Article

Diabetologia

, Volume 55, Issue 12, pp 3228-3237

Moderate alcohol consumption is associated with improved insulin sensitivity, reduced basal insulin secretion rate and lower fasting glucagon concentration in healthy women

  • F. BonnetAffiliated withService Endocrinologie–Diabétologie, CHU Rennes, Université Rennes 1 Email author 
  • , E. DisseAffiliated withCentre de Recherche en Nutrition Humaine, CRNH Rhône-Alpes
  • , M. LavilleAffiliated withCentre de Recherche en Nutrition Humaine, CRNH Rhône-Alpes
  • , A. MariAffiliated withInstitute of Biomedical Engineering
  • , K. HojlundAffiliated withDepartment of Endocrinology, Odense University Hospital
  • , C. H. AnderwaldAffiliated withDepartment of Internal Medicine III, Medical University of ViennaMedical Direction, Specialized Hospital Complex AgathenhofMetabolic Unit, Istituto di Ingegneria Biomedica-Consiglio Nazionale delle Ricerche (ISIB-CNR)
  • , P. PiattiAffiliated withSan Raffaele Scientific Institute, Internal Medicine Department, and Metabolic and Cardiovascular Science Division
  • , B. BalkauAffiliated withService Endocrinologie–Diabétologie, CHU Rennes, Université Rennes 1Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of diabetes, obesity and chronic kidney disease over the lifecourse and determinants of early nutritionUniversity Paris Sud 11
  • , for the RISC Study Group

Abstract

Aims/hypothesis

Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes with a stronger effect in women. As the underlying mechanisms remain poorly characterised, we investigated its relationship with insulin resistance, insulin secretion, clearance of insulin and glucagon concentration.

Methods

One-thousand two-hundred and seventy-six non-diabetic individuals from the RISC (relationship between insulin sensitivity and cardiovascular disease) study without high alcohol consumption were studied; all had a euglycaemic–hyperinsulinaemic clamp and an OGTT with assessment of insulin sensitivity, secretion and clearance.

Results

Alcohol consumption was positively associated with insulin sensitivity in women (β = 0.15, p trend  = 0.005) and in men (β = 0.07, p trend  = 0.07) after controlling for age, centre, waist, smoking and physical activity. In women, this association persisted after adjustment for adiponectin but was attenuated after controlling for HDL-cholesterol, suggesting that part of the protection is related to a higher HDL-cholesterol concentration. Higher alcohol consumption was associated with lower basal insulin secretion in women only (β = −0.10, p trend  = 0.004) and this association persisted after adjustment for insulin sensitivity. In men, increasing alcohol consumption was associated with enhanced insulin clearance and increased fasting NEFA concentrations, independently of insulin sensitivity. Fasting glucagon decreased with increasing alcohol in women only (abstainers 9.2 ± 4.4; <28 g/week 8.6 ± 4.0; 28–64 g/week 8.1 ± 3.7; >64 g/week 7.5 ± 3.1 pmol/l; p trend  = 0.01).

Conclusions/interpretation

Light-to-moderate alcohol consumption was associated in healthy women with enhanced insulin sensitivity, reduced basal insulin secretion rate and lower fasting plasma glucagon concentration, providing consistent mechanisms for the reduced risk of diabetes.

Keywords

Alcohol Glucagon Insulin clearance Insulin resistance Insulin secretion