Impact of Inflammation on the Relationship Among Alcohol Consumption, Mortality, and Cardiac Events

Maraldi, Cinzia; Volpato, Stefano; Kritchevsky, Stephen B.; Cesari, Matteo; Andresen, Elena M.; Leeuwenburgh, Christiaan; Harris, Tamara B.; Newman, Anne B.; Kanaya, Alka M.; Johnson, Karen C.; Rodondi, Nicolas; Pahor, Marco

doi:10.1001/archinte.166.14.1490

Cited by 52 publications

(29 citation statements)

References 38 publications

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“…This contrasts with our previous results for CHD, for which inflammatory markers appeared to explain ϳ20% of the association (4). Two other studies, however, showed no substantially mediating effect of inflammation on the association of alcohol consumption with CHD (19,20). Our results suggest that inflammation and endothelial dysfunction may have little role in the association between alcohol consumption and type 2 diabetes.…”

Section: Mediating Biomarkerscontrasting

confidence: 99%

Alcohol Consumption, Mediating Biomarkers, and Risk of Type 2 Diabetes Among Middle-Aged Women

Beulens

Rimm

et al. 2008

Diabetes Care

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OBJECTIVE -The purpose of this study was to investigate whether adiponectin concentrations and biomarkers of inflammation, endothelial dysfunction, and insulin resistance mediate the association between alcohol consumption and diabetes.RESEARCH DESIGN AND METHODS -In a nested case-control study of 705 women with incident diabetes and 787 matched control subjects, we examined the adjusted relationship between baseline alcohol consumption and risk of diabetes before and after adjustment for markers of inflammation/endothelial dysfunction (C-reactive protein, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin, tumor necrosis factor-␣ receptor 2, and interleukin-6), fasting insulin, and adiponectin concentrations.RESULTS -Alcohol consumption was associated with a decreased risk of diabetes (odds ratio per 12.5 g/day increment in alcohol use 0.58; 95% CI 0.49 -0.69; P Ͻ 0.001). Adjustment for BMI attenuated the association by 25%. None of the markers of inflammation or fasting insulin appeared to account for Ͼ2% of the observed relationship. Without adjustment for BMI, these biomarkers individually explained slightly more of the association, but Ͻ10% in all cases. Adiponectin accounted for 25% in a fully adjusted model and for 29% without adjustment for BMI.CONCLUSIONS -In this population of women, alcohol consumption was inversely associated with risk of type 2 diabetes. Adiponectin appeared to be a mediator of this association, but circulating biomarkers of inflammation, endothelial dysfunction, and fasting insulin did not explain this association. These results suggest that further research is needed into the potentially mediating roles of other biomarkers affected by alcohol consumption.

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Section: Mediating Biomarkerscontrasting

confidence: 99%

Alcohol Consumption, Mediating Biomarkers, and Risk of Type 2 Diabetes Among Middle-Aged Women

Beulens

Rimm

et al. 2008

Diabetes Care

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“…18 Albumin and creatinine values were also used as surrogates for overall illness severity. 13,[19][20][21][22][23] In addition, we calculated the Laboratory-based Acute Physiology Score (LAPS) to measure the severity of illness. 24,25 To create diagnostic variables, each admission's primary ICD-9 code was classified using the Healthcare Cost and Utilization Project database.…”

Section: Admission-level Covariatesmentioning

confidence: 99%

Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies

Southern

Arnsten

2015

J GEN INTERN MED

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“…Overall, the group representing moderate alcohol consumers exhibited lower levels of white blood cell counts and inflammatory markers including fibrinogen and C-reactive protein compared with nondrinkers and heavy drinkers, after adjustment for potential confounders. Maraldi et al 53 followed 2487 subjects without known history of heart disease for 5.6 years. Patients classified as mild drinkers, defined by 1 to 7 drinks per week, had a significant reduction in all-cause mortality.…”

Section: Alcohol and Markers Of Inflammationmentioning

confidence: 99%

To Drink or Not to Drink? That Is the Question

2007

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Abstract-Numerous studies have used a J-shaped or U-shaped curve to describe the relationship between alcohol use and total mortality. The nadir of the curves based on recent meta-analysis suggested optimal benefit at approximately half a drink per day. Fewer than 4 drinks per day in men and fewer than 2 per day in women appeared to confer benefit. Reductions in cardiovascular death and nonfatal myocardial infarction were also associated with light to moderate alcohol intake. Although some studies suggested that wine had an advantage over other types of alcoholic beverages, other studies suggested that the type of drink was not important. Heavy drinking was associated with an increase in mortality, hypertension, alcoholic cardiomyopathy, cancer, and cerebrovascular events, including cerebrovascular hemorrhage. Paradoxically, light-to-moderate alcohol use actually reduced the development of heart failure and did not appear to exacerbate it in most patients who had underlying heart failure. Numerous mechanisms have been proposed to explain the benefit that light-to-moderate alcohol intake has on the heart, including an increase of high-density lipoprotein cholesterol, reduction in plasma viscosity and fibrinogen concentration, increase in fibrinolysis, decrease in platelet aggregation, improvement in endothelial function, reduction of inflammation, and promotion of antioxidant effects. Controversy exists on whether alcohol has a direct cardioprotective effect on ischemic myocardium. Studies from our laboratory do not support the concept that alcohol has a direct cardioprotective effect on ischemic/reperfused myocardium. Perhaps the time has come for a prospectively randomized trial to determine whether 1 drink per day (or perhaps 1 drink every other day) reduces mortality and major cardiovascular events. Key Words: alcohol Ⅲ arrhythmia Ⅲ cardiomyopathy Ⅲ heart failure Ⅲ myocardial infarction A lcohol is an old drug that has attracted human interest for thousands of years. Evidence of wine making was depicted on the walls of the temples of the pharaohs in Egypt and the Sumerians of Mesopotamia. Scientific debate about the risks and benefits of alcohol started in Europe several centuries ago and continues today. How much alcohol should people drink, what should they drink, and who should be doing the drinking are important questions that need definitive answers. This article provides an in-depth analysis of the effect of alcohol on the human heart and its clinical relevance to patient care.A recurring theme is that although high doses of alcohol are harmful to the heart (cardiomyopathy, arrhythmias, and hypertension), mild to moderate alcohol consumption has been associated with reductions in coronary artery disease and even total mortality.When we reviewed the literature, it became very evident that definitions describing how much alcohol is in a drink vary remarkably by article and country, and terms such as light, moderate, and heavy drinking are variably defined. Table 1 provides some of the definitions we could...

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Impact of Inflammation on the Relationship Among Alcohol Consumption, Mortality, and Cardiac Events

Abstract: Light to moderate alcohol consumption was associated with significantly lower rates of cardiac events and longer survival, independent of its anti-inflammatory effect.

Cited by 52 publications

References 38 publications

Alcohol Consumption, Mediating Biomarkers, and Risk of Type 2 Diabetes Among Middle-Aged Women

Alcohol Consumption, Mediating Biomarkers, and Risk of Type 2 Diabetes Among Middle-Aged Women

Increased Risk of Mortality among Patients Cared for by Physicians with Short Length-of-Stay Tendencies

To Drink or Not to Drink? That Is the Question

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