Koppes Lando L J, Twisk J W R, Van Mechelen W, Snel J, Kemper H C G
EMGO Institute, VU University Medical Center, Department of Public and Occupational Health, Amsterdam, The Netherlands.
J Stud Alcohol. 2005 Nov;66(6):713-21. doi: 10.15288/jsa.2005.66.713.
Serum lipids, blood pressure and body mass may mediate the U-shaped relationship of alcohol consumption with type 2 diabetes mellitus and coronary heart disease. This study examines the cross-sectional and long-term longitudinal relationships of (changes in) alcohol consumption with (changes in) serum lipids, blood pressure and body mass indices.
In this prospective, observational cohort study, two measurements of alcohol consumption, serum total and high-density lipoprotein cholesterol, triglycerides, blood pressure, body weight, the thickness of four skinfolds and waist circumference were performed 4 years apart in healthy volunteers (143 men and 174 women, 32 years old at the first measurement). Alcohol consumption from beer, wine and distilled spirits was assessed using an extensive dietary history interview. Linear regression analyses were performed to study the cross-sectional relationships between the amount of alcohol consumed at the age of 32 years and the levels of the lipids, blood pressure and body weight indices, and to study the longitudinal relationships between the changes in the amount of alcohol consumed over the 4 years of follow-up and the concurrent changes in the lipids, blood pressure and body weight indices. Nonlinearity was investigated for the cross-sectional relationships.
A 10-g/day difference in alcohol consumption was positively related with a 0.05 mmol/L (1.9 mg/dl) difference in high-density lipoprotein cholesterol in both cross-sectional (p = .004), and longitudinal (p < .0001) analyses. This relationship did not differ for men and women or for the consumption of beer, wine or distilled spirits. Relationships with changes in total cholesterol, triglycerides, systolic, diastolic, and pulse pressure, body weight and the sum of four skinfolds were not significant. A borderline significant inverse longitudinal relationship was found with waist circumference. The other lifestyle behaviors (tobacco smoking, physical activity and dietary habits) were major confounders of most cross-sectional relationships between alcohol and serum lipids, blood pressure and body mass indices. The longitudinal relationships, however, were not confounded by changes in the other lifestyle behaviors. A significant nonlinear relationship was found for systolic blood pressure, in which drinkers of about 30 g/day had the lowest values.
Moderate alcohol consumption and moderate long-term changes in alcohol consumption are positively related with the levels and changes in high-density lipoprotein cholesterol in healthy adult men and women. A moderate inverse association between alcohol and waist circumference may be expected. No relationships were found with triglycerides, blood pressure, body weight and the sum of the thickness of four skinfolds. Other lifestyle behaviors confound the cross-sectional, but not the longitudinal, relationships between alcohol consumption and serum lipids, blood pressure and body mass indices. Gender and type of beverage do not modify the relationships between alcohol consumption and these indices.
血清脂质、血压和体重可能介导饮酒量与2型糖尿病和冠心病之间的U型关系。本研究探讨饮酒量（变化）与血清脂质、血压和体重指数（变化）之间的横断面关系和长期纵向关系。
在这项前瞻性观察队列研究中，对健康志愿者（143名男性和174名女性，首次测量时年龄为32岁）进行了两次饮酒量、血清总胆固醇和高密度脂蛋白胆固醇、甘油三酯、血压、体重、四处皮褶厚度和腰围测量，两次测量间隔4年。通过广泛的饮食史访谈评估啤酒、葡萄酒和蒸馏酒的饮酒量。进行线性回归分析，以研究32岁时饮酒量与脂质、血压和体重指数水平之间的横断面关系，以及随访4年期间饮酒量变化与脂质、血压和体重指数同期变化之间的纵向关系。对横断面关系进行非线性研究。
在横断面分析（p = .004）和纵向分析（p < .0001）中，饮酒量每天相差10克与高密度脂蛋白胆固醇相差0.05 mmol/L（1.9 mg/dl）呈正相关。这种关系在男性和女性中以及啤酒、葡萄酒或蒸馏酒的消费情况中并无差异。与总胆固醇、甘油三酯、收缩压、舒张压、脉压、体重和四处皮褶厚度总和的变化之间的关系不显著。发现与腰围存在边缘显著的反向纵向关系。其他生活方式行为（吸烟、体育活动和饮食习惯）是饮酒与血清脂质、血压和体重指数之间大多数横断面关系的主要混杂因素。然而，纵向关系并未因其他生活方式行为的变化而受到混杂。发现收缩压存在显著的非线性关系，即每天饮酒约30克者的收缩压值最低。
适度饮酒以及饮酒量的适度长期变化与健康成年男性和女性高密度脂蛋白胆固醇的水平及变化呈正相关。预计饮酒与腰围之间存在适度的负相关。未发现与甘油三酯、血压、体重和四处皮褶厚度总和存在关系。其他生活方式行为会混淆饮酒与血清脂质、血压和体重指数之间的横断面关系，但不会混淆纵向关系。性别和饮料类型不会改变饮酒与这些指标之间的关系。
