 4 y of follow-up between 2003 and 2006.

RESULTS

Compared with nondrinkers, the multivariate relative risk [RR (95% CI)] of the metabolic syndrome for very light drinkers consuming 0.1 to 5 g of alcohol per day (g/d) was 1.06 (0.71, 1.58), that for light drinkers consuming 5.1 to 15 g/d was 1.13 (0.69, 1.83), that for moderate drinkers consuming 15.1 to 30 g/d was 1.25 (0.75, 2.09), and that for heavy drinkers consuming >30 g/d was 1.63 (1.02, 2.62). All individual components of the metabolic syndrome were significantly associated with heavy drinking, particularly among heavy liquor drinkers.

CONCLUSIONS

Heavy drinking, in particular among liquor drinkers, is associated with an increased risk of the metabolic syndrome by influencing its components. Further data are warranted to clarify the association between drinking minimal alcohol and the metabolic syndrome as well as the beverage-specific association for drinking beer or wine.

Autoantibodies against modified apolipoprotein B-100 in relation to low-density lipoprotein size and the metabolic syndrome in otherwise healthy men

The role of inflammation in atherosclerotic disease is well established, but the role of autoantibodies against modified apolipoprotein (apo) B-100 remains unclear. The metabolic syndrome is associated with a proinflammatory state, a predominance of small dense low-density lipoprotein (LDL) particles, and an increased risk for atherosclerotic diseases. Previous studies have shown specific autoantibodies against modified apo B-100 (within LDL) to be related to human atherosclerotic disease. The objective of the present study was to investigate whether autoantibodies against modified apo B-100 are related to parameters of the metabolic syndrome, such as small dense LDL. Two hundred ninety-one healthy men were investigated for different metabolic, anthropometric, and inflammatory variables; LDL peak particle size; and distribution of LDL in 4 subfractions. Subjects were grouped according to LDL peak size > or = 23.5 nm (pattern A, n = 230) or <23.5 nm (pattern B, n = 61). Immunoglobulin (Ig) G and IgM antibodies against 2 aldehyde-modified peptide sequences, denoted as 45 and 210, within apo B-100 were quantified. Levels of IgG(45), but not the other autoantibodies, were significantly higher in pattern B individuals (with a predominance of small dense LDL particles) compared with pattern A (P < .01). Relationships for both IgG(45) and IgG(210) with parameters typically associated with the metabolic syndrome were found. Only IgG(45) tended to be higher in individuals with the metabolic syndrome compared with those without (P = .07). We conclude that subjects with a predominance of small dense LDL particles have elevated concentrations of IgG(45) in the circulation, which reflect an activated immune response to a specific epitope of modified apo B-100.

Fatty acid desaturases in human adipose tissue: relationships between gene expression, desaturation indexes and insulin resistance

AIMS/HYPOTHESIS

Fatty acid desaturases introduce double bonds into growing fatty acid chains. The key desaturases in humans are Delta5-desaturase (D5D), Delta6-desaturase (D6D) and stearoyl-CoA desaturase (SCD). Animal and human data implicate hepatic desaturase activities in insulin resistance, obesity and dyslipidaemia. However, the role of desaturase activity in adipose tissue is uncertain. We therefore evaluated relationships between adipose mRNA expression, estimated desaturase activities (fatty acid ratios) in adipose tissue and insulin resistance.

METHODS

Subcutaneous adipose tissue mRNA expression of D5D (also known as FADS1), D6D (also known as FADS2) and SCD was determined in 75 individuals representative of the study population of 294 healthy 63-year-old men. Desaturation indexes (product/substrate fatty acid ratios) were generated from adipose tissue fatty acid composition in all individuals. Insulin resistance was defined as the upper quartile of the updated homeostasis model assessment (HOMA-2) index.

RESULTS

The relevant desaturation indexes (16:1/16:0, 18:1/18:0, 20:4/20:3 and 18:3/18:2) reflected expression of SCD, but not of D5D or D6D in adipose tissue. Insulin-resistant individuals had a higher adipose tissue 18:1/18:0, but not 16:1/16:0 ratio than insulin-sensitive individuals. Individuals with a high adipose tissue 18:1/18:0 ratio were 4.4-fold (95% CI 1.8-11.8) more likely to be insulin resistant [threefold (95% CI 1.1-8.6) after adjustment for waist circumference and plasma triacylglycerol]. In a multiple regression model predicting HOMA-2, the independent effect of the 18:1/18:0 ratio was borderline (p=0.086).

CONCLUSIONS/INTERPRETATION

Adipose tissue desaturation indexes of SCD reflect the expression of the gene encoding the enzyme in this tissue. Elevated SCD activity within adipose tissue is closely coupled to the development of insulin resistance.

Influenza viruses in animal wildlife populations

Influenza viruses belong to the family Orthomyxoviridae. Genus Influenza A viruses are true zoonotic agents with many animal reservoirs, whereas genus Influenza B viruses are generally considered to be a virus of humans. The genome of influenza A viruses consists of eight unique segments of single-stranded RNA of negative polarity; they are typed according to their surface proteins, hemagglutinin (HA) and neuraminidase (NA). HA and NA, the major antigenic determinants of influenza A viruses, are present in 16 and nine serologic subtypes, respectively. Annual epidemics and occasional pandemics of influenza in humans depend on the continued evolution of influenza viruses. Although they have numerous potential host populations, most of our genetic and biologic data are obtained from studies of domestic populations of species such as chickens, turkeys, swine, and horses. Concerning wildlife populations, including wild populations of these domesticated species, much less is known. The purpose of this review is to establish what role wildlife populations play in the continued evolution of influenza viruses. Future work needs to determine what chain of events makes it possible for an influenza virus to be successfully transmitted to, and more importantly within, an alternative host population. Even questions as fundamental as which hosts can transmit viruses to humans remain unanswered so far.

Nutritional strategies in the prevention and treatment of metabolic syndrome

The metabolic syndrome (MetS) is a clustering of metabolic abnormalities that increase the risk of developing atherosclerotic cardiovascular disease and type 2 diabetes. The exact etiology remains unclear, but it is known to be a complex interaction between genetic, metabolic, and environmental factors. Among environmental factors, dietary habits are of central importance in the prevention and treatment of this condition. However, there is currently no firm consensus on the most appropriate dietary recommendations. General recommendations include decreasing obesity, increasing physical activity, and consuming an anti-atherogenic diet, and have traditionally focused on low total fat intake. A major problem with the focus on low fat is that high-carbohydrate diets can contribute to increasing triglyceride and decreasing high-density lipoprotein (HDL) concentrations. Low-carbohydrate diets have been popular in recent years. However, such diets are typically higher in saturated fat and lower in fruits, vegetables, and whole grains than national dietary recommendations. More recently the quality of carbohydrate has been studied in relation to MetS, including a focus on dietary fiber and glycemic index. Similarly, there has been a move from limiting total fat to a focus on the quality of the fat, with evidence of beneficial effects of replacing some carbohydrate with monounsaturated fat. Other nutrients examined for possible importance include calcium, vitamin D, and magnesium. Together, the evidence suggests that the components of diet currently recommended as "healthy" are likely also protective against MetS, including low saturated and trans fat (rather than low total fat) and balanced carbohydrate intake rich in dietary fiber, as well as high fruit and vegetable intake (rather than low total carbohydrate); and the inclusion of low-fat dairy foods. Accelerating research on gene-diet interactions is likely to contribute interesting information that may lead to further individualized dietary guidance in the future.

Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome

OBJECTIVE

To evaluate the association between physical activity, sleeping hours, alcohol intake and smoking and metabolic syndrome.

METHODS

Social, demographic, personal and family medical histories and behavioral characteristics were collected as self-reported for 2164 participants (1332 women; 832 men), aged 18-92 years old, randomly selected during 1999-2003, among residents in Porto, Portugal, evaluated in the Department of Epidemiology of Porto Medical School. Metabolic syndrome was defined according to the NCEP-ATPIII. Associations between metabolic syndrome and lifestyles factors were computed as odds ratios (OR) and 95% confidence intervals (95% CI).

RESULTS

After adjustment, higher total physical activity (OR=0.63 95% CI%: 0.43, 0.94--females; OR=0.55 95% CI: 0.33, 0.91--males) and work activity levels in females (OR=0.55; 95% CI: 0.33, 0.91) were significantly associated with lower prevalence of the metabolic syndrome. More sleeping hours were positively associated with metabolic syndrome (OR=1.25; 95% CI: 1.13, 1.38--females; OR=1.19; 95% CI: 1.04, 1.36--males). Regarding smoking, the only statistically significant association was found in women that smoked less than 10 cigarettes per day (OR=0.32 95% CI: 0.11, 0.92). No statistically significant association was found between ethanol intake and metabolic syndrome.

CONCLUSIONS

An association between decreased physical activity, increased sleeping hours and metabolic syndrome was found. No association was found between cigarette smoking, alcohol intake and the metabolic syndrome.

Alcohol consumption and risk of leukemia: A multicenter case–control study

A population-based case-control study of 649 leukemia cases and 1771 controls carried out in 11 Italian areas, offered the opportunity to evaluate the relationship between alcohol consumption and leukemia risk. For all leukemias, acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL), we found a non-significantly inverse association for moderate levels of total alcohol and wine intake, but increased risks at high levels, with, in most cases, significant trend effects (odd ratios (OR) for all leukemias in the lowest quartile of total alcohol consumption [0.1-9.0 g/day of ethanol] versus never-drinker = 0.73; 95% confidence intervals (95% CI) = 0.51-1.03; OR in the highest quartile [> 31.7 g/day] = 1.15; 95% CI = 0.82-1.63; p of the linear trend test = 0.007). For chronic myeloid leukemia (CML), we found a non-significantly positive association for all levels of total alcohol and wine intake, and a significant positive linear trend effect (p = 0.03) for wine intake (OR for 0.1-9.0 g/day of ethanol intake from wine = 1.34; 95% CI = 0.61-2.94; OR in the highest quartile of wine intake [> 27.7 g/day] = 2.13; 95% CI = 1.01-4.50). No consistent dose-response was detected analysing duration of alcohol consumption for any leukemia subtypes. In conclusion, even though our study did not show a clear association between alcohol intake and leukemia risk, some of the patterns of the risk estimates (a possible J-shaped dose-response curve between alcohol intake and ALL, AML, and CLL risks, and the positive association between alcohol and CML), may be suggestive.