Hung Chung-Lieh, Chang Shun-Chuan, Chang Sheng-Hsiung, Chi Po-Ching, Lai Yu-Jun, Wang Shih-Wei, Wu Yih-Jer, Yeh Hung-I, Lin Shing-Jong, Chen Che-Hong, Mochly-Rosen Daria, Wang Li-Yu
Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Zhongzheng Rd. New Taipei City Sanzhi Dist. 252, New Taipei City 25245, Taiwan.
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Section 2, Chung Shan North Road, Taipei 10449, Taiwan.
Alcohol Alcohol. 2017 Nov 1;52(6):638-646. doi: 10.1093/alcalc/agx049.
Excessive consumption of alcoholic beverages is associated with cardiac remodeling and cardiomyopathy. We examined the possible association of alcohol use, common Asian genetic variants in genes involved in alcohol metabolism, and cardiac structures/functions alterations.
A prospective, community-dwelling survey among individuals with available complete echocardiography examined the associations of alcohol use, cardiac structure/functions, and three common alcohol metabolizing genetic variants, including aldehyde dehydrogenase 2 (ALDH2), alcohol dehydrogenase 1B (ADH1B) and cytochrome P450 (CYP) isoform 2E1 (CYP2E1).
Among 1577 participants (mean age: 53 ± 9, 59.7% female), we observed that in subjects with more frequent weekly ethanol intake showed greater left ventricle (LV) mass, more impaired diastolic functions, and reduced global longitudinal strain (GLS), systolic (SRs) and early diastolic strain rates (SRe) (P<0.05). After propensity matching for clinical confounders (n = 330:30 for frequent users and non-users), frequent alcohol use and subjects carrying ALDH2 (A/G or A/A), ADH1B (A/A) or CYP2E1(T/C or T/T) polymorphisms were all associated with worse GLSRs and GLSRe, with combined alcohol use and any given genetic variant aggravated these associations (all P < 0.05). Finally, we observed Gene-Gene synergistic effects on LV functional decline in frequent alcohol users by using linear mixed effect model (all interaction P < 0.05).
Among East Asians, even moderate alcohol consumption can confer subclinical adverse effects on cardiac systolic functions, which was most pronounced in subjects carrying common variants in alcohol metabolizing genes. These findings challenge the notion of beneficial influences of less heavy ethanol consumption on the heart, especially among East Asians.
This study evaluated the association of level of alcohol consumption and genetic variants in genes involved in alcohol metabolism with changes in cardiac function in East Asians. Even moderate alcohol use conferred subclinical adverse effects on cardiac systolic functions, which were most pronounced in subjects carrying common alcohol metabolizing genes.
过量饮用酒精饮料与心脏重塑和心肌病有关。我们研究了饮酒、亚洲人群中酒精代谢相关基因的常见遗传变异与心脏结构/功能改变之间的可能关联。
对有完整超声心动图检查结果的社区居民进行前瞻性调查，研究饮酒、心脏结构/功能与三种常见酒精代谢基因变异之间的关联，这三种基因变异包括乙醛脱氢酶2（ALDH2）、乙醇脱氢酶1B（ADH1B）和细胞色素P450（CYP）同工酶2E1（CYP2E1）。
在1577名参与者中（平均年龄：53±9岁，女性占59.7%），我们观察到每周饮酒更频繁的受试者左心室（LV）质量更大、舒张功能受损更严重、整体纵向应变（GLS）、收缩期（SRs）和舒张早期应变率（SRe）降低（P<0.05）。在对临床混杂因素进行倾向匹配后（n = 330：频繁饮酒者与不饮酒者比例为30:1），频繁饮酒以及携带ALDH2（A/G或A/A）、ADH1B（A/A）或CYP2E1（T/C或T/T）多态性的受试者均与较差的GLSRs和GLSRe相关，饮酒与任何特定基因变异共同作用会加剧这些关联（所有P < 0.05）。最后，我们使用线性混合效应模型观察到频繁饮酒者中基因-基因对左心室功能下降的协同效应（所有相互作用P < 0.05）。
在东亚人群中，即使适度饮酒也可能对心脏收缩功能产生亚临床不良影响，这在携带酒精代谢基因常见变异的受试者中最为明显。这些发现挑战了少量饮酒对心脏有益的观点，尤其是在东亚人群中。
本研究评估了东亚人群中饮酒水平和酒精代谢相关基因变异与心脏功能变化之间的关联。即使适度饮酒也会对心脏收缩功能产生亚临床不良影响，这在携带常见酒精代谢基因的受试者中最为明显。
