Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies

By S. Brien, P. Ronksley, B. Turner, K. Mukamal, W. Ghali. British medical journal, 2011

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Objective To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease. Design Systematic review and meta-analysis. Data sources Medline (1950 to October 2009) and Embase (1980 to October 2009) without limits. Study selection Two reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected. Results Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits). Alcohol significantly increased levels of high density lipoprotein cholesterol (pooled mean difference 0.094 mmol/L, 95% confidence interval 0.064 to 0.123), apolipoprotein A1 (0.101 g/L, 0.073 to 0.129), and adiponectin (0.56 mg/L, 0.39 to 0.72). Alcohol showed a dose-response relation with high density lipoprotein cholesterol (test for trend P=0.013). Alcohol decreased fibrinogen levels (−0.20 g/L, −0.29 to −0.11) but did not affect triglyceride levels. Results were similar for crossover and before and after studies, and across beverage types. Conclusions Favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.

Subfields: Cardiology and Cardiovascular Medicine, Epidemiology, Pathology and Forensic Medicine

View Paper: https://www.semanticscholar.org/paper/50e793e3edec56cbead782439c493a034e8c6f91

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Citations in the corpus

Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. (2014, background): “The protective effect of moderate alcohol consumption may be related to increased levels of HDL-C, apolipoprotein A1, and adiponectin, as well as lower levels of fibrinogen and decreased platelet aggregation.(332,333) Heavy alcohol use may elevate stroke risk through increasing risks of hypertension”
Dietary (Poly)phenolics in Human Health: Structures, Bioavailability, and Evidence of Protective Effects Against Chronic Diseases (2013, neutral): “It is well accepted that excessive alcohol consumption leads to increased BP in normotensive and hypertensive subjects (364, 365), whereas low/moderate consumption reduces specific cardiovascular risk factors (51, 384).”
2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. (2019, background): “major impact on TG levels, particularly in individuals with HTG.(153,170) The detrimental effects of a high-carbohydrate diet on TGs occur mainly when refined carbohydrate-rich foods are consumed, while they are much less prominent if the diet is based largely on fibre-rich, low-glycaemic index food”
Alcohol Consumption and Cardiovascular Disease (2020, positive): “19 We confirmed a positive association between genetically predicted alcohol intake and higher levels of high-density lipoprotein cholesterol.”
Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies (2018, positive): “50 They have contrasting associations with cardiovascular disease outcomes: the inverse association of HDL-C with cardiovascular disease is substantially stronger for coronary disease than stroke, 53,54 whereas the positive association of systolic blood with cardiovascular disease is considerably…”
2016 European Guidelines on cardiovascular disease prevention in clinical practice. (2016, background): “Ischaemic heart disease mortality is 65% higher in male heavy drinkers and more than double in female heavy drinkers.(540)”
Evidence-based policymaking: promise, challenges and opportunities for accounting and financial markets research** (2018, neutral): “Many studies as well as several meta-analyses suggest a J-shaped relation between alcohol consumption and mortality risk, indicating reduced risk for occasional and low-volume drinkers but higher risk for higher volume drinkers (e.g. Brien et al. 2011, Ronksley et al. 2011).”
2016 European Guidelines on cardiovascular disease prevention in clinical practice (2016, background): “Ischaemic heart disease mortality is 65% higher in male heavy drinkers and more than double in female heavy drinkers.(540)”
Epigenetic clock analysis of diet, exercise, education, and lifestyle factors (2017, neutral): “Alternatively, this may be the result of reverse causation, whereby individuals suffering from health issues abstain from alcohol consumption [75], though interventional studies support a causal protective effect of moderated alcohol intake on cardiovascular blood biomarkers [76].”
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. (2016, background): “While in individuals with HTG even a small amount of alcohol can induce a further elevation of TG concentrations, in the general population alcohol exerts detrimental effects on TG levels only if the intake is excessive.(152,177)”