Kuwahara Keisuke, Kochi Takeshi, Nanri Akiko, Tsuruoka Hiroko, Kurotani Kayo, Pham Ngoc Minh, Akter Shamima, Kabe Isamu, Mizoue Tetsuya
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Alcohol Clin Exp Res. 2014 Apr;38(4):1042-8. doi: 10.1111/acer.12323. Epub 2014 Jan 15.
Influences of alcohol use on glucose metabolism may depend on alcohol flushing response. We investigated the effect of alcohol flushing response on the associations between alcohol consumption and markers of glucose metabolism in Japanese men and women.
The subjects were 979 employees (885 men and 94 women), aged 18 to 69 years, of a manufacturing company in Japan. Flushing response and alcohol consumption were determined using a self-administered questionnaire. Homeostasis model assessment-insulin resistance (HOMA-IR) and homeostasis model assessment for β-cell function (HOMA-β) were computed using fasting plasma glucose and insulin. For each group of flushers and nonflushers, multiple regression analysis was used to estimate means of fasting plasma glucose, hemoglobin A1c (HbA1c), and HOMAs for each category of alcohol consumption, with adjustments for potential confounders.
In flushers, alcohol consumption was associated with HbA1c levels in a U-shaped manner, with the lowest HbA1c levels being observed at an alcohol consumption level of 23.0 to <34.5 g ethanol/d (p for quadratic trend = 0.002). In nonflushers, alcohol consumption was linearly and inversely associated with HbA1c levels (p for linear trend = 0.001). Decreases in HbA1c were more evident among flushers compared with nonflushers at moderate alcohol consumption levels (p for interaction = 0.049). An increase of fasting glucose associated with highest alcohol consumption was observed in both flushers and nonflushers. A statistically significant decrease in HOMA-IR with increasing alcohol consumption was observed in flushers (p for trend = 0.007), whereas HOMA-IR levels slightly decreased at higher alcohol consumption in nonflushers. HOMA-β similarly decreased with increasing alcohol consumption in both flushers and nonflushers (both p for trend < 0.001).
The results suggest that the alcohol flushing response may improve glucose metabolism and insulin resistance at moderate alcohol use levels in apparently healthy Japanese adults.
饮酒对葡萄糖代谢的影响可能取决于酒精潮红反应。我们研究了酒精潮红反应对日本男性和女性饮酒量与葡萄糖代谢标志物之间关联的影响。
研究对象为日本一家制造公司的979名员工（885名男性和94名女性），年龄在18至69岁之间。使用自我管理问卷确定潮红反应和饮酒量。使用空腹血糖和胰岛素计算稳态模型评估胰岛素抵抗（HOMA-IR）和β细胞功能稳态模型评估（HOMA-β）。对于每组潮红者和非潮红者，采用多元回归分析估计每种饮酒量类别下空腹血糖、糖化血红蛋白（HbA1c）和HOMA的均值，并对潜在混杂因素进行调整。
在潮红者中，饮酒量与HbA1c水平呈U形关联，在酒精摄入量为23.0至<34.5克乙醇/天时观察到最低的HbA1c水平（二次趋势p = 0.002）。在非潮红者中，饮酒量与HbA1c水平呈线性负相关（线性趋势p = 0.001）。在中等饮酒量水平下，潮红者的HbA1c下降比非潮红者更明显（交互作用p = 0.049）。在潮红者和非潮红者中，均观察到与最高饮酒量相关的空腹血糖升高。在潮红者中，随着饮酒量增加，HOMA-IR有统计学意义的下降（趋势p = 0.007），而非潮红者在较高饮酒量时HOMA-IR水平略有下降。在潮红者和非潮红者中，HOMA-β均随着饮酒量增加而类似地下降（趋势p均<0.001）。
结果表明，在明显健康的日本成年人中，酒精潮红反应可能在适度饮酒水平下改善葡萄糖代谢和胰岛素抵抗。
