Current Diabetes Reports

, Volume 1, Issue 2, pp 187–191 | Cite as

Alcohol consumption and risk of coronary heart disease among individuals with type 2 diabetes

  • Mihaela Tanasescu
  • Frank B. Hu
Article

Abstract

The epidemiologic evidence on the association between moderate alcohol intake and risk of coronary heart disease (CHD), biological mechanisms for this association, and potential hazards of alcohol intake in individuals with type 2 diabetes is reviewed here. Three prospective cohort studies have examined the association between alcohol consumption and risk of CHD among diabetics. The results indicated significant risk reductions, ranging from 34% to 79%, associated with light to moderate alcohol intake. Potential mechanisms include increased high-density lipoprotein cholesterol, decreased coagulation, and enhanced insulin sensitivity. Alcohol intake is also associated with certain risks among diabetics. However, for moderate alcohol consumption, the benefits would likely outweigh the risks.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Calles-Escandon J, Garcia-Rubi E, Mirza S, Mortensen A: Type 2 diabetes: one disease, multiple cardiovascular risk factors. Coron Artery Dis 1999, 10:23–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Haffner SM, Lehto S, Ronnemaa T, et al.: Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998, 339:229–234.PubMedCrossRefGoogle Scholar
  3. 3.
    Manson JE, Colditz GA, Stampfer MJ, et al.: A prospective study of maturity-onset diabetes mellitus and risk of coronary heart disease and stroke in women. Arch Intern Med 1991, 151:1141–1147.PubMedCrossRefGoogle Scholar
  4. 4.
    American Diabetes Association Clinical Practice Recommendations 2001 [no authors listed]. Diabetes Care 2001, 24 (suppl 1):S1–S133.Google Scholar
  5. 5.
    Rimm EB, Williams P, Fosher K, et al.: Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 1999, 319:1523–1528. This is a meta-analysis of all experimental studies that assessed the effects of moderate alcohol intake on concentrations of HDL-C, apolipoprotein A1, fibrinogen, triglycerides, and other biological markers previously found to be associated with risk of CHD.PubMedGoogle Scholar
  6. 6.
    Rimm EB, Klatsky A, Grobbee D, Stampfer MJ: Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ 1996, 312:731–736.PubMedGoogle Scholar
  7. 7.
    Constant J: Alcohol, ischemic heart disease, and the French paradox. Clin Cardiol 1997, 20:420–424.PubMedGoogle Scholar
  8. 8.
    Das DK, Sato M, Ray PS, et al.: Cardioprotection of red wine: role of polyphenolic antioxidants. Drugs Exp Clin Res 1999, 25:115–120.PubMedGoogle Scholar
  9. 9.
    Bell DS: Alcohol and the NIDDM patient. Diabetes Care 1996, 19:509–513.PubMedCrossRefGoogle Scholar
  10. 10.
    Valmadrid CT, Klein R, Moss SE, et al.: Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus. JAMA 1999, 282:239–246.PubMedCrossRefGoogle Scholar
  11. 11.
    Solomon CG, Hu FB, Stampfer MJ, et al.: Moderate alcohol consumption and risk of coronary heart disease among women with type 2 diabetes mellitus. Circulation 2000, 102:494–499.PubMedGoogle Scholar
  12. 12.
    Ajani UA, Gaziano JM, Lotufo PA, et al.: Alcohol consumption and risk of coronary heart disease by diabetes status. Circulation 2000, 102:500–505.PubMedGoogle Scholar
  13. 13.
    Giovannucci E, Colditz G, Stampfer MJ, et al.: The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 1991, 133:810–817.PubMedGoogle Scholar
  14. 14.
    Gaziano JM, Hennekens CH, Godfried SL, et al.: Type of alcoholic beverage and risk of myocardial infarction. Am J Cardiol 1999, 83:52–57.PubMedCrossRefGoogle Scholar
  15. 15.
    Morishita E, Asakura H, Jokaji H, et al.: Hypercoagulability and high lipoprotein(a) levels in patients with type II diabetes mellitus. Atherosclerosis 1996, 120:7–14.PubMedCrossRefGoogle Scholar
  16. 16.
    Bruno G, Cavallo-Perin P, Bargero G, et al.: Association of fibrinogen with glycemic control and albumin excretion rate in patients with non-insulin-dependent diabetes mellitus. Ann Intern Med 1996, 125:653–657.PubMedGoogle Scholar
  17. 17.
    McKenzie CR, Eisenberg PR: Alcohol, coagulation, and arterial thrombosis. In Alcohol and the Cardiovascular System. Research monograph-31. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, NIH publication No. 96-4133; 1996:413–439.Google Scholar
  18. 18.
    Sobel BE, Woodcock-Mitchell J, Schneider DJ, et al.: Increased plasminogen activator inhibitor type 1 in coronary artery atherectomy specimens from type 2 diabetic compared with nondiabetic patients: a potential factor predisposing to thrombosis and its persistence. Circulation 1998, 97:2213–2221.PubMedGoogle Scholar
  19. 19.
    Grenett HE, Aikens ML, Tabengwa EM, et al.: Ethanol down-regulates transcription of the PAI-1 gene in cultured human endothelial cells. Thromb Res 2000, 97:247–255.PubMedCrossRefGoogle Scholar
  20. 20.
    Ridker PM, Vaughan DE, Stampfer MJ, et al.: Association of moderate alcohol consumption and plasma concentration of endogenous tissue-type plasminogen activator. JAMA 1994, 272:929–933.PubMedCrossRefGoogle Scholar
  21. 21.
    Stubbs CD, Rubin R: Effect of ethanol on platelet phospholipase A2. Lipids 1992, 27:255–260.PubMedCrossRefGoogle Scholar
  22. 22.
    Renaud SC, Ruf JC: Effects of alcohol on platelet functions. Clin Chim Acta 1996, 246:77–89.PubMedCrossRefGoogle Scholar
  23. 23.
    Schmidt AM, Stern D: Atherosclerosis and diabetes: the RAGE connection. Curr Atheroscler Rep 2000, 2:430–436.PubMedGoogle Scholar
  24. 24.
    Chappey O, Dosquet C, Wautier MP, Wautier JL: Advanced glycation end products, oxidant stress and vascular lesions. Eur J Clin Invest 1997, 27:97–108.PubMedCrossRefGoogle Scholar
  25. 25.
    Al-Abed Y, Mitsuhashi T, Li H, et al.: Inhibition of advanced glycation endproduct formation by acetaldehyde: role in the cardioprotective effect of ethanol. Proc Natl Acad Sci U S A 1999, 96:2385–2390.PubMedCrossRefGoogle Scholar
  26. 26.
    Facchini F, Chen YD, Reaven GM: Light-to-moderate alcohol intake is associated with enhanced insulin sensitivity. Diabetes Care 1994, 17:115–119.PubMedCrossRefGoogle Scholar
  27. 27.
    Kiechl S, Willeit J, Poewe W, et al.: Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study. BMJ 1996, 313:1040–1044.PubMedGoogle Scholar
  28. 28.
    Rimm EB, Chan J, Stampfer MJ, et al.: Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 1995, 310:555–559.PubMedGoogle Scholar
  29. 29.
    Avogaro A, Tiengo A: Alcohol, glucose metabolism and diabetes. Diabetes Metab Rev 1993, 9:129–146.PubMedCrossRefGoogle Scholar
  30. 30.
    Siler SQ, Neese RA, Christiansen MP, Hellerstein MK: The inhibition of gluconeogenesis following alcohol in humans. Am J Physiol 1998, 275(5 Pt 1):E897-E907.PubMedGoogle Scholar
  31. 31.
    Puhakainen I, Koivisto VA, Yki-Jarvinen H: No reduction in total hepatic glucose output by inhibition of gluconeogenesis with ethanol in NIDDM patients. Diabetes 1991, 40:1319–1327.PubMedCrossRefGoogle Scholar
  32. 32.
    Burge MR, Zeise TM, Sobhy TA, et al.: Low-dose ethanol predisposes elderly fasted patients with type 2 diabetes to sulfonylurea-induced low blood glucose. Diabetes Care 1999, 22:2037–2043.PubMedCrossRefGoogle Scholar
  33. 33.
    Koivisto VA, Tulokas S, Toivonen M, et al.: Alcohol with a meal has no adverse effects on postprandial glucose homeostasis in diabetic patients. Diabetes Care 1993, 16:1612–1614.PubMedCrossRefGoogle Scholar
  34. 34.
    Christiansen C, Thomsen C, Rasmussen O, et al.: Effect of alcohol on glucose, insulin, free fatty acid and triacylglycerol responses to a light meal in non-insulin-dependent diabetic subjects. Br J Nutr 1994, 71:449–454.PubMedCrossRefGoogle Scholar
  35. 35.
    Christiansen C, Thomsen C, Rasmussen O, et al.: The acute impact of ethanol on glucose, insulin, triacylglycerol, and free fatty acid responses and insulin sensitivity in type 2 diabetes. Br J Nutr 1996, 76:669–675.PubMedCrossRefGoogle Scholar
  36. 36.
    Young RJ, McCulloch DK, Prescott RJ, Clarke BF: Alcohol: another risk factor for diabetic retinopathy? BMJ 1984, 288:1035–1037.PubMedCrossRefGoogle Scholar
  37. 37.
    Moss SE, Klein R, Klein BE: The association of alcohol consumption with the incidence and progression of diabetic retinopathy. Ophthalmology 1994, 101:1962–1968.PubMedGoogle Scholar
  38. 38.
    Mitchell BD, Vinik A: Alcohol consumption: a risk factor for diabetic neuropathy? Diabetes 1987, 36(suppl 1):71A.Google Scholar
  39. 39.
    Camargo CA, Rimm EB: Epidemiological research on moderate alcohol consumption and blood pressure. In Alcohol and the Cardiovascular System. Research monograph-31. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, NIH publication No. 96-4133; 1996:25–62.Google Scholar
  40. 40.
    Hillbom M, Juvela S, Numminen H: Alcohol intake and the risk of stroke. J Cardiovasc Risk 1999, 6:223–228.PubMedGoogle Scholar
  41. 41.
    Stampfer MJ, Colditz GA, Willett WC, et al.: A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med 1988, 319:267–273.PubMedCrossRefGoogle Scholar
  42. 42.
    Thun MJ, Peto R, Lopez AD, et al.: Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med 1997, 337:1705–1714.PubMedCrossRefGoogle Scholar
  43. 43.
    Fuchs CS, Stampfer MJ, Colditz GA, et al.: Alcohol consumption and mortality among women. N Engl J Med 1995, 332:1245–1250.PubMedCrossRefGoogle Scholar
  44. 44.
    Hillborn M, Juvela S: Alcohol and risk for stroke. In Alcohol and the Cardiovascular System. Research monograph-31. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, NIH publication No. 96-4133; 1996:63–83.Google Scholar

Copyright information

© Current Science Inc. 2001

Authors and Affiliations

  • Mihaela Tanasescu
    • 1
  • Frank B. Hu
    • 1
  1. 1.Department of NutritionHarvard School of Public HealthBostonUSA

Personalised recommendations