Association between Alcohol Intake and Hemoglobin A1c in the Korean Adults: The 2011-2013 Korea National Health and Nutrition Examination Survey

Abstract

BackgroundAlthough alcohol consumption is commonly encountered in clinical practice, few studies have investigated the clinical significance of alcohol intake on the use of the hemoglobin A1c (HbA1c) level.ObjectivesThis study was performed to investigate the association between alcohol intake and HbA1c level in the general population.MethodsAmong the 24,594 participants who participated in the 2011–2013 Korea National Health and Nutrition Examination Survey (KNHANES), 12,923 participants were analyzed in this study. We excluded diabetic patients currently taking antidiabetes medication. We compared the HbA1c level and proportions of patients with an HbA1c level of ≥5.7%, ≥6.1%, and ≥6.5% according to the fasting plasma glucose (FPG) concentration range and the amount of alcohol intake. The average amounts of daily alcohol intake were categorized into three groups: 0 g/day, <30 g/day, ≥30 g/day.ResultsThe mean HbA1c level was 5.65%, and the mean FPG concentration was 95.3 mg/dl. The percentages of patients with an HbA1c level of ≥5.7%, ≥6.1%, and ≥6.5% were 42.6%, 13.4%, and 4.5%, respectively. The average amount of alcohol intake was 12.3 g/day. The percentages of subjects with alcohol intake 0, <30, and ≥ 30 g/day were 16.5%, 69.7%, and 13.8%, respectively.There was a significant positive relationship between alcohol intake and FPG concentration (P < 0.001), the prevalence of impaired fasting glucose (P < 0.001), and the prevalence of diabetes (P < 0.001). However, there was no significant relationship between the alcohol intake and HbA1c level.Overall, the adjusted HbA1c levels decreased across alcohol intake (5.70% ± 0.01%, 5.66% ± 0.01%, and 5.55% ± 0.01%) after adjustment for confounding factors such as age, sex, FPG concentration, college graduation, smoking history, presence of hypertension, waist circumference, serum total cholesterol concentration, serum high-density lipoprotein cholesterol concentration, serum triglyceride concentration, presence of anemia, serum white blood cell count, and serum alanine aminotransferase concentration (P < 0.001). The adjusted proportions (%) of patients with an HbA1c level of ≥5.7% (P < 0.001), ≥6.1% (P < 0.001), and ≥6.5% (P < 0.001) showed significant negative trends across alcohol intake after adjustment for confounders. Logistic regression analyses showed that, when using the group that abstained as the control, the group that consumed ≥ 30g/day was negatively associated with the risk of an HbA1c level of ≥5.7% (P < 0.001), ≥6.1% (P < 0.001), and ≥6.5% (P < 0.001), using the above-mentioned variables as covariates.ConclusionsHigher alcohol intake was associated with lower HbA1c levels, even after adjusting for confounding factors, including the FPG concentration, in this nationally representative sample of Korean adults. These results suggest that excessive drinking shifts the HbA1c level downward, which might complicate use of the HbA1c level for the diagnosis of diabetes or prediabetes.

Correlation of Dietary Advanced Glycation End Products with the Hematological and Biochemical Markers of Patients with Chronic Kidney Disease Undergoing Hemodialysis

“…The moderate consumption of alcohol is also correlated with a decreased incidence of DM and a decreased incidence of heart diseases in individuals with DM [12][13]. The results of this survey among patients with ESRD showed that the consumption of a moderate amount of alcohol, mostly in the form of wine, is correlated with increased HbA1c levels, and this is in contrast with the survey of Hong et al, who observed that the intake of alcoholic beverages was positively correlated with the drop in HbA1c levels, although in healthy individuals and not in patients with ESRD under hemodialysis [14]. It should be noted, however, that the high consumption of alcohol is linked with the formation of AGEs, insulin resistance, and secondary DM complications since acetaldehyde, one of the main metabolites of alcohol, when in excess, turns into a toxic substance, forming addition compounds with DNA, lipids, and proteins.…”

Diagnosing diabetes mellitus in patients with porphyria cutanea tarda

“…An increased alcohol intake is often seen in PCT patients. However, the influence of a high alcohol intake on HbA1c is controversial, as studies show that HbA1c may be both decreased and increased by high alcohol consumption …”

The prevalence of and factors associated with high-risk alcohol consumption in Korean adults: The 2009–2011 Korea National Health and Nutrition Examination Survey

“…As described in detail previously [9,10], a standard drink was defined as a single glass of liquor, wine, or the Korean traditional distilled liquor So-ju. One bottle of beer (355 mL) was counted as 1.6 standard drinks.…”

“…One bottle of beer (355 mL) was counted as 1.6 standard drinks. We calculated the amount of alcohol consumed per standard drink to be 10 g, and the average daily alcohol intake was assessed [9,10]. An average consumption of 30 g per day or more, a level of exposure associated with health risks, was considered heavy alcohol drinking [9,11–14].…”