Vu Khanh N, Ballantyne Christie M, Hoogeveen Ron C, Nambi Vijay, Volcik Kelly A, Boerwinkle Eric, Morrison Alanna C
School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States of America.
Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, United States of America.
PLoS One. 2016 Feb 5;11(2):e0148765. doi: 10.1371/journal.pone.0148765. eCollection 2016.
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.
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.
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).
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.
低至适度饮酒对健康的益处可能通过改善血脂状况来实现。采用孟德尔随机化（MR）方法来研究饮酒是否对血脂水平有因果影响。
该分析纳入了来自社区动脉粥样硬化风险（ARIC）研究的10893名欧裔美国人（EA）。对乙醇脱氢酶和乙醛脱氢酶基因中的常见和罕见变异进行了MR假设评估。选择位于ADH1B、ADH1C和ADH4基因中的五个变异作为遗传工具，并将其合并为一个未加权的遗传评分。分析了甘油三酯（TG）、总胆固醇、高密度脂蛋白胆固醇（HDL-c）及其亚组分（HDL2-c和HDL3-c）、低密度脂蛋白胆固醇（LDL-c）、小而密低密度脂蛋白胆固醇（sdLDL-c）、载脂蛋白B（apoB）和脂蛋白（a）[Lp（a）]水平。
饮酒显著升高了HDL2-c水平，并降低了TG、总胆固醇、LDL-c、sdLDL-c和apoB水平。对于这些血脂指标中的每一项，均观察到非线性趋势。与饮酒量的第一个四分位数相比，第三个四分位数的TG水平降低了12.3%（p<0.001），总胆固醇水平降低了7.71mg/dL（p=0.007），HDL2-c水平升高了10.3%（p=0.007），LDL-c水平降低了6.87mg/dL（p=0.012），sdLDL-c水平降低了7.4%（p=0.037），apoB水平降低了3.5%（p=0.058，总体p=0.022）。
本研究支持规律的低至适度饮酒在升高HDL2-c、降低TG、总胆固醇和LDL-c方面的因果作用，并为低至适度饮酒可降低EA人群的apoB和sdLDL-c水平这一新发现提供了证据。然而，鉴于饮酒影响的非线性，即使在低至适度饮酒范围内，饮酒量增加并不总是会带来更大的益处。
