The Effect of Smoking and Sex on the Association Between Long-term Alcohol Consumption and Metabolic Syndrome in a Middle-aged and Older Population

Abstract

Background The effect of smoking and sex on the relationship between alcohol consumption and risk of developing metabolic syndrome (MetS) and its components has not been investigated. Methods A total of 5,629 Korean adults aged 40–69 years without MetS were recruited at baseline. Alcohol consumption was assessed biennially, and participants were classified as never, light, moderate, or heavy drinkers. Smoking status was examined at baseline and categorized into non-smokers and current smokers. Risk of incident MetS and its components according to alcohol consumption was examined by smoking status and sex using a multivariate Cox proportional hazards model. Results During a follow-up of 12 years, 2,336 participants (41.5%) developed MetS. In non-smokers, light or moderate alcohol drinkers had a lower risk of developing MetS, abdominal obesity, hyperglycemia, hypertriglyceridemia, and low HDL-C compared with never drinkers. Heavy alcohol consumption was associated with a higher risk of incident elevated blood pressure (hazard ratio [HR] 1.48; 95% confidence interval [CI], 1.07–2.06; P = 0.020) in men and abdominal obesity (HR 1.86; 95% CI, 1.06–3.27; P = 0.030) in women. However, in smokers, the inverse association of light or moderate alcohol consumption with hypertriglyceridemia and abdominal obesity was not present, whereas a positive association between heavy alcohol consumption and hyperglycemia (HR 1.39; 95% CI, 1.07–1.80; P = 0.014) was observed. Conclusions Smoking status and sex strongly affects the association between long-term alcohol consumption and MetS and its components by the amount of alcohol consumed.

Association of Alcohol Drinking Patterns with Metabolic Syndrome and Its Components in Korean Adults: The Korea National Health and Nutrition Examination Survey 2016–2018

“…MetS poses a major challenge for public health professionals and policy makers. Because living habits such as alcohol drinking, smoking, and physical activity are known to be major risk factors for MetS and its components, recommendations for a healthy lifestyle are needed [ 6 , 7 ].…”

Sex Differences in the Relationship between Excessive Alcohol Consumption and Metabolic Abnormalities: A Community-Based Study in Taiwan

“…Our study showed that males with low-risk drinking were at a greater risk of hyperglycemia than those with no drinking and that low-risk drinking increased the risk of obesity in females. Smoking status and sex strongly influenced the association between long-term alcohol consumption and MetS and its components in terms of the amount of alcohol consumed [ 45 , 46 ]. Sex differences were also observed in the neural response to taste among people with obesity [ 47 ].…”

Lifestyle elements and risk of metabolic syndrome in adults

“…The results of studies on the relationships between alcohol consumption and the prevalence of MetS and its components are ambiguous and may vary depending on sex and interactions with other health behaviors [18]. An increased risk of MetS, resulting from heavy drinking, stems from the influence of large amounts of alcohol on, in particular, blood pressure [19], blood sugar [20], and TG concentrations [21].…”