Skip to main content

Moderate alcohol consumption and atherosclerosis

Meta-analysis of effects on lipids and inflammation

Summary

Objective

Alcohol consumption plays an important role in the risk of major cardiovascular diseases. We conducted a meta-analysis to summarize the association between moderate alcohol consumption and atherosclerosis.

Design

In this study four databases and reference lists of retrieved articles were searched to identify eligible studies. A meta-analysis was carried out of all interventional studies that assessed the effects of moderate alcohol consumption on concentrations of low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, apolipoprotein A I, interleukin 6, plasminogen activator inhibitor 1, fibrinogen, and other biomarkers previously found to be associated with risk of atherosclerosis.

Results

A total of 31 studies met the eligibility criteria. In response to moderate alcohol consumption, low density lipoprotein cholesterol decreased by 0.08 mmol/l (P = 0.05), and high density lipoprotein cholesterol increased by 0.08 mmol/l (P < 0.00001), whereas total cholesterol and triglyceride remained the same. Moreover, interleukin 6 decreased by 0.43 pg/ml (P = 0.03), whereas C‑reactive protein and tumor necrosis factor a remained the same. Several hemostatic factors and adiponectin were modestly affected by alcohol consumption.

Conclusion

Moderate alcohol consumption is causally related to lower risk of atherosclerosis through changes in lipid profiles and inflammation.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Rehm J, Shield KD, Roerecke M, Gmel G. Modelling the impact of alcohol consumption on cardiovascular disease mortality for comparative risk assessments: An overview. BMC Public Health. 2016;16:363.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Muth ND, Laughlin GA, von Muhlen D, Smith SC, Barrett-Connor E. High-density lipoprotein subclasses are a potential intermediary between alcohol intake and reduced risk of cardiovascular disease: The Rancho Bernardo Study. Br J Nutr. 2010;104(7):1034–42.

    CAS  Article  PubMed  Google Scholar 

  3. Hannuksela ML, Liisanantti MK, Savolainen MJ. Effect of alcohol on lipids and lipoproteins in relation to atherosclerosis. Crit Rev Clin Lab Sci. 2002;39(3):225–83.

    CAS  Article  PubMed  Google Scholar 

  4. Chiva-Blanch G, Urpi-Sarda M, Llorach R, Rotches-Ribalta M, Guillen M, Casas R, et al. Differential effects of polyphenols and alcohol of red wine on the expression of adhesion molecules and inflammatory cytokines related to atherosclerosis: a randomized clinical trial. Am J Clin Nutr. 2012;95(2):326–34.

    CAS  Article  PubMed  Google Scholar 

  5. Alber HF, Suessenbacher A, Weidinger F. The role of inflammation in the pathophysiology of acute coronary syndromes. Wien Klin Wochenschr. 2005;117(13–14):445–55.

    CAS  Article  PubMed  Google Scholar 

  6. Onat A, Hergenc G, Dursunoglu D, Ordu S, Can G, Bulur S, et al. Associations of alcohol consumption with blood pressure, lipoproteins, and subclinical inflammation among Turks. Alcohol. 2008;42(7):593–601.

    CAS  Article  PubMed  Google Scholar 

  7. National Institute on Alcohol Abuse and Alcoholism. Health risks and benefits of alcohol consumption. Alcohol Res Health. 2000;24(1):5–11.

    Google Scholar 

  8. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  9. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4):1088–101.

    CAS  Article  PubMed  Google Scholar 

  10. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999–3058.

    Article  PubMed  Google Scholar 

  11. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105(9):1135–43.

    CAS  Article  PubMed  Google Scholar 

  12. Lau DC, Dhillon B, Yan H, Szmitko PE, Verma S. Adipokines: molecular links between obesity and atheroslcerosis. Am J Physiol Heart Circ Physiol. 2005;288(5):2031–41.

    Article  Google Scholar 

  13. Galkina E, Ley K. Immune and inflammatory mechanisms of atherosclerosis. Annu Rev Immunol. 2009;27:165–97.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. Kontush A, Chapman MJ. Functionally defective high-density lipoprotein: A new therapeutic target at the crossroads of dyslipidemia, inflammation, and atherosclerosis. Pharmacol Rev. 2006;58(3):342–74.

    CAS  Article  PubMed  Google Scholar 

  15. Ernst E, Koenig W. Fibrinogen and cardiovascular risk. Vasc Med. 1997;2(2):115–25.

    CAS  Article  PubMed  Google Scholar 

  16. de Oliveira C, de Mattos AB, Silva CB, Mota JF, Zemdegs JC. Nutritional and hormonal modulation of adiponectin and its receptors adipoR1 and adipoR2. Vitam Horm. 2012;90:57–94.

    Article  PubMed  Google Scholar 

  17. Matsuzawa Y. The metabolic syndrome and adipocytokines. Febs Lett. 2006;580(12):2917–21.

    CAS  Article  PubMed  Google Scholar 

  18. Arranz S, Chiva-Blanch G, Valderas-Martinez P, Medina-Remon A, Lamuela-Raventos RM, Estruch R. Wine, beer, alcohol and polyphenols on cardiovascular disease and cancer. Nutrients. 2012;4(7):759–81.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  19. O’Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ. Alcohol and cardiovascular health: the dose makes the poison … or the remedy. Mayo Clin Proc. 2014;89(3):382–93.

    Article  PubMed  Google Scholar 

  20. Djousse L, Himali JJ, Beiser A, Kelly-Hayes M, Wolf PA. Apolipoprotein e, alcohol consumption, and risk of ischemic stroke: the Framingham Heart Study revisited. J Stroke Cerebrovasc Dis. 2009;18(5):384–8.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Imhof A, Koenig W. Alcohol inflammation and coronary heart disease. Addict Biol. 2003;8(3):271–7.

    CAS  Article  PubMed  Google Scholar 

  22. Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women - An updated Meta-analysis of 34 prospective studies. Arch Intern Med. 2006;166(22):2437–45.

    Article  PubMed  Google Scholar 

  23. Connor J. Alcohol consumption as a cause of cancer. Addiction. 2017;112(2):222–8.

    Article  PubMed  Google Scholar 

  24. Poli A, Marangoni F, Avogaro A, Barba G, Bellentani S, Bucci M, et al. Moderate alcohol use and health: A consensus document. Nutr Metab Cardiovasc Dis. 2013;23(6):487–504.

    CAS  Article  PubMed  Google Scholar 

  25. Barboriak JJ, Hogan WJ. Preprandial drinking and plasma lipids in man. Atherosclerosis. 1976;24(1–2):323–5.

    CAS  Article  PubMed  Google Scholar 

  26. Couzigou P, Fleury B, Crockett R, Rautou JJ, Blanchard P, Lemoine F, et al. High density lipoprotein cholesterol and apoprotein A1 in healthy volunteers during long-term moderate alcohol intake. Ann Nutr Metab. 1984;28(6):377–84.

    CAS  Article  PubMed  Google Scholar 

  27. Burr ML, Fehily AM, Butland BK, Bolton CH, Eastham RD. Alcohol and high-density-lipoprotein cholesterol: A randomized controlled trial. Br J Nutr. 1986;56(1):81–6.

    CAS  Article  PubMed  Google Scholar 

  28. Bertiere MC, Betoulle D, Apfelbaum M, Girard-Globa A. Time-course, magnitude and nature of the changes induced in HDL by moderate alcohol intake in young non-drinking males. Atherosclerosis. 1986;61(1):7–14.

    CAS  Article  PubMed  Google Scholar 

  29. Moore RD, Smith CR, Kwiterovich PO, Pearson TA. Effect of low-dose alcohol use versus abstention on apolipoproteins A‑I and B. Am J Med. 1988;84(5):884–90.

    CAS  Article  PubMed  Google Scholar 

  30. Valimaki M, Taskinen MR, Ylikahri R, Roine R, Kuusi T, Nikkila EA. Comparison of the effects of two different doses of alcohol on serum lipoproteins, HDL-subfractions and apolipoproteins A–I and A–II: a controlled study. Eur J Clin Invest. 1988;18(5):472–80.

    CAS  Article  PubMed  Google Scholar 

  31. Hagiage M, Marti C, Rigaud D, Senault C, Fumeron F, Apfelbaum M, et al. Effect of a moderate alcohol intake on the lipoproteins of normotriglyceridemic obese subjects compared with normoponderal controls. Metab Clin Exp. 1992;41(8):856–61.

    CAS  Article  PubMed  Google Scholar 

  32. Suzukawa M, Ishikawa T, Yoshida H, Hosoai K, Nishio E, Yamashita T, et al. Effects of alcohol consumption on antioxidant content and susceptibility of low-density lipoprotein to oxidative modification. J Am Coll Nutr. 1994;13(3):237–42.

    CAS  Article  PubMed  Google Scholar 

  33. Sharpe PC, McGrath LT, McClean E, Young IS, Archbold GP. Effect of red wine consumption on lipoprotein (a) and other risk factors for atherosclerosis. QJM. 1995;88(2):101–8.

    CAS  PubMed  Google Scholar 

  34. Clevidence BA, Reichman ME, Judd JT, Muesing RA, Schatzkin A, Schaefer EJ, et al. Effects of alcohol consumption on lipoproteins of premenopausal women. A controlled diet study. Arterioscler Thromb Vasc Biol. 1995;15(2):179–84.

    CAS  Article  PubMed  Google Scholar 

  35. McConnell MV, Vavouranakis I, Wu LL, Vaughan DE, Ridker PM. Effects of a single, daily alcoholic beverage on lipid and hemostatic markers of cardiovascular risk. Am J Cardiol. 1997;80(9):1226–8.

    CAS  Article  PubMed  Google Scholar 

  36. De Oliveira e Silva ER, Foster D, McGee Harper M, Seidman CE, Smith JD, Breslow JL, et al. Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins A–I and A–II. Circulation. 2000;102(19):2347–52.

    Article  PubMed  Google Scholar 

  37. Mezzano D, Leighton F, Martinez C, Marshall G, Cuevas A, Castillo O, et al. Complementary effects of Mediterranean diet and moderate red wine intake on haemostatic cardiovascular risk factors. Eur J Clin Nutr. 2001;55(6):444–51.

    CAS  Article  PubMed  Google Scholar 

  38. Davies MJ, Baer DJ, Judd JT, Brown ED, Campbell WS, Taylor PR. Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: A randomized controlled trial. JAMA. 2002;287(19):2559–62.

    CAS  Article  PubMed  Google Scholar 

  39. Cartron E, Fouret G, Carbonneau MA, Lauret C, Michel F, Monnier L, et al. Red-wine beneficial long-term effect on lipids but not on antioxidant characteristics in plasma in a study comparing three types of wine – description of two O‑methylated derivatives of gallic acid in humans. Free Radic Res. 2003;37(9):1021–35.

    CAS  Article  PubMed  Google Scholar 

  40. Sierksma A, Vermunt SH, Lankhuizen IM, van der Gaag MS, Scheek LM, Grobbee DE, et al. Effect of moderate alcohol consumption on parameters of reverse cholesterol transport in postmenopausal women. Alcohol Clin Exp Res. 2004;28(4):662–6.

  41. Retterstol L, Berge KE, Braaten O, Eikvar L, Pedersen TR, Sandvik L. A daily glass of red wine: Does it affect markers of inflammation? Alcohol Alcohol. 2005;40(2):102–5.

    CAS  Article  PubMed  Google Scholar 

  42. Jensen T, Retterstol LJ, Sandset PM, Godal HC, Skjonsberg OH. A daily glass of red wine induces a prolonged reduction in plasma viscosity: A randomized controlled trial. Blood Coagulation Fibrinolysis. 2006;17(6):471–6.

    CAS  Article  PubMed  Google Scholar 

  43. Djurovic S, Berge KE, Birkenes B, Braaten O, Retterstol L. The effect of red wine on plasma leptin levels and vasoactive factors from adipose tissue: a randomized crossover trial. Alcohol Alcohol. 2007;42(6):525–8.

    CAS  Article  PubMed  Google Scholar 

  44. Romeo J, Warnberg J, Nova E, Diaz LE, Gonzalez-Gross M, Marcos A. Changes in the immune system after moderate beer consumption. Ann Nutr Metab. 2007;51(4):359–66.

    CAS  Article  PubMed  Google Scholar 

  45. Bantle AE, Thomas W, Bantle JP. Metabolic effects of alcohol in the form of wine in persons with type 2 diabetes mellitus. Metab Clin Exp. 2008;57(2):241–5.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  46. Imhof A, Blagieva R, Marx N, Koenig W. Drinking modulates monocyte migration in healthy subjects: a randomised intervention study of water, ethanol, red wine and beer with or without alcohol. Diabetes Vasc Dis Res. 2008;5(1):48–53.

    Article  Google Scholar 

  47. Joosten MM, Beulens JW, Kersten S, Hendriks HF. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: A randomised, crossover trial. Diabetologia. 2008;51(8):1375–81.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  48. Joosten MM, Witkamp RF, Hendriks HF. Alterations in total and high-molecular-weight adiponectin after 3 weeks of moderate alcohol consumption in premenopausal women. Metab Clin Exp. 2011;60(8):1058–63.

    CAS  Article  PubMed  Google Scholar 

  49. Joosten MM, van Erk MJ, Pellis L, Witkamp RF, Hendriks HF. Moderate alcohol consumption alters both leucocyte gene expression profiles and circulating proteins related to immune response and lipid metabolism in men. Br J Nutr. 2012;108(4):620–7.

    CAS  Article  PubMed  Google Scholar 

  50. Queipo-Ortuno MI, Boto-Ordonez M, Murri M, Gomez-Zumaquero JM, Clemente-Postigo M, Estruch R, et al. Influence of red wine polyphenols and ethanol on the gut microbiota ecology and biochemical biomarkers. Am J Clin Nutr. 2012;95(6):1323–34.

    CAS  Article  PubMed  Google Scholar 

  51. Zheng JS, Yang J, Huang T, Hu XJ, Luo M, Li D. Effects of Chinese liquors on cardiovascular disease risk factors in healthy young humans. TheScientificWorldJournal. 2012;2012:372143. doi:10.1100/2012/372143

  52. Chiva-Blanch G, Urpi-Sarda M, Ros E, Valderas-Martinez P, Casas R, Arranz S, et al. Effects of red wine polyphenols and alcohol on glucose metabolism and the lipid profile: a randomized clinical trial. Clin Nutr. 2013;32(2):200–6.

    CAS  Article  PubMed  Google Scholar 

  53. Chiva-Blanch G, Magraner E, Condines X, Valderas-Martinez P, Roth I, Arranz S, et al. Effects of alcohol and polyphenols from beer on atherosclerotic biomarkers in high cardiovascular risk men: a randomized feeding trial. Nutr Metab Cardiovasc Dis. 2015;25(1):36–45.

    CAS  Article  PubMed  Google Scholar 

  54. Gepner Y, Golan R, Harman-Boehm I, Henkin Y, Schwarzfuchs D, Shelef I, et al. Effects of initiating moderate alcohol intake on Cardiometabolic risk in adults with type 2 diabetes: a 2‑year randomized, controlled trial. Ann Intern Med. 2015;163(8):569–79.

    Article  PubMed  Google Scholar 

Download references

Funding

National Natural Science Foundation of China (No: 81503063), Natural Science Foundation of Guangdong Province (No: 2016A030310270) and Medical and health science and technology project of Guangzhou (No. 20161A011093).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yunying Huang.

Ethics declarations

Conflict of interest

Y. Huang, Y. Li, S. Zheng, X. Yang, T. Wang and J. Zeng declare that they have no competing interests.

Additional information

Author contributions Y.H. and Y.L. carried out the search and abstracted the data for the analysis. S.Z. and X.Y. did the statistical analysis. T.W. and J.Z. wrote the first draft of the manuscript. Y.H. will act as guarantor for the paper.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Huang, Y., Li, Y., Zheng, S. et al. Moderate alcohol consumption and atherosclerosis. Wien Klin Wochenschr 129, 835–843 (2017). https://doi.org/10.1007/s00508-017-1235-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-017-1235-6

Keywords

  • Alcohol consumption
  • Atherosclerosis
  • Lipid
  • Inflammation
  • Meta-analysis