Causal Role of Alcohol Consumption in an Improved Lipid Profile: The Atherosclerosis Risk in Communities (ARIC) Study

<div><p>Introduction</p><p>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.</p><p>Methods</p><p>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 <i>ADH1B</i>, <i>ADH1C</i>, and <i>ADH4</i> 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.</p><p>Results</p><p>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, p_overall = 0.022).</p><p>Conclusions</p><p>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.</p></div

Sensitivity IV analysis excluding heavy drinkers.

<p>Sensitivity IV analysis excluding heavy drinkers.</p

Final instrumental SNPs.

<p>Final instrumental SNPs.</p

Instrumental Variable analysis using 2SLS.

<p>Instrumental Variable analysis using 2SLS.</p

Characteristics of 10,893 ARIC EAs.

<p>Characteristics of 10,893 ARIC EAs.</p

Association between observed alcohol consumption category and lipids.

<p>Association between observed alcohol consumption category and lipids.</p

Adjusted percent differences in plasma lactate in the ARIC Carotid MRI Study.

<p>Adjusted differences in plasma lactate (vs non-users of diabetes medications) in users of thiazolidinediones, Insulin, Sulfonylureas, and Metformin in those with type 2 diabetes in the ARIC Carotid MRI Study: Percent differences and 95% confidence intervals. Adjusted for age, sex, race, and education, sport and leisure activity, and body mass index.</p

Effect of medication combinations on percent differences and 95% confidence intervals in serum lactate level.

<p>Effect of medication combinations on percent differences and 95% confidence intervals in serum lactate level (mg/dl) among persons with type 2 diabetes in the ARIC Carotid MRI Study. All comparisons based on a model containing age, sex, race, education, sport and leisure activity, and body mass index. Diabetes medication use was constructed as a factor variable with mutually exclusive groups representing each medication separately and in combination. All groups are compared to no diabetes medication use. Not all combinations are shown.</p

Characteristics of 493 Adults Aged 61–84 With Type 2 Diabetes in the ARIC Carotid MRI Study by Diabetes Medication Use.

<p>Bolded values indicate p-values<0.05 for the t-test of the difference for Yes – No.</p><p>All estimates are survey weighted mean (SE) except where indicated as % (SE). SE = linearized standard error.</p>a<p>. Geometric mean and 95% confidence interval for blood lactate (mg/dl).</p

Supplementary_Tables_v5_2clean - The Association of Biomarkers of Inflammation and Extracellular Matrix Degradation With the Risk of Abdominal Aortic Aneurysm: The ARIC Study

<p>Supplementary_Tables_v5_2clean for The Association of Biomarkers of Inflammation and Extracellular Matrix Degradation With the Risk of Abdominal Aortic Aneurysm: The ARIC Study by Weihong Tang, Lu Yao, Ron C. Hoogeveen, Alvaro Alonso, David J. Couper, Pamela L. Lutsey, Carol C. Steenson, Weihua Guan, David W. Hunter, Frank A. Lederle, and Aaron R. Folsom in Angiology</p