1
|
Khan TZ, Schatz U, Bornstein SR, Barbir M. Hypertriglyceridaemia: contemporary management of a neglected cardiovascular risk factor. Glob Cardiol Sci Pract 2021; 2021:e202119. [PMID: 34805377 PMCID: PMC8587207 DOI: 10.21542/gcsp.2021.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/30/2021] [Indexed: 11/05/2022] Open
Abstract
Hypertriglyceridaemia represents one of the most prevalent lipid abnormalities, however it is often eclipsed by focus on LDL cholesterol and is frequently overlooked by clinicians, despite it being an important cardiovascular risk factor. For most patients, hypertriglyceridaemia arises from a combination of environmental factors and multiple genetic variations with small effects. Even in cases with apparent familial clustering of hypertriglyceridaemia, a monogenetic cause is rarely identified. Common secondary causes include obesity, uncontrolled diabetes, alcohol, and various commonly used drugs. Correction of these factors, along with lifestyle optimisation, should be prioritised prior to commencing medication. The goal of drug treatment is to reduce the risk of cardiovascular disease in those with moderate hypertriglyceridaemia and the risk of pancreatitis in those with severe hypertriglyceridaemia. Recent and ongoing trials demonstrate the important role of triglycerides (TG) in determining residual risk in patients with cardiovascular disease (CVD) already established on statin therapy. Novel and emerging data on omega-3 fatty acids (high-dose icosapent ethyl) and the selective PPAR modulator pemafibrate are eagerly awaited and may provide further clarity for clinicians in determining which patients will benefit from TG lowering and help inform clinical guidelines. There are numerous novel therapies on the horizon that reduce TG by decreasing the activity of proteins that inhibit lipoprotein lipase such as apolipoprotein C-III (including Volanesorsen which was recently approved in Germany) and ANGPTL 3/4 which may offer promise for the future.
Collapse
Affiliation(s)
- Tina Z. Khan
- Department of Cardiology, Harefield Hospital, Royal Brompton & Harefield NHS Foundation Trust Hospital, Hill End Road, Harefield UB9 6JH, United Kingdom
| | - Ulrike Schatz
- University Hospital Carl Gustav Carus, Fetscher Street 74, Dresden 01307, Germany
| | - Stefan R. Bornstein
- University Hospital Carl Gustav Carus, Fetscher Street 74, Dresden 01307, Germany
| | - Mahmoud Barbir
- Department of Cardiology, Harefield Hospital, Royal Brompton & Harefield NHS Foundation Trust Hospital, Hill End Road, Harefield UB9 6JH, United Kingdom
- University Hospital Carl Gustav Carus, Fetscher Street 74, Dresden 01307, Germany
| |
Collapse
|
2
|
Keirns BH, Sciarrillo CM, Koemel NA, Emerson SR. Fasting, non-fasting and postprandial triglycerides for screening cardiometabolic risk. J Nutr Sci 2021; 10:e75. [PMID: 34589207 PMCID: PMC8453457 DOI: 10.1017/jns.2021.73] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 12/23/2022] Open
Abstract
Fasting triacylglycerols have long been associated with cardiovascular disease (CVD) and other cardiometabolic conditions. Evidence suggests that non-fasting triglycerides (i.e. measured within 8 h of eating) better predict CVD than fasting triglycerides, which has led several organisations to recommend non-fasting lipid panels as the new clinical standard. However, unstandardised assessment protocols associated with non-fasting triglyceride measurement may lead to misclassification, with at-risk individuals being overlooked. A third type of triglyceride assessment, postprandial testing, is more controlled, yet historically has been difficult to implement due to the time and effort required to execute it. Here, we review differences in assessment, the underlying physiology and the pathophysiological relevance of elevated fasting, non-fasting and postprandial triglycerides. We also present data suggesting that there may be a distinct advantage of postprandial triglycerides, even over non-fasting triglycerides, for early detection of CVD risk and offer suggestions to make postprandial protocols more clinically feasible.
Collapse
Affiliation(s)
- Bryant H. Keirns
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK74075, USA
| | | | - Nicholas A. Koemel
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW2006, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW2006, Australia
| | - Sam R. Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK74075, USA
| |
Collapse
|
3
|
Abstract
Hypertriglyceridemia is one of the most common lipid abnormalities encountered in clinical practice. Many monogenic disorders causing severe hypertriglyceridemia have been identified, but in most patients triglyceride elevations result from a combination of multiple genetic variations with small effects and environmental factors. Common secondary causes include obesity, uncontrolled diabetes, alcohol misuse, and various commonly used drugs. Correcting these factors and optimizing lifestyle choices, including dietary modification, is important before starting drug treatment. The goal of drug treatment is to reduce the risk of pancreatitis in patients with severe hypertriglyceridemia and cardiovascular disease in those with moderate hypertriglyceridemia. This review discusses the various genetic and acquired causes of hypertriglyceridemia, as well as current management strategies. Evidence supporting the different drug and non-drug approaches to treating hypertriglyceridemia is examined, and an easy to adopt step-by-step management strategy is presented.
Collapse
Affiliation(s)
- Vinaya Simha
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
| |
Collapse
|
4
|
Rhee EJ, Kim HC, Kim JH, Lee EY, Kim BJ, Kim EM, Song Y, Lim JH, Kim HJ, Choi S, Moon MK, Na JO, Park KY, Oh MS, Han SY, Noh J, Yi KH, Lee SH, Hong SC, Jeong IK. 2018 Guidelines for the Management of Dyslipidemia in Korea. J Lipid Atheroscler 2019; 8:78-131. [PMID: 32821702 PMCID: PMC7379116 DOI: 10.12997/jla.2019.8.2.78] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 06/19/2019] [Indexed: 12/29/2022] Open
Affiliation(s)
- Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Jin Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Mi Kim
- Department of Nutrition and Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - YoonJu Song
- Department of Food Science and Nutrition, The Catholic University of Korea, Bucheon, Korea
| | - Jeong Hyun Lim
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seonghoon Choi
- Division of Cardiology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jin Oh Na
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sang Youb Han
- Division of Nephrology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Junghyun Noh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Kyung Hee Yi
- Department of Pediatrics, Wonkwang University Sanbon Medical Center, Gunpo, Korea
| | - Sang-Hak Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soon-Cheol Hong
- Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea
| | - In-Kyung Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | | |
Collapse
|
5
|
Rhee EJ, Kim HC, Kim JH, Lee EY, Kim BJ, Kim EM, Song Y, Lim JH, Kim HJ, Choi S, Moon MK, Na JO, Park KY, Oh MS, Han SY, Noh J, Yi KH, Lee SH, Hong SC, Jeong IK. 2018 Guidelines for the management of dyslipidemia. Korean J Intern Med 2019; 34:723-771. [PMID: 31272142 PMCID: PMC6610190 DOI: 10.3904/kjim.2019.188] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023] Open
Affiliation(s)
- Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Byung Jin Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Mi Kim
- Department of Nutrition and Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - YoonJu Song
- Department of Food Science and Nutrition, The Catholic University of Korea, Bucheon, Korea
| | - Jeong Hyun Lim
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seonghoon Choi
- Division of Cardiology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jin Oh Na
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sang Youb Han
- Divisions of Nephrology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Junghyun Noh
- Divisions of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Kyung Hee Yi
- Department of Pediatrics, Wonkwang University Sanbon Medical Center, Gunpo, Korea
| | - Sang-Hak Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soon-Cheol Hong
- Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea
| | - In-Kyung Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- Correspondence to In-Kyung Jeong, M.D. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea Tel: +82-10-4283-9809, Fax: +82-2-440-7053, E-mail:
| |
Collapse
|
6
|
Beer, wine consumption, and 10-year CVD incidence: the ATTICA study. Eur J Clin Nutr 2018; 73:1015-1023. [DOI: 10.1038/s41430-018-0296-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/24/2018] [Accepted: 08/07/2018] [Indexed: 11/08/2022]
|
7
|
Kwak SM, Choi MR, Bang SH, Choi IY, Rho MJ, Jo H, Kim DJ. Prevalence Risk of Metabolic Syndrome Associated with Alcohol Use Behavior in Korean Women. Psychiatry Investig 2018; 15:219-225. [PMID: 29475224 PMCID: PMC5900393 DOI: 10.30773/pi.2017.05.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/28/2017] [Accepted: 05/12/2017] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Considerable research has been conducted on the relationship between alcohol consumption and metabolic syndrome. Although various standards for the amount and frequency of alcohol consumption have been suggested, a tool to measure individual alcohol use behavior against a consistent standard is required. Moreover, the association of alcohol use behavior with health should be examined on the basis of such a standard. In this study, we examined the relationships between alcohol use behavior according to the Alcohol Use Disorders Identification Test (AUDIT) and metabolic syndrome and its components in Korean women. METHODS This study utilized data from the fifth Korean National Health and Nutrition Examination Survey, which was administered from 2010 through 2012. We investigated the relationships between alcohol use behavior and metabolic syndrome and its components in a sample of 2,906 women by using analysis of covariance and logistic regression analysis. RESULTS After adjusting for confounding variables, alcohol use behavior was significantly associated with metabolic syndrome [odds ratio (OR) 2.877; 95% confidence interval (CI) 1.523-5.435 in the problem use group]. AUDIT score also was significantly related to abdominal obesity (OR 2.263; 95% CI 1.704-4.459 in the problem use group), hypertension (OR 3.377; 95% CI 1.871-6.095 in the problem use group), hypertriglyceridemia (OR 3.204; 95% CI 1.800-5.702 in the problem use group), and impaired fasting glucose (OR 3.034; 95% CI 1.721-5.348 in the problem use group). CONCLUSION In this study, positive associations were observed between AUDIT score and risk of metabolic syndrome and its components.
Collapse
Affiliation(s)
- Su Min Kwak
- Department of Biomedical Science, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Mi Ran Choi
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Sol Hee Bang
- Department of Biomedical Science, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - In Young Choi
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Catholic Institute for Healthcare Management and Graduate School of Healthcare, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi Jung Rho
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Catholic Institute for Healthcare Management and Graduate School of Healthcare, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Jo
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Dai-Jin Kim
- Department of Biomedical Science, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
8
|
Koloverou E, Panagiotakos DB. Inflammation: a New Player in the Link Between Mediterranean Diet and Diabetes Mellitus: a Review. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0209-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
9
|
Kim S, Cho MR, Kim T, Lim HJ, Lee JW, Kang HT. Factors Positively Influencing Health Are Associated with a Lower Risk of Development of Metabolic Syndrome in Korean Men: The 2007-2009 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 2017; 38:148-155. [PMID: 28572891 PMCID: PMC5451449 DOI: 10.4082/kjfm.2017.38.3.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/08/2016] [Accepted: 07/19/2016] [Indexed: 12/20/2022] Open
Abstract
Background The prevalence of metabolic syndrome (MetS) has risen rapidly worldwide, including in South Korea. Factors related to lifestyle are closely associated with the development of MetS. The aim of this study was to investigate the association between MetS and a number of factors positively influencing health, namely non-smoking, low-risk drinking, sufficient sleep, regular exercise, and the habit of reading food labels, among Korean men. Methods This cross-sectional study included 3,869 men from the 2007–2009 Korean National Health and Nutrition Examination Survey. Information on five factors positively influencing their health was obtained using a self-reported questionnaire. We categorized subjects into four groups, depending on the number of positive factors reported (group I, 0–1 factor; group II, 2 factors; group III, 3 factors; group IV, 4–5 factors). Results Men who reported a greater number of positive health factors had better laboratory and anthropometric values than men who reported fewer positive health factors. The prevalence of MetS was 29.1, 27.2, 20.7, and 14.6% in groups I to IV, respectively. Compared to group I, odds ratios (95% confidence intervals) for MetS were 0.96 (0.78–1.19) in group II, 0.67 (0.52–0.87) in group III, and 0.52 (0.35–0.76) in group IV, after adjusting for confounding factors. Odds ratios for abdominal obesity, glucose intolerance, and hypertriglyceridemia were statistically significant. Conclusion A greater number of positive lifestyle factors influencing health were associated with a lower risk of developing MetS, in a nationally representative sample of Korean men.
Collapse
Affiliation(s)
- Shinhye Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Mi-Ra Cho
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Taejong Kim
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyoung-Ji Lim
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae Woo Lee
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|
10
|
Abstract
Public health policy on alcohol is changing in many countries. This article reviews public health messages with regard to alcohol in Australia, Canada, the United Kingdom (UK) and the United States (US) and highlights the common as well as the different messages delineated. The messages from these four countries are then compared with those of certain other developed and developing countries. Some of the significant differences include definitions of moderate alcohol consumption, the consumption of alcohol by women, underage consumption, and advice to abstainers, which may reflect differences in the characteristics of consumers among countries. Central to the current debate is the concern that incomplete, inconsistent or misleading messages on alcohol consumption could lead to an increase in alcohol abuse, misuse and hence harm, or, conversely, to abstention by particular population groups.
Collapse
|
11
|
2015 Korean Guidelines for the Management of Dyslipidemia: Executive Summary (English Translation). Korean Circ J 2016; 46:275-306. [PMID: 27275165 PMCID: PMC4891593 DOI: 10.4070/kcj.2016.46.3.275] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/06/2016] [Accepted: 04/12/2016] [Indexed: 11/23/2022] Open
|
12
|
Vu KN, Ballantyne CM, Hoogeveen RC, Nambi V, Volcik KA, Boerwinkle E, Morrison AC. Causal Role of Alcohol Consumption in an Improved Lipid Profile: The Atherosclerosis Risk in Communities (ARIC) Study. PLoS One 2016; 11:e0148765. [PMID: 26849558 PMCID: PMC4744040 DOI: 10.1371/journal.pone.0148765] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 01/21/2016] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Health benefits of low-to-moderate alcohol consumption may operate through an improved lipid profile. A Mendelian randomization (MR) approach was used to examine whether alcohol consumption causally affects lipid levels. METHODS This analysis involved 10,893 European Americans (EA) from the Atherosclerosis Risk in Communities (ARIC) study. Common and rare variants in alcohol dehydrogenase and acetaldehyde dehydrogenase genes were evaluated for MR assumptions. Five variants, residing in the ADH1B, ADH1C, and ADH4 genes, were selected as genetic instruments and were combined into an unweighted genetic score. Triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-c) and its subfractions (HDL2-c and HDL3-c), low-density lipoprotein cholesterol (LDL-c), small dense LDL-c (sdLDL-c), apolipoprotein B (apoB), and lipoprotein (a) (Lp(a)) levels were analyzed. RESULTS Alcohol consumption significantly increased HDL2-c and reduced TG, total cholesterol, LDL-c, sdLDL-c, and apoB levels. For each of these lipids a non-linear trend was observed. Compared to the first quartile of alcohol consumption, the third quartile had a 12.3% lower level of TG (p < 0.001), a 7.71 mg/dL lower level of total cholesterol (p = 0.007), a 10.3% higher level of HDL2-c (p = 0.007), a 6.87 mg/dL lower level of LDL-c (p = 0.012), a 7.4% lower level of sdLDL-c (p = 0.037), and a 3.5% lower level of apoB (p = 0.058, poverall = 0.022). CONCLUSIONS This study supports the causal role of regular low-to-moderate alcohol consumption in increasing HDL2-c, reducing TG, total cholesterol, and LDL-c, and provides evidence for the novel finding that low-to-moderate consumption of alcohol reduces apoB and sdLDL-c levels among EA. However, given the nonlinearity of the effect of alcohol consumption, even within the range of low-to-moderate drinking, increased consumption does not always result in a larger benefit.
Collapse
Affiliation(s)
- Khanh N. Vu
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Christie M. Ballantyne
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, United States of America
- Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, United States of America
| | - Ron C. Hoogeveen
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, United States of America
- Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, United States of America
| | - Vijay Nambi
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, United States of America
- Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, United States of America
- Michael E DeBakey Veterans Affairs Hospital, Houston, Texas, United States of America
| | - Kelly A. Volcik
- Department of Biochemistry and Molecular Biology, University of Texas Medical School at Houston, Houston, Texas, United States of America
| | - Eric Boerwinkle
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- The Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Alanna C. Morrison
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- * E-mail:
| |
Collapse
|
13
|
Affiliation(s)
- Miae Doo
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Yangha Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| |
Collapse
|
14
|
Zhang J, Liu TT, Zhang W, Li Y, Niu XY, Fang YL, Ma LS, Li CX. Hyperhomocysteinemia Is Associated with Vitamin B-12 Deficiency: A Cross-sectional Study in a Rural, Elderly Population of Shanxi China. J Nutr Health Aging 2016; 20:594-601. [PMID: 27273348 DOI: 10.1007/s12603-015-0650-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To report the association of lifestyle factors and plasma vitamin B-12 with hyperhomocysteinemia in a large sample of men and women living in a region of China where there is an increased risk of NTDs. DESIGN Community-based, cross-sectional study of Lvliang City, Shanxi Province, China. SETTING Hyperhomocysteinemia is an independent risk factor for cardiovascular disease (CVD) and a sensitive marker of vitamin B-12 and folate deficiency. PARTICIPANTS A total of 2355 (1044 men and 1311 women) participants born before 1 January 1958 (≥55 years of age) and living in Lvliang City for at least 2 months a year were included. MEASUREMENTS The participants were assessed regarding demographic characteristics, height, weight, as well as having a physical examination and blood sampling for serum cholesterol, total homocysteine (tHcy), folate, and vitamin B12 levels. RESULTS The median (25th-75th percentile) tHcy concentration was 21.5 (15.8-33.6) µmol/L in men and 18.0 (13.4-24.8) µmol/L in women. The overall prevalence of hyperhomocysteinemia (tHcy ≥15 µmol/L) was 72.6% (84.3% in men and 63.2% in women), inversely correlated with folate (r=-0.230, P=0.006) and vitamin B-12 (r=-0.540, P<0.001), and positively correlated with uric acid (r=0.054, P<0.001). Vitamin B-12 and folate deficiency, older age, and male gender were associated with elevated tHcy; with vitamin B-12 deficiency being the strongest. CONCLUSIONS Plasma tHcy concentration and hyperhomocysteinemia were significantly higher in this population than in previously studied populations. Vitamin B-12 and folate supplementation, concomitant lifestyle changes such as smoking cessation, and lipid-lowering treatments may help to decrease plasma tHcy concentrations and reduce the CVD risk in this population.
Collapse
Affiliation(s)
- J Zhang
- Professor Xiao-Yuan Niu, Department of Neurology, First Hospital of Shanxi Medical University. No. 85, Jiefang Nan Street, Yingze District, Taiyuan City, PRC. E-mail: , Telephone/Fax: +8603514639510
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Relationship between Alcohol Consumption and Components of the Metabolic Syndrome in Adult Population from Maracaibo City, Venezuela. Adv Prev Med 2015; 2015:352547. [PMID: 26779349 PMCID: PMC4686638 DOI: 10.1155/2015/352547] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/08/2015] [Accepted: 11/17/2015] [Indexed: 01/20/2023] Open
Abstract
Introduction. Although the relationships between alcohol and disorders such as cancer and liver disease have been thoroughly researched, its effects on cardiometabolic health remain controversial. Therefore, the objective of this study was to assess the association between alcohol consumption, the Metabolic Syndrome (MS), and its components in our locality. Materials and Methods. Descriptive, cross-sectional study with randomized, multistaged sampling, which included 2,230 subjects of both genders. Two previously determined population-specific alcohol consumption pattern classifications were utilized in each gender: daily intake quartiles and conglomerates yielded by cluster analysis. MS was defined according to the 2009 consensus criteria. Association was evaluated through various multiple logistic regression models. Results. In univariate analysis (daily intake quartiles), only hypertriacylglyceridemia was associated with alcohol consumption in both genders. In multivariate analysis, daily alcohol intake ≤3.8 g/day was associated with lower risk of hypertriacylglyceridemia in females (OR = 0.29, CI 95%: 0.09–0.86; p = 0.03). Among men, subjects consuming 28.41–47.33 g/day had significantly increased risk of MS, hyperglycemia, high blood pressure, hypertriacylglyceridemia, and elevated waist circumference. Conclusions. The relationship between drinking, MS, and its components is complex and not directly proportional. Categorization by daily alcohol intake quartiles appears to be the most efficient method for quantitative assessment of alcohol consumption in our region.
Collapse
|
16
|
Hernandez-Hernandez A, Gea A, Ruiz-Canela M, Toledo E, Beunza JJ, Bes-Rastrollo M, Martinez-Gonzalez MA. Mediterranean Alcohol-Drinking Pattern and the Incidence of Cardiovascular Disease and Cardiovascular Mortality: The SUN Project. Nutrients 2015; 7:9116-26. [PMID: 26556367 PMCID: PMC4663584 DOI: 10.3390/nu7115456] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/25/2015] [Accepted: 10/29/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We assessed the still unclear effect of the overall alcohol-drinking pattern, beyond the amount of alcohol consumed, on the incidence of cardiovascular clinical disease (CVD). METHODS We followed 14,651 participants during up to 14 years. We built a score assessing simultaneously seven dimensions of alcohol consumption to capture the conformity to a traditional Mediterranean alcohol-drinking pattern (MADP). It positively scored moderate alcohol intake, alcohol intake spread out over the week, low spirit consumption, preference for wine, red wine consumption, wine consumed during meals and avoidance of binge drinking. RESULTS During 142,177 person-years of follow-up, 127 incident cases of CVD (myocardial infarction, stroke or cardiovascular mortality) were identified. Compared with the category of better conformity with the MADP, the low-adherence group exhibited a non-significantly higher risk (HR) of total CVD ((95% CI) = 1.55 (0.58-4.16)). This direct association with a departure from the traditional MADP was even stronger for cardiovascular mortality (HR (95% CI) = 3.35 (0.77-14.5)). Nevertheless, all these associations were statistically non-significant. CONCLUSION Better conformity with the MADP seemed to be associated with lower cardiovascular risk in most point estimates; however, no significant results were found and more powered studies are needed to clarify the role of the MADP on CVD.
Collapse
Affiliation(s)
- Aitor Hernandez-Hernandez
- Department of Cardiology, Clínica Universidad de Navarra, 31009 Pamplona, Spain.
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| | - Juan-José Beunza
- Department of Clinical Sciences, School of Biomedical and Health Sciences, Universidad Europea de Madrid, Laureate International Universities, 28029 Madrid, Spain.
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| | - Miguel A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| |
Collapse
|
17
|
|
18
|
Artero A, Artero A, Tarín JJ, Cano A. The impact of moderate wine consumption on health. Maturitas 2014; 80:3-13. [PMID: 25449821 DOI: 10.1016/j.maturitas.2014.09.007] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 09/20/2014] [Indexed: 12/29/2022]
Abstract
Wine is a traditional beverage that has been associated with both healthy and harmful effects. Conceptions like the so-called "French paradox" or the beneficial impact of the Mediterranean diet suggest benefit. Wine has a complex composition, which is affected by whether it is red or white or by other variables, like the variety of grapes or others. Alcohol and phenolic compounds have been attributed a participation in the benefits ascribed to wine. The case of alcohol has been extensively studied, but the key question is whether wine offers additional benefits. Resveratrol, a non-flavonoid compound, and quercetin, a flavonol, have received particular attention. There is much experimental work confirming a beneficial balance for both substances, particularly resveratrol, in various organs and systems. The pharmacological dosages used in many of those experiments have shed doubt, however, on the clinical translation of those findings. Clinical studies are limited by their observational nature as well as for the difficulties to abstract the benefits of wine from other confounders. Notwithstanding the doubts, there is reasonable unanimity in beneficial effects of moderate wine consumption in cardiovascular disease, diabetes, osteoporosis, maybe neurological diseases, and longevity. Observations are less enthusiastic in what refers to cancer. While considering these limitations, clinicians may spread the message that the balance of moderate wine consumption seems beneficial.
Collapse
Affiliation(s)
- Ana Artero
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario, Av Blasco Ibáñez 17, 46010 Valencia, Spain.
| | - Arturo Artero
- Department of Internal Medicine, Hospital Univesitario Dr. Peset, Av Gaspar Aguilar 90, 46017 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Av Blasco Ibáñez 15, 46010 Valencia, Spain.
| | - Juan J Tarín
- Department of Functional Biology and Physical Anthropology, School of Biological Sciences, Burjasot Campus, University of Valencia, Valencia, Spain.
| | - Antonio Cano
- Service of Obstetrics and Gynecology, Clínico University Hospital, Av Blasco Ibáñez 17, 46010 Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av Blasco Ibáñez 15, 46010 Valencia, Spain.
| |
Collapse
|
19
|
Koloverou E, Panagiotakos DB, Pitsavos C, Chrysohoou C, Georgousopoulou EN, Metaxa V, Stefanadis C. Effects of alcohol consumption and the metabolic syndrome on 10-year incidence of diabetes: the ATTICA study. DIABETES & METABOLISM 2014; 41:152-9. [PMID: 25190450 DOI: 10.1016/j.diabet.2014.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 06/21/2014] [Accepted: 07/07/2014] [Indexed: 01/08/2023]
Abstract
AIM The purpose of this prospective study was to investigate the effect of alcohol consumption on the 10-year diabetes incidence. METHODS In 2001-2002, a random sample of 1514 men (18-89 years old) and 1528 women (18-87 years old) was selected to participate in the ATTICA study (Athens metropolitan area, Greece). Among various other characteristics, average daily alcohol intakes (abstention, low, moderate, high) and type of alcoholic drink were evaluated. Diabetes was defined according to American Diabetes Association criteria. During 2011-2012, the 10-year follow-up was performed. RESULTS The 10-year incidence of diabetes was 13.4% in men and 12.4% in women. After making various adjustments, those who consumed up to 1 glass/day of alcohol had a 53% lower diabetes risk (RR=0.47; 95% CI: 0.26, 0.83) compared with abstainers, while trend analysis revealed a significant U-shaped relationship between quantity of alcohol drunk and diabetes incidence (P<0.001 for trend). Specific types of drinks were not associated with diabetes incidence; however, a one-unit increase in ratio of wine/beer/vodka vs. other spirits was associated with an 89% lower risk of diabetes (RR=0.11; 95% CI: 0.02, 0.67). The protective effect of low alcohol consumption on diabetes incidence was more prominent among individuals with stricter adherence to the Mediterranean diet (RR=0.08; 95% CI: 0.011, 0.70) and without the metabolic syndrome (RR=0.34; 95% CI: 0.16, 0.70). CONCLUSION This work revealed the protective effect of modest alcohol consumption of particularly wine and beer against the long-term incidence of diabetes, possibly due to their pleiotropic health effects.
Collapse
Affiliation(s)
- E Koloverou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - D B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
| | - C Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - C Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - E N Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - V Metaxa
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - C Stefanadis
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | |
Collapse
|
20
|
Affiliation(s)
- Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
| |
Collapse
|
21
|
Abstract
BACKGROUND Alcohol is considered to be a cocarcinogen or a tumor promoter, and various studies have shown a linear dose-dependent association between alcohol consumption and colorectal cancer. However, a few studies suggest that moderate alcohol consumption may have a protective effect, similar to that in cardiovascular disease. OBJECTIVE The aim of this study was to evaluate the relationship of colorectal cancer to quantity and type of alcohol consumed. DESIGN This was case-control study. SETTINGS The study was conducted in the area of Attica, Greece. PARTICIPANTS A total of 250 consecutive patients with a first diagnosis of colorectal cancer were matched for age group and sex with 250 controls recruited from the community. The mean age was 63 (SD, 12) years for the patient group (147 men, 59%; 103 women, 41%) and 55 (SD, 13) years for the control group (112 men; 44.8%; 138 women, 55.2%). MAIN OUTCOME MEASURES Questionnaires were administered by trained interviewers to assess sociodemographic, clinical, and lifestyle characteristics, in addition to dietary habits and quantity and type of alcoholic beverages usually consumed during the preceding year. Adherence to the Mediterranean diet was evaluated with the MedDietScore (theoretical range, 0-55). RESULTS With intake of less than 12 g of alcohol per day as the reference, moderate alcohol intake (12-35 g/day) was associated with a significantly decreased likelihood of colorectal cancer in men (OR, 0.35; 95% CI, 0.16-0.74) and in women (OR, 0.40; 95% CI, 0.18-0.91). High alcohol intake (more than 48 g/day) was associated with an increased likelihood, which was significant in men (OR, 3.45; 95% CI, 1.35-8.83) but not in women (OR, 3.40; 95% CI, 0.50-22.92). Drinking red wine was associated with reduced odds of colorectal cancer, significant in men (OR, 0.47; 95% CI, 0.23-0.96) but not in women (OR, 0.54; 95% CI, 0.23-1.30). None of the associations between other beverage types and colorectal cancer were significant. Adherence to the Mediterranean diet was independently associated with lower odds of colorectal cancer overall (p < 0.001), in men (OR, 0.90; 95% CI, 0.83-0.97), and in women (OR, 0.87; 95% CI, 0.80-0.94). LIMITATIONS The major limitations of this study included the inability of a case-control design to determine causation and the potential for recall bias. CONCLUSIONS The association between quantity of alcohol consumed and the presence of colorectal cancer followed a J-shaped curve. While demonstrating the detrimental effect of consuming large amounts of alcohol, the results of this study suggest that moderate alcohol consumption exerts a protective effect on colorectal cancer in both men and women, possibly related to the effects of red wine.
Collapse
|
22
|
Kim J, Chu SK, Kim K, Moon JR. Alcohol use behaviors and risk of metabolic syndrome in South Korean middle-aged men. BMC Public Health 2011; 11:489. [PMID: 21693063 PMCID: PMC3151233 DOI: 10.1186/1471-2458-11-489] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 06/22/2011] [Indexed: 01/08/2023] Open
Abstract
Background It is thought that small volumes of alcohol may have positive effects on health. However, excessive drinking results in serious health problems. An accurate method to determine individual alcohol use behaviors are needed to assess objectively the extent to which drinking affects health. This study investigated the association between risk of metabolic syndrome (MetS) and alcohol use behaviors in middle-aged South Korean men using the Alcohol Use Disorders Identification Test. Methods This study used data from the South Korea National Health and Nutrition Examination (KNHANES) IV (2008), which extracted the standard survey household by using the proportional systematic sampling method. Data of 714 participants from KNHANES IV, 2008 were analyzed using Surveyfreq and Surveylogistic regression to investigate the association between MetS and alcohol use behaviors in middle-aged South Korean men. Results After adjustment for education, smoking, and physical activity, alcohol use behaviors were significantly associated with an increased risk of hypertension [odds ratio (OR) = 2.54, 95% confidence interval (CI) = 1.5-4.06 in the hazardous group; OR = 2.99, 95% CI = 1.84-4.92 in the problem group]; impaired fasting glucose (OR = 2.15, 95% CI = 1.16-3.99 in the hazardous group; OR = 2.48, 95% CI = 1.42-4.33 in the problem group); dyslipidemia (OR = 2.19, 95% CI = 1.38-3.47 in the problem group); abdominal obesity (OR = 1.93, 95% CI = 1.17-3.19 in the hazardous group; OR = 1.85, 95% CI = 1.17-2.92 in the problem group); and MetS (OR = 2.16, 95% CI = 1.24-3.77 in the hazardous group; OR = 2.54, 95% CI = 1.41-4.58 in problem group). Conclusions This study found that excessive alcohol use behaviors increased the risk of hypertension, diabetes, dyslipidemia, abdominal obesity, and MetS. Considering the rising rate of alcohol consumption and heavy drinking at single sittings, a culture of less risky alcohol consumption must be established to promote health among middle-aged men.
Collapse
Affiliation(s)
- Jinhee Kim
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | | | | | | |
Collapse
|
23
|
Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, Goldberg AC, Howard WJ, Jacobson MS, Kris-Etherton PM, Lennie TA, Levi M, Mazzone T, Pennathur S. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2011; 123:2292-333. [PMID: 21502576 DOI: 10.1161/cir.0b013e3182160726] [Citation(s) in RCA: 1245] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
24
|
Lee MY, Kim MY, Kim SY, Kim JH, Kim BH, Shin JY, Shin YG, Yun JH, Ryu SY, Lee TY, Koh SB, Chung CH. Association between alcohol intake amount and prevalence of metabolic syndrome in Korean rural male population. Diabetes Res Clin Pract 2010; 88:196-202. [PMID: 20189260 DOI: 10.1016/j.diabres.2010.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/29/2009] [Accepted: 01/05/2010] [Indexed: 11/26/2022]
Abstract
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.
Collapse
Affiliation(s)
- Mi Young Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Prasain JK, Carlson SH, Wyss JM. Flavonoids and age-related disease: risk, benefits and critical windows. Maturitas 2010; 66:163-71. [PMID: 20181448 DOI: 10.1016/j.maturitas.2010.01.010] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 01/15/2010] [Indexed: 02/07/2023]
Abstract
Plant derived products are consumed by a large percentage of the population to prevent, delay and ameliorate disease burden; however, relatively little is known about the efficacy, safety and underlying mechanisms of these traditional health products, especially when taken in concert with pharmaceutical agents. The flavonoids are a group of plant metabolites that are common in the diet and appear to provide some health benefits. While flavonoids are primarily derived from soy, many are found in fruits, nuts and more exotic sources, e.g., kudzu. Perhaps the strongest evidence for the benefits of flavonoids in diseases of aging relates to their effect on components of the metabolic syndrome. Flavonoids from soy, grape seed, kudzu and other sources all lower arterial pressure in hypertensive animal models and in a limited number of tests in humans. They also decrease the plasma concentration of lipids and buffer plasma glucose. The underlying mechanisms appear to include antioxidant actions, central nervous system effects, gut transport alterations, fatty acid sequestration and processing, PPAR activation and increases in insulin sensitivity. In animal models of disease, dietary flavonoids also demonstrate a protective effect against cognitive decline, cancer and metabolic disease. However, research also indicates that the flavonoids can be detrimental in some settings and, therefore, are not universally safe. Thus, as the population ages, it is important to determine the impact of these agents on prevention/attenuation of disease, including optimal exposure (intake, timing/duration) and potential contraindications.
Collapse
Affiliation(s)
- J K Prasain
- Department Pharmacology and Toxicology of the University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | | |
Collapse
|
26
|
Physical activity and fibrinogen concentrations in 23,201 men and women in the EPIC-Norfolk population-based study. Atherosclerosis 2008; 198:419-25. [DOI: 10.1016/j.atherosclerosis.2007.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Revised: 09/14/2007] [Accepted: 09/18/2007] [Indexed: 11/30/2022]
|
27
|
Volcik KA, Ballantyne CM, Fuchs FD, Sharrett AR, Boerwinkle E. Relationship of alcohol consumption and type of alcoholic beverage consumed with plasma lipid levels: differences between Whites and African Americans of the ARIC study. Ann Epidemiol 2008; 18:101-7. [PMID: 17855114 PMCID: PMC2819069 DOI: 10.1016/j.annepidem.2007.07.103] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Revised: 06/21/2007] [Accepted: 07/19/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Alcohol consumption has been shown to contribute to a favorable lipid profile, and most studies have reported a reduction in coronary heart disease risk with low-to-moderate consumption of alcohol that is generally attributed to the beneficial effects of alcohol on lipids. The influence of different types of alcoholic beverages on plasma lipid levels has been investigated to a lesser extent and in limited populations. METHODS We investigated the effect of overall alcohol consumption, as well as the type of alcoholic beverage consumed, on multiple lipid measures in the large bi-ethnic population of the Atherosclerosis Risk in Communities study. RESULTS We found both low-to-moderate and heavy alcohol consumption, regardless of the type of alcoholic beverage consumed, to result in significantly greater levels of high-density lipoprotein (HDL) cholesterol, HDL3 cholesterol, and apolipoprotein A-I in both white and African-American males and females. Associations with other lipid measures contrasted between whites and African Americans, with greater levels of alcohol consumption resulting in significantly greater triglyceride levels in African Americans. CONCLUSIONS Our results confirm previous studies associating alcohol consumption, regardless of beverage type, with greater HDL cholesterol levels, with additional consistent associations detected for the major HDL cholesterol density subfraction, HDL3 cholesterol, and the major HDL cholesterol structural apolipoprotein, apolipoprotein A-I.
Collapse
Affiliation(s)
- Kelly A Volcik
- Human Genetics Center, University of Texas Health Science Center, Houston, TX 77030, USA.
| | | | | | | | | |
Collapse
|
28
|
Kushner I, Rzewnicki D, Samols D. What does minor elevation of C-reactive protein signify? Am J Med 2006; 119:166.e17-28. [PMID: 16443421 DOI: 10.1016/j.amjmed.2005.06.057] [Citation(s) in RCA: 247] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Accepted: 06/16/2005] [Indexed: 12/30/2022]
Abstract
Reports of the predictive value of minor elevation of serum C-reactive protein (CRP) levels (between 3 and 10 mg/L) for atherosclerotic events have generated considerable interest, as well as a degree of controversy and confusion. CRP concentrations in this range are found in about one third of the American population. To better understand the mechanisms underlying minor elevation of CRP, we have surveyed its reported associations with a variety of states and conditions. It has become clear that even minimal environmental irritants and inflammatory stimuli elicit a minor CRP response. Minor CRP elevation has been found associated with a number of genetic polymorphisms, with membership in different demographic and socioeconomic groups, with a variety of dietary patterns and with many medical conditions that are not apparently inflammatory. Finally, minor CRP elevation bears negative prognostic implications for many conditions, particularly age-related diseases, and predicts mortality in both diseased and apparently healthy individuals. In sum, minor CRP elevation is associated with a great many diverse conditions, some of which are, or may prove to be, causal. Many of these reported associations imply a mild degree of tissue stress or injury, suggesting the hypothesis that the presence of distressed cells, rather than a resulting inflammatory response, is commonly the stimulus for CRP production.
Collapse
Affiliation(s)
- Irving Kushner
- Department of Medicine, Case Western Reserve University, MetroHealth Medical Center Campus, Cleveland, Ohio, USA.
| | | | | |
Collapse
|
29
|
Peasey A, Bobak M, Malyutina S, Pajak A, Kubinova R, Pikhart H, Kurilovitch S, Poledne R, Marmot M. Do lipids contribute to the lack of cardio-protective effect of binge drinking: alcohol consumption and lipids in three eastern European countries. Alcohol Alcohol 2005; 40:431-5. [PMID: 15939709 DOI: 10.1093/alcalc/agh161] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS The cardio-protective effect of moderate alcohol consumption is partly mediated by HDL cholesterol. However, epidemiological studies suggest that binge drinking may not be associated with reduced risk of heart disease; a possible explanation is that the relationship of blood lipids with binge drinking is different from that with moderate intake. We investigated this hypothesis in a population study in three eastern European countries. METHODS We conducted a cross-sectional study in random population samples in Novosibirsk (Russia), Krakow (Poland) and Karvina (Czech Republic). A sub-sample of 282 men aged 45-64 years who provided a fasting blood sample were analysed. Annual alcohol intake and the frequency of heavy binge drinking (> or =140 g of ethanol per session) were estimated from a graduated frequency questionnaire. RESULTS Annual intake of alcohol was positively associated with total and HDL cholesterol. After controlling for annual intake, the frequency of heavy binge drinking was associated with increased concentrations of total and HDL cholesterol. By combining annual intake and drinking pattern, we found that men consuming >8 l of alcohol per year who had a heavy binge at least once a month had the mean total, HDL and LDL cholesterol 1.69 (SE 0.35), 0.61 (0.11) and 0.97 (0.34) mmol/l, respectively, higher than non-drinkers; this resulted in more favourable ratios of total and LDL cholesterol relative to HDL cholesterol in frequent heavy bingers. Triglycerides were not related to alcohol intake or binge drinking. CONCLUSIONS Blood lipids do not seem to explain the apparent lack of the cardio-protective effect of binge drinking reported in epidemiological studies.
Collapse
Affiliation(s)
- Anne Peasey
- International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WCIE 6BT UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Affiliation(s)
- Ramon Estruch
- Department of Medicine, Hospital Clinic, Institut d'Investgació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | | |
Collapse
|
31
|
Abstract
PURPOSE OF REVIEW Epidemiological studies consistently link moderate alcohol use with a lower risk of cardiovascular disease, but a number of important issues remain controversial. These include the putative impact of non-alcoholic constituents of some alcoholic beverages, the role of genetic factors, potential mechanisms for this association, and confirmation of the relationship in experimental models. RECENT FINDINGS Although high-density lipoprotein cholesterol (HDL-C) is considered the primary mediator of the cardiovascular effects of moderate drinking, recent evidence has shown the alcohol-HDL-C relation is not linear beyond the range of moderate drinking. Moderate alcohol use also has important inverse relations with inflammatory factors. Some, but not all, animal models confirm the anti-atherogenic effects of ethanol and highlight inflammatory factors as one possible mechanism. The non-alcoholic constituents of red wine also have anti-atherogenic and perhaps even life-extending properties in vitro, but their relevance to humans remains uncertain. Genetic variants of the apolipoprotein E and interleukin 6 genes in humans may modify how alcohol influences atherosclerosis, further emphasizing the importance of HDL-C and inflammatory factors as mediators. SUMMARY The robust relationship between moderate drinking and lower risk of cardiovascular disease remains an intriguing area of investigation. Clarifying potential gene-environment interactions and translational research into uses for non-alcoholic components will be important areas for future investigation.
Collapse
Affiliation(s)
- Joseph M Li
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | | |
Collapse
|
32
|
Chrysohoou C, Panagiotakos DB, Pitsavos C, Antoniades C, Skoumas J, Brown M, Stefanadis C. Evidence for association between endothelial nitric oxide synthase gene polymorphism (G894T) and inflammatory markers: the ATTICA study. Am Heart J 2004; 148:733-8. [PMID: 15459608 DOI: 10.1016/j.ahj.2004.04.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We evaluated the effect of the point mutation of guanine to thymine at nucleotide position 894 (G894T) of the endothelial nitric oxide synthase (eNOS) gene on inflammatory and oxidative stress markers. METHODS We studied genetic information from 270 men (18-87 years old) and 325 women (18-89 years old). Participants without any clinical evidence of cardiovascular or other atherosclerotic disease were randomly selected from the general population according to the age-sex distribution of Athens greater area. Genomic DNA was extracted from 2 to 5 mL of fresh or frozen whole blood using standard methods. RESULTS The DNA analysis showed that 10.6% of the participants were Asp-homozygotes (Asp/Asp), 40% heterozygotes (Asp/Glu) and 49.4% Glu-homozygotes (Glu/Glu). Compared to Asp/Glu and Glu/Glu, Asp/Asp had higher levels of fibrinogen (332 +/- 46 or 329 +/- 33 vs 319 +/- 29 mg/dL, P =.029), white blood cells (6.9 +/- 0.6 or 6.5 +/- 0.3 vs 6.1 +/- 0.9 x 10(3) counts, P =.044), and oxidized low-density lipoprotein cholesterol (68 +/- 21 or 61 +/- 22 vs 59 +/- 20 mg/dL, P =.039), after controlling for several potential confounders. An insignificant association was found between homocysteine (P =.08), C-reactive protein (P =.096), and the distribution of G894T polymorphism (P <.1). No association between the distribution of the polymorphism and hypertension status of the participants was observed. CONCLUSIONS Our results imply that G894T polymorphism of the endothelial nitric oxide synthase gene is associated with elevated levels of inflammatory and oxidative stress markers, which may partially explain the increased prevalence of G894T polymorphism among patients with cardiovascular disease.
Collapse
Affiliation(s)
- Christine Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | | | | | | | | | | | |
Collapse
|
33
|
Gikas A, Triantafillidis JK, Apostolidis N, Mallas E, Peros G, Androulakis G. Relationship of smoking and coffee and alcohol consumption with seroconversion to Helicobacter pylori: a longitudinal study in hospital workers. J Gastroenterol Hepatol 2004; 19:927-33. [PMID: 15242498 DOI: 10.1111/j.1440-1746.2004.03404.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIM There are few data concerning the relationship between Helicobacter pylori seroconversion, and smoking habits and coffee and alcohol consumption. The aim of the present study was to investigate the relationship between smoking habits, coffee and alcohol consumption, and H. pylori seroconversion. METHODS The data used were derived from a sample of 238 subjects (hospital employees) who were initially (on 1994) seronegative to H. pylori. These subjects were tested again 5 years later (1999). Information concerning smoking habits and coffee and alcohol consumption was collected by the use of a special questionnaire, which was completed by the same cohort of subjects in two different periods (1994 and 1999). Logistic regression was used to assess the relationship between H. pylori seroconversion and the aforementioned lifestyle factors. RESULTS Neither smoking nor coffee consumption was significantly related to H. pylori seroconversion. Adjusted odds ratio for alcohol drinkers as compared with non-/occasional drinkers was 0.59 (95% confidence interval [CI]: 0.31-1.16, P = 0.13). However, the odds ratio was significantly lower (0.26, 95%CI: 0.07-0.95, P = 0.042) in subjects who reported moderate alcohol consumption at first (1994) examination, as compared with non-/occasional drinkers. Small and heavy drinking were not associated with H. pylori seroconversion. CONCLUSIONS There is no significant relation between H. pylori seroconversion and smoking and coffee consumption. The present findings suggest that moderate alcohol consumption might be inversely associated with H. pylori seroconversion.
Collapse
Affiliation(s)
- Aristofanis Gikas
- Department of Gastroenterology, Saint Panteleimon General State Hospital, Nicea, Greece.
| | | | | | | | | | | |
Collapse
|
34
|
Skoumas J, Pitsavos C, Panagiotakos DB, Chrysohoou C, Zeimbekis A, Papaioannou I, Toutouza M, Toutouzas P, Stefanadis C. Physical activity, high density lipoprotein cholesterol and other lipids levels, in men and women from the ATTICA study. Lipids Health Dis 2003; 2:3. [PMID: 12852790 PMCID: PMC194868 DOI: 10.1186/1476-511x-2-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2003] [Accepted: 06/12/2003] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Physical activity has long been associated with reduced risk of coronary heart disease (CHD). In this work we evaluated the effect of physical activity on lipid levels, in a sample of cardiovascular disease free people. METHODS The ATTICA study is a population-based cohort that has randomly enrolled 2772 individuals, stratified by age-gender (according to the census 2001), from the greater area of Athens, during 2001-2002. Of them, 1376 were men (45 +/- 12 years old, range: 18-86) and 1396 women (45 +/- 13 years old, range: 18-88). We assessed the relationship between physical activity status (measured in kcal/min expended per day) and several lipids, after taking into account the effect of several characteristics of the participants. RESULTS 578 (42%) men and 584 (40%) women were classified as physically active. Compared to sedentary physically active women had significantly lower levels of total serum cholesterol (p < 0.05), LDL (p < 0.05) and oxidized LDL cholesterol (p < 0.05), triglycerides (p < 0.05), apolipoprotein B (p < 0.05), and higher levels of HDL cholesterol (p < 0.05) and apolipoprotein A1 (p < 0.05). Similar associations were observed in men, but the benefits did not reach statistical significance. However, when we adjusted for age, smoking habits and body mass index, physical activity was only significantly associated with higher HDL-cholesterol (p < 0.05) and apolipoprotein A1 (p < 0.05) levels, in women, but not in men. CONCLUSIONS Substantial independent increases in HDL-cholesterol and apolipoprotein A1 concentrations were observed in women, but not in men, in a Mediterranean cohort.
Collapse
Affiliation(s)
- John Skoumas
- Cardiology Clinic, School of Medicine, University of Athens, Greece
| | | | | | | | - Akis Zeimbekis
- Cardiology Clinic, School of Medicine, University of Athens, Greece
| | | | - Marina Toutouza
- Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - Pavlos Toutouzas
- Cardiology Clinic, School of Medicine, University of Athens, Greece
| | | |
Collapse
|