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Alcohol in moderation may lower risk of diabetes, metabolic syndrome

Posted Dec 12 2010 12:00am

With the emergence of an epidemic of obesity and type 2 diabetes (DM) throughout the world, the association of lifestyle habits that may affect the risk of metabolic diseases is especially important. Most prospective studies have shown that moderate alcohol drinkers tend to have about 30 percent lower risk of developing late onset diabetes than do non-drinkers, and moderate drinkers also tend to be at lower risk of developing metabolic syndrome (MS). A cross-sectional analysis of 6172 subjects ages 35 to 75 years in Switzerland related varying levels of alcohol intake to the presence of (diabetes mellitus) DM, metabolic syndrome (MS), and an index of insulin resistance (HOMA-IR).

Alcohol consumption was categorized as non-drinkers (0), low-risk (1-13 drinks per week), medium-to-high-risk (14-34 drinks/week), and very-high-risk (35 or more drinks/week) drinkers. 73 percent of participants consumed alcohol, 16 percent were medium-to-high-risk drinkers, and 2 percent very-high risk drinkers.

Study findings: In multivariate analysis, the prevalence of the metabolic syndrome, type 2 diabetes and the mean HOMA-IR all decreased with low-risk drinking and increased with high-risk drinking. Adjusted prevalence of the metabolic syndrome was 24 percent in non-drinkers, 19 percent in low-risk, 20 percent in medium-to-high-risk and 29 percent in very-high-risk drinkers. Adjusted prevalence of diabetes was 6.0 percent in non-drinkers, 3.6 percent in low-risk, 3.8 percent in medium-to-high-risk and 6.7 percent in very-high-risk drinkers. These relationships did not differ according to beverage types.

Moderate drinkers also had the lowest weight, tryglycerides, and blood pressure. All drinkers had higher HDL-cholesterol values (”good cholesterol”) than did non-drinkers.

Comments from the academic forum:

Metabolic syndrome is the name given to a so-called “lifestyle disease,” where patients exhibit multiple medical problems including high blood pressure, late onset diabetes, and high cholesterol.

The strengths of this paper include being population-based and having a large number of subjects who reported that they consumed 14 or more drinks/week. Also, there was a good percentage (27 percent) of subjects reporting no alcohol intake during the one week of assessment used for classifying subjects. Another strength is the careful confirmation of drinking status with state-of-the-art laboratory tests. In multivariate analysis, the prevalence of the metabolic syndrome, type 2 diabetes and the mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. No differences in risk or prevention were noted according to the type of beverage consumed.

This is a cross-sectional analysis, so a causative relation between alcohol intake and the metabolic outcomes cannot be assessed. Still, the data supports much that has been shown in prospective studies. Several Forum members commented on potential problems when considering a number of physiologic conditions as the “metabolic syndrome” and focusing therapy on the syndrome; they believed that each metabolic factor should be evaluated and treated singly (Courtesy of EurekAlert!, a service of AAAS).

The authors’ abstract and details from the forum critique are available free online here:

Reference: Clerc O, et al. Alcohol drinking, the metabolic syndrome and diabetes in a population with high mean alcohol consumption. Diabet Med 2010;27: 1241-1249.

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