Alcohol consumption and lipodystrophy in HIV-infected adults with alcohol problems

Lipodystrophy is a common long-term complication of HIV infection that may lead to decreased quality of life and less adherence to antiretroviral therapy (ART). A complete understanding of the etiology of HIV-associated lipodystrophy has not yet been achieved, although factors related to the virus, per se, and use of ART appear to be related. Alcohol use is common among HIV-infected patients and has biological effects on fat distribution, yet alcohol's relationship to HIV-associated lipodystrophy has not been examined. The goal of this clinical study was to assess the effect of alcohol consumption on lipodystrophy in HIV-infected adults with alcohol problems. This was a prospective study (2001-2006) of 289 HIV-infected persons with alcohol problems. The primary outcome was self-reported lipodystrophy, which was assessed at one time point (median 29 months after enrollment). Alcohol use was assessed every 6 months and classified as: abstinent at all interviews; ≥1 report of moderate drinking but no heavy drinking; 1 or 2 reports of heavy drinking; or ≥3 reports of heavy drinking. Multivariable logistic regression models were fit to the data. Fifty-two percent (150/289) of subjects reported lipodystrophy. Alcohol consumption was: 34% abstinent at all interviews; 12% ≥1 report of moderate drinking, but no heavy drinking; 34% 1-2 reports of heavy drinking; and 20% ≥3 reports of heavy drinking. Although not statistically significant, subjects with alcohol use had a higher odds of lipodystrophy (adjusted odds ratios and 95% confidence interval: ≥1 report of moderate drinking, 2.36 [0.89, 6.24]; 1-2 reports of heavy drinking, 1.34 [0.69, 2.60]; ≥3 reports of heavy drinking, 2.07 [0.90, 4.73]). Alcohol use may increase the odds of developing HIV-associated lipodystrophy among subjects with alcohol problems. However, larger studies are needed to fully elucidate the role and impact of alcohol consumption on the development of this common long-term complication of HIV infection and its treatment.     

Alcohol consumption, cardiovascular health, and endothelial function markers

Cardiovascular diseases are among the worldwide leading causes of shorter life expectancy and loss of quality of life. Thus, any influence of diet or life habits on the cardiovascular system may have important implications for public health. Most world populations consume alcoholic beverages. Since alcohol may have both protective and harmful effects on cardiovascular health, the identification of biochemical mechanisms that could explain such paradoxical effects is warranted. The vascular endothelium is the target of important mediating pathways of differential ethanol concentrations, such as oxidative stress, lipoproteins, and insulin resistance. Alcohol-induced endothelial damage or protection may be related to the synthesis or action of several markers, such as nitric oxide, cortisol, endothelin-1, adhesion molecules, tumor necrosis factor alpha, interleukin-6, C-reactive protein, and haemostatic factors. The expression of these markers is consistent with the J-shaped curve between alcohol consumption and cardiovascular health. However, there is genetic and phenotypic heterogeneity in alcohol response, and despite the apparent beneficial biochemical effects of low doses of ethanol, there is not enough clinical and epidemiological evidence to allow the recommendation to consume alcoholic beverages for abstemious individuals. Considering the potential for addiction of alcoholic beverage consumption and other negative consequences of alcohol, it would be worthwhile to identify substances able to mimic the beneficial effects of low doses of ethanol without its adverse effects.     

Effect of alcohol consumption during pregnancy on total and high-density lipoprotein cholesterol levels in the rat

The effect of alcohol consumption during pregnancy on total and high-density lipoprotein cholesterol levels was studied in Sprague-Dawley rats. Animals were assigned to one of three groups (n=6/group). Group 1 received 10% ethanol (v/v) in drinking water and lab chow ad libitum. After one week, the ethanol content was increased to 20%. Group 2 animals received the amount of chow consumed by Group 1 animals during the previous 24 hours, plus corn starch calorically equivalent to the alcohol consumed, whereas Group 3 animals received chow and water ad libitum. After four weeks on these diets, animals were bred and the concentration of ethanol in drinking water of Group 1 animals was increased to 30%. Animals were sacrificed on day 21 of gestation, and serum was analyzed for total and high-density lipoprotein (HDL) cholesterol levels. Alcohol-fed animals had total cholesterol levels averaging 54.1 mg/dl, significantly lower than levels in both pair-fed (79.4 mg/dl) and ad libitum controls (90.0 mg/dl). HDL cholesterol levels in the alcohol-fed animals were also lower than those in ad libitum controls (27.5 mg/dl vs. 40.0 mg/dl, p<0.05). These observations in pregnant females contrast with the effect of alcohol on HDL cholesterol levels in male animals.     

饮酒与健康

“饮酒与健康”是一个古老的话题。就对健康的影响而言 ,酒是一把“双刃剑” ,即过量饮酒有害健康 ,而适量饮酒有益于健康。近 10多年来 ,适量饮酒对健康的好处引起了许多学者的极大兴趣。许多流行病学和实验研究已证实 ,适量饮酒 ,尤其是红葡萄酒 ,可明显降低心血管疾病的危险性 ,抑制某些肿瘤的生长 ,以及减少阿尔海默化病和痴呆的危险性 ,等等。作者着重介绍适当饮酒有益于健康的最新研究成果及其机理 ,旨在指导人们科学饮酒 ,提高健康水准。     

Alcohol: A Nutrient with Multiple Salutary Effects

Numerous studies have shown that cardiovascular disease is lower among alcohol consumers than among nonconsumers. Many of the metabolic effects of alcohol are mediated by its terminal metabolite, acetate, which has reported insulinemic properties. There have been few rational metabolic targets that underly its cardioprotective effects until it was reported that acetate, the terminal product of alcohol metabolism, is the ligand for G-protein coupled receptor 43 (GPCR43), which is highly expressed in adipose tissue. Here, we recast much of some of the major lipid and lipoprotein effects of alcohol in the context of this newly discovered G-protein and develop a mechanistic model connecting the interaction of acetate with adipose tissue-GPCR43 with these effects. According to our model, ingestions of acetate could replace alcohol as a means of improving plasma lipid risk factors, improving glucose disposal, and reducing cardiovascular disease. Future studies should include biochemical, cell, animal, and human tests of acetate on energy metabolism.     

Extra Virgin Olive Oil Prevents the Age-Related Shifts of the Distribution of HDL Subclasses and Improves Their Functionality

High-density lipoproteins (HDL) maintain cholesterol homeostasis through the role they play in regulating reverse cholesterol transport (RCT), a process by which excess cholesterol is transported back to the liver for elimination. However, RCT can be altered in the presence of cardiovascular risk factors, such as aging, which contributes to the increase in the incidence of cardiovascular diseases (CVD). The present study was aimed at investigating the effect of extra virgin olive oil (EVOO) intake on the cholesterol efflux capacity (CEC) of HDL, and to elucidate on the mechanisms by which EVOO intake improves the anti-atherogenic activity of HDL. A total of 84 healthy women and men were enrolled and were distributed, according to age, into two groups: 27 young (31.81 ± 6.79 years) and 57 elderly (70.72 ± 5.6 years) subjects. The subjects in both groups were given 25 mL/d of extra virgin olive oil (EVOO) for 12 weeks. CEC was measured using J774 macrophages radiolabeled with tritiated cholesterol ((³H) cholesterol). HDL subclass distributions were analyzed using the Quantimetrix Lipoprint® system. The HDL from the elderly subjects exhibited a lower level of CEC, at 11.12% (p < 0.0001), than the HDL from the young subjects. The CEC of the elderly subjects returned to normal levels following 12 weeks of EVOO intake. An analysis of the distribution of HDL subclasses showed that HDL from the elderly subjects were composed of lower levels of large HDL (L-HDL) (p < 0.03) and higher levels of small HDL (S-HDL) (p < 0.002) compared to HDL from the young subjects. A multiple linear regression analysis revealed a positive correlation between CEC and L-HDL levels (r = 0.35 and p < 0.001) as well as an inverse correlation between CEC and S-HDL levels (r = −0.27 and p < 0.01). This correlation remained significant even when several variables, including age, sex, and BMI as well as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose levels (β = 0.28, p < 0.002, and β = 0.24, p = 0.01) were accounted for. Consuming EVOO for 12 weeks modulated the age-related difference in the distribution of HDL subclasses by reducing the level of S-HDL and increasing the level of intermediate-HDL/large-HDL (I-HDL/L-HDL) in the elderly subjects. The age-related alteration of the CEC of HDL was due, in part, to an alteration in the distribution of HDL subclasses. A diet enriched in EVOO improved the functionality of HDL through an increase in I-HDL/L-HDL and a decrease in S-HDL.     

Alcohol consumption and blood pressure. An Italian study

We studied the relationship between alcohol consumption and arterial pressure in 1190 subjects of both sexes aged between 18 and 63 years who were examined during the course of a program of preventive medicine organized by Centro Diagnostico Italiano. In 711 subjects who were not requested to alter their usual alcohol consumption we found a significant relationship between alcohol consumption and systolic arterial pressure, b+SE(b), 4.6 ± 2.1 mmHg/100 g ethanol/day. In particular, males who were heavy drinkers (> 50 g_ethanol/day) presented significantly higher systolic pressure levels than the other men, d±SE(d), 3.7 ± 1.6 mmHg, whereas no significant differences were observed among the various classes of women subdivided according to alcohol intake (only 4.6% of the women consumed > 50 g ethanol/day). On the other hand, in 479 subjects who were requested to abstain from alcohol consumption during the three days preceding the examination, no significant relation was found between alcohol intake and arterial pressure. The difference between the systolic pressure levels of the male heavy drinkers and those of the male moderate and non-drinkers was only 0.1 mmHg.Excessive alcohol consumption, in this case, mainly in the form of wine, was therefore associated with higher systolic pressure levels. However, it seems that abstaining from alcohol for even a brief period may modify this relation considerably.     

Alcohol consumption and risk of colorectal cancer: the Findrink study

We investigated the association between alcohol consumption and colorectal cancer because previous studies have yielded conflicting results. As part of the Findrink study, data from the Kuopio Ischaemic Heart Disease (KIHD) Risk Factor Study were analysed. The KIHD study is a cohort of 2,682 men from Eastern Finland with no history of cancer at baseline. The men were grouped into five groups according to their weekly alcohol intake in grams. Association between alcohol and colorectal cancer was examined using Cox proportional hazard models. There were 59 cases of colorectal cancer during an average follow up of 16.7 years. Men within the highest quintile of alcohol consumption had a median weekly alcohol intake of 198.8 g. Age and examination year adjusted risk ratio of colorectal cancer among men within the highest quintile of alcohol consumption was 4.4 (95% CI: 1.6-11.9, P-value = 0.004). After adjusting for potential confounders, such as vegetable consumption, fibre intake, smoking, family history of cancer, socio-economic status, leisure time physical activity, men with the highest amount of alcohol consumption still had a 3.5-fold (95% CI: 1.2-9.9, P-value = 0.021) increased risk of colorectal cancer. Exclusion of men diagnosed with colorectal cancer during the first 2 years of follow up from the analyses did not alter the risk increase. In conclusion, this study gives further evidence of a positive association between alcohol consumption and the risk of colorectal cancer.     

Optimum alcohol taxation: Balancing consumption and external costs

This paper considers alternative approaches to the evaluation of the total cost of alcohol consumption in Australia. It calculates the impact of alternative tax rates on beer, wine and spirits separately and the ‘consumption cost’ of these taxes in terms of the distortion caused to consumption patterns. Two separate analyses are carried out. First optimal taxation is calculated which minimises the total loss from the ‘consumption cost’ of taxation plus the external cost of alcohol consumption. Secondly, the benefits of life are separated from other benefits and the impact of tax expressed in terms of the cost per life year gained. Conceptualised in this way, the results of this ‘tax’ program may be expressed in the same way as other health programs, namely as a net cost per life year gained. Alcohol taxation may then be compared with other life saving interventions. The chief conclusion reached is that in Australia there is a very compelling case for a new tax base and for a very significant increase in the rate of alcohol taxation.     

The density of alcohol outlets and adolescent alcohol consumption: An Australian longitudinal analysis

Higher density of alcohol outlets has been linked to increased levels of adolescent alcohol-related behaviour. Research to date has been cross-sectional. A longitudinal design using two waves of annual survey data from the Australian arm of the International Youth Development Study was used. The sample comprised 2835 individuals with average age at wave 2 of 14 years (SD=1.67; range=11–17 years). GSEM was used to examine how absolute levels of alcohol outlet density was associated with student-reported alcohol use one year later, while controlling for prior alcohol use, risk factors at wave one and changes in density over the 2 years. Adolescents' perception of alcohol availability and friends' alcohol use were tested as potential mediators of the association between alcohol outlet density and adolescent alcohol use. Elasticity modelling identified a 10% increase in overall density at wave one was associated with an approximately 17% increase in odds of adolescent alcohol consumption at wave two. Living in areas with a higher density of outlets was associated with a statistically significant increase in the likelihood of adolescents developing early age alcohol consumption.     

Associations of alcohol consumption with blood pressure, lipoproteins, and subclinical inflammation among Turks

Gender-related impact of alcohol consumption on blood pressure (BP), serum lipoprotein profile, and C-reactive protein (CRP) concentrations was evaluated prospectively. Alcohol drinking status was assessed as abstainers and categories of light, moderate, and heavy (daily >40 ml ethanol) intake. Mean age of the 3,443 men and women who were followed up for a mean of 7.4 years was 47.6 ± 12 years. In each multivariable linear or logistic regression analysis, alcohol drinking status was adjusted for age, sex, smoking status, and physical activity. Among men, drinking was significantly associated positively with low-density lipo protein (LDL) cholesterol, apolipoprotein (apo) B, systolic and diastolic BP, and with CRP in a log-linear manner exhibiting features of a threshold at heavy drinking. With respect to response of serum triglycerides to light-to-moderate drinking, whereas men exhibited a significant increase, women exhibited a decline (P < .05). Lower BPs (P < .03) and CRP levels (P = .032) were observed in female drinkers than abstainers and, as distinct from men, no increases in LDL cholesterol and apoB were noted. Heavy drinking tended to protect the sexes against the risk of developing low high-density lipoprotein cholesterol levels in prospective multi adjusted analyses. Sex modulates response of cardiometabolic risk variables to moderate alcohol consumption among Turks. Only women respond with lower triglycerides and CRP, whereas men show a log-linear positive association of drinking categories with BP, LDL cholesterol, apoB, and CRP.     

Alcohol advertising and alcohol consumption by adolescents

This study investigates the effects of alcohol advertising on adolescent alcohol consumption. The theory of an industry response function and evidence from prior studies indicate the importance of maximizing the variance in advertising measures. Monitoring the Future (MTF) and National Longitudinal Survey of Youth 1997 (NLSY97) data are augmented with alcohol advertising, originating on the market level, for five media. The large sample of the MTF allows estimation of race and gender-specific models. The longitudinal nature of the NLSY97 allows controls for unobserved heterogeneity with state-level and individual fixed effects. Price and advertising effects are generally larger for females relative to males. Controls for individual heterogeneity yield larger advertising effects, implying that the MTF results may understate the effects of alcohol advertising. Results from the NLSY97 suggest that a 28% reduction in alcohol advertising would reduce adolescent monthly alcohol participation from 25% to between 24 and 21%. For binge participation, the reduction would be from 12% to between 11 and 8%. The past month price-participation elasticity is estimated at -0.26, consistent with prior studies. The results show that reduction of alcohol advertising can produce a modest decline in adolescent alcohol consumption, though effects may vary by race and gender.     

Alcohol consumption during pregnancy: A urge to increase prevention and screening

Alcohol consumption was evaluated in 1,027 pregnant women in the Auvergne region of central France. Only 53% declared total abstinence during pregnancy. 33% had 1–4 units on monthly occasion, while 13% drunk more frequently. One percent had 5 or more units per occasion. Despite the consensus recommending total abstinence during pregnancy, prenatal alcohol exposure remains a major public health issue.     

饮酒与三种转氨酶关系的探讨

目的 探讨长期饮酒人群中酒精摄入量与丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)三种转氨酶的关系.方法 采用自行编制的调查问卷对云南省楚雄彝族自治州的彝族居民进行饮酒行为调查,根据纳入标准(平均每周饮酒次数≥3次或平均每次饮酒折合成高度白酒2.5两或以上),按照随机原则在以上饮酒者中选取124人,对其生化指标进行分析.结果 平均酒精摄入量与饮酒者的log ALT(r=0.378,P＜0.01)、log AST(r=0.406,P＜0.01)、log GGT(r=0.468,P＜0.01)水平均呈正相关;按不同酒精摄入量分组,各组在三项转氨酶水平上差异有统计学意义,随着酒精摄入量的增加,三项转氨酶水平也随之增高.结论 肝细胞转氨酶水平与酒精摄入量有一定的关系,因此对长期饮酒者进行血清转氨酶检测有着重要意义.     

Alcohol consumption and blood pressure: a comparison of native Japanese to American men

We compared the cross-sectional association of alcohol consumption with blood pressure in 810 Japanese men (JM) living in Tokyo and 946 white men (WM) living in New York. Mean systolic (JM and WM, p < 0.001) and diastolic blood pressure (JM, p < 0.002; WM, p < 0.001) were associated with alcohol consumption in both groups. Compared to abstainers, the heaviest drinkers had the highest systolic (JM, p = 0.001; WM, p < 0.01) and diastolic (JM, p < 0.002; WM, p < 0.05) blood pressures. The relation of blood pressure to alcohol intake was J-shaped in the Americans, but linear in the Japanese. Exploratory analyses revealed that the J-shape may have been due to under-reporting of heavy alcohol ingestion by American abstainers. When abstainers were excluded, the relationships were similar in both the American and Japanese. The positive association between blood pressure and alcohol consumption persisted after adjustment for age, cigarette smoking, use of antihypertensive medications, body mass index, heart rate, abdominal skinfold thickness, hematocrit, fasting blood glucose, serum uric acid levels and urinary sodium/potassium ratio. Alcohol use was also related to prevalence of hypertension. These findings confirm the presence of an independent association between alcohol intake and blood pressure in both JM and WM and suggest that, despite differences in the metabolism of alcohol, the relation of alcohol consumption to blood pressure is similar in both nationalities.     

男性饮酒与缺血性脑卒中发病关系的研究

目的 探讨中国男性人群中饮酒与缺血性脑卒中发病的关系。方法 1982～1985年在全国10组人群中分别整群随机抽取2000～4000人进行饮酒及心血管病危险因素调查,并对其中无冠心病、脑卒中及恶性肿瘤者脑卒中事件的发生情况进行随访观察,随访至1999～2000年,平均随访15.2年。结果 在12352名男性中共发生缺血性脑卒中283例。在控制了多种危险因素后,每日饮酒量(酒精含量)在0～、15～、30～和60g各组与不饮酒者相比,发生缺血性脑卒中的相对危险(OR值95％CI)分别为0.86(0.57～1.27)、1.20(0.87～1.65)、1.26(0.86～1.84)、1.96(1.30～2.93)。结论 在中国男性人群中,小量饮酒并不增加缺血性脑卒中发生的危险性,大量饮酒会使缺血性脑卒中发生的危险明显增加。     

Alcohol consumption and mortality: a dose-response analysis in terms of time

PurposeLow-to-moderate alcohol consumption is associated with decreased mortality. However, many aspects of this association are still debated. Our aim was to complement available information by conducting a dose-response analysis of the association between alcohol consumption and survival time.MethodsIn a Swedish population-based cohort of 67,706 middle-aged and elderly men and women, frequency and amount of drinking were assessed through a self-administrated questionnaire. During 15 years of follow-up, 13,323 participants died. Differences in survival (10th percentile differences, PDs) according to levels of alcohol consumption were estimated using Laplace regression.ResultsWe found evidence of nonlinearity between alcohol consumption and survival. Among women, we observed a rapid increase in survival up to 6 g/d of alcohol consumption (0.5 drinks/d) where survival was 17 months longer (PD = 17 months, 95% confidence interval, 10 to 24). After this peak, higher alcohol consumption was progressively associated with shorter survival. Among men, survival improved up to 15 g/d (1.5 drinks/d) where we observed a PD of 15 months (95% confidence interval, 8 to 22).ConclusionsLow alcohol consumption was associated with improved survival up to 1.5 years for women with an average consumption of 0.5 drinks per day and to 1.3 years for men with an average consumption of 1.5 drinks per day.