Abstract
Moderate ethanol intake consistently has been associated with a decreased risk of cardiovascular disease (CVD) in observational studies [1-3], although the decrease is most pronounced and consistent for coronary heart disease [1] and less so for stroke [1]. Although a few studies have shown increases [4] or no changes [5] in carotid atherosclerosis by ultrasound (carotid intima-media thickness, CIMT) with moderate ethanol intake, most have reported decreased CIMT in men but curiously no change in women [6-8]. Heavy ethanol intake appears to have adverse effects on CIMT [9, 10]. Ethanol appears favorably to affect many risk factors for atherosclerosis and CVD, including antithrombotic/anticoagulant factors (see ref. [11] for a review) and antiinflammatory factors (see ref. [12] for review). The best-studied effect, however, is an increase in plasma concentrations of high density lipoprotein (HDL), and it is estimated that about half of the relationship between ethanol and CVD may be attributed to its effects on HDL [3, 12]. For these reasons, the effects of ethanol on HDL metabolism, as outlined in this chapter, are of clinical, as well as research interest.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Gaziano JM, Gaziano TA, Glynn RJ et al (2000) Light-to-moderate alcohol consumption and mortality in the Physicians’ Health Study enrollment cohort. J Am Coll Cardiol 35(1):96–105
Sesso HD (2001) Alcohol and cardiovascular health: recent findings. Am J Cardiovasc Drugs 1(3):167–172
Hannuksela ML, Liisanantti MK, Savolainen MJ (2002) Effect of alcohol on lipids and lipoproteins in relation to atherosclerosis. Crit Rev Clin Lab Sci 39(3):225–283
Juonala M, Viikari JS, Kahonen M et al (2009) Alcohol consumption is directly associated with carotid intima-media thickness in Finnish young adults: the Cardiovascular Risk in Young Finns Study. Atherosclerosis 204(2):e93-e98
Kitamura A, Iso H, Imano H et al (2004) Prevalence and correlates of carotid atherosclerosis among elderly Japanese men. Atherosclerosis 172(2):353–359
Zureik M, Gariepy J, Courbon D et al (2004) Alcohol consumption and carotid artery structure in older French adults: the Three-City Study. Stroke 35(12):2770–2775
Fujisawa M, Okumiya K, Matsubayashi K, Hamada T, Endo H, Doi Y (2008) Factors associated with carotid atherosclerosis in community-dwelling oldest elderly aged over 80 years. Geriatr Gerontol Int 8(1):12–18
Lee YH, Shin MH, Kweon SS et al (2009) Alcohol consumption and carotid artery structure in Korean adults aged 50 years and older. BMC Public Health 9(1):358
Schminke U, Luedemann J, Berger K et al (2005) Association between alcohol consumption and subclinical carotid atherosclerosis: the Study of Health in Pomerania. Stroke 36(8):1746–1752
Mukamal KJ, Kronmal RA, Mittleman MA et al (2003) Alcohol consumption and carotid atherosclerosis in older adults: the Cardiovascular Health Study. Arterioscler Thromb Vasc Biol 23(12):2252–2259
van Tol A (2001) Moderate alcohol consumption: effects on lipids and cardiovascular disease risk. Curr Opin Lipidol 12:19–23
Li JM, Mukamal KJ (2004) An update on alcohol and atherosclerosis. Curr Opin Lipidol 15(6):673–680
Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K (2000) Alcohol and coronary heart disease: a meta-analysis. Addiction 95(10):1505–1523
Standridge JB, Zylstra RG, Adams SM (2004) Alcohol consumption: an overview of benefits and risks. South Med J 97(7):664–672
White IR (1999) The level of alcohol consumption at which all-cause mortality is least. J Clin Epidemiol 52(10):967–975
Johansen D, Andersen PK, Jensen MK, Schnohr P, Gronbaek M (2003) Nonlinear relation between alcohol intake and high-density lipoprotein cholesterol level: results from the Copenhagen City Heart Study. Alcohol Clin Exp Res 27(8):1305–1309
Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ (1999) Moderate alcohol intake and lower risk of coronary heart disease: meta- analysis of effects on lipids and haemostatic factors. BMJ 319(7224):1523–1528
Jerrard-Dunne P, Sitzer M, Risley P et al (2003) Interleukin-6 promoter polymorphism modulates the effects of heavy alcohol consumption on early carotid artery atherosclerosis: the Carotid Atherosclerosis Progression Study (CAPS). Stroke 34(2):402–407
Mukamal KJ, Conigrave KM, Mittleman MA et al (2003) Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med 348(2):109–118
Kauhanen J, Kaplan GA, Goldberg DE, Salonen R, Salonen JT (1999) Pattern of alcohol drinking and progression of atherosclerosis. Arterioscler Thromb Vasc Biol 19(12):3001–3006
Kauhanen J, Kaplan GA, Goldberg DE, Salonen JT (1997) Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based study. BMJ 315(7112):846–851
Peasey A, Bobak M, Malyutina S et al (2005) Do lipids contribute to the lack of cardio-protective effect of binge drinking: alcohol consumption and lipids in three eastern European countries. Alcohol Alcohol 40(5):431–435
Frohlich JJ (1996) Effects of alcohol on plasma lipoprotein metabolism. Clin Chim Acta 246(1-2):39–49
Di Castelnuovo A, Rotondo S, Iacoviello L, Donati MB, De Gaetano G (2002) Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation 105(24):2836–2844
Marques-Vidal P, Montaye M, Haas B et al (2001) Relationships between alcoholic beverages and cardiovascular risk factor levels in middle-aged men, the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction Study. Atherosclerosis 157(2):431–440
Rimm EB, Klatsky A, Groggee D, Stampfer MJ (1996) Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits? BMJ 312:731–736
Volcik KA, Ballantyne CM, Fuchs FD, Sharrett AR, Boerwinkle E (2008) Relationship of alcohol consumption and type of alcoholic beverage consumed with plasma lipid levels: differences between Whites and African Americans of the ARIC study. Ann Epidemiol 18(2):101–107
Nishiwaki M, Ishikawa T, Ito T et al (1994) Effects of alcohol on lipoprotein lipase, hepatic lipase, cholesteryl ester transfer protein, and lecithin:cholesterol acyltransferase in high-density lipoprotein cholesterol elevation. Atherosclerosis 111(1):99–109
Valimaki M, Nikkila EA, Taskinen MR, Ylikahri R (1986) Rapid decrease in high density lipoprotein subfractions and postheparin plasma lipase activities after cessation of chronic alcohol intake. Atherosclerosis 59(2):147–153
Haskell WI, Camargo C, Williams PT (1984) The effect of cessation and resumption of moderate alcohol intake on serum high density lipoprotein subfractions: a controlled study. N Engl J Med 310:805–810
Diehl AK, Fuller JH, Mattock MB, Salter AM, el-Gohari R, Keen H (1988) The relationship of high density lipoprotein subfractions to alcohol consumption, other lifestyle factors, and coronary heart disease. Atherosclerosis 69(2-3):145–153
Sillanaukee P, Koivula T, Jokela H, Myllyharju H, Seppa K (1993) Relationship of alcohol consumption to changes in HDL-subfractions. Eur J Clin Invest 23(8):486–491
Sillanaukee P, Koivula T, Jokela H, Pitkajarvi T, Seppa K (2000) Alcohol consumption and its relation to lipid-based cardiovascular risk factors among middle-aged women: the role of HDL(3) cholesterol. Atherosclerosis 152(2):503–510
Gardner CD, Tribble DL, Young DR, Ahn D, Fortmann SP (2000) Associations of HDL, HDL(2), and HDL(3) cholesterol and apolipoproteins A-I and B with lifestyle factors in healthy women and men: the Stanford Five City Project. Prev Med 31(4):346–356
Hartung GH, Foreyt JP, Reeves RS et al (1990) Effect of alcohol dose on plasma lipoprotein subfractions and lipolytic enzyme activity in active and inactive men. Metabolism 39(1):81–86
Clevidence BA, Reichman ME, Judd JT et al (1995) Effects of alcohol consumption on lipoproteins of premenopausal women. A controlled diet study. Arterioscler Thromb Vasc Biol 15:179–184
Gaziano JM, Buring JE, Breslow JL et al (1993) Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 329(25):1829–1834
Valimaki M, Taskinen MR, Ylikahri R, Roine R, Kuusi T, Nikkila EA (1988) 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 18(5):472–480
Lagrost L, Athias A, Herbeth B et al (1996) Opposite effects of cholesteryl ester transfer protein and phospholipid transfer protein on the size distribution of plasma high density lipoproteins. Physiological relevance in alcoholic patients. J Biol Chem 271(32):19058–19065
Valimaki M, Kahri J, Laitinen K et al (1993) High density lipoprotein subfractions, apolipoprotein A-I containing lipoproteins, lipoprotein (a), and cholesterol ester transfer protein activity in alcoholic women before and after ethanol withdrawal. Eur J Clin Invest 23(7):406–417
Beulens JW, Sierksma A, van Tol A et al (2004) Moderate alcohol consumption increases cholesterol efflux mediated by ABCA1. J Lipid Res 45(9):1716–1723
Atmeh RG, Robenek H (1996) Measurement of small high density lipoprotein subclass by an improved immunoblotting technique. J Lipid Res 37(11):2461–2469
Taskinen MR, Valimaki M, Nikkila EA, Kuusi T, Ehnholm C, Ylikahri R (1982) High density lipoprotein subfractions and postheparin plasma lipases in alcoholic men before and after ethanol withdrawal. Metabolism 31(11):1168–1174
Savolainen MJ, Hannuksela M, Seppanen S, Kervinen K, Kesaniemi YA (1990) Increased high-density lipoprotein cholesterol concentration in alcoholics is related to low cholesteryl ester transfer protein activity. Eur J Clin Invest 20(6):593–599
Perret B, Ruidavets JB, Vieu C et al (2002) Alcohol consumption is associated with enrichment of high-density lipoprotein particles in polyunsaturated lipids and increased cholesterol esterification rate. Alcohol Clin Exp Res 26(8):1134–1140
Sierksma A, Vermunt SH, Lankhuizen IM et al (2004) Effect of moderate alcohol consumption on parameters of reverse cholesterol transport in postmenopausal women. Alcohol Clin Exp Res 28(4):662–666
Hannuksela ML, Ramet ME, Nissinen AE, Liisanantti MK, Savolainen MJ (2003) Effects of ethanol on lipids and atherosclerosis. Pathophysiology 10(2):93–103
Valimaki M, Laitinen K, Ylikahri R, Ehnholm C (1991) The effect of moderate alcohol intake on serum apolipoprotein A-I-containing lipoproteins and lipoprotein (a). Metabolism 40:1168–1172
Hirano K, Matsuzawa Y, Sakai N et al (1992) Polydisperse low-density lipoproteins in hyperalphalipoproteinemic chronic alcohol drinkers in association with marked reduction of cholesteryl ester transfer protein activity. Metabolism 41(12):1313–1318
Lin RC, Miller BA, Kelly TJ (1995) Concentrations of apolipoprotein AI, AII, and E in plasma and lipoprotein fractions of alcoholic patients: gender differences in the effects of alcohol. Hepatology 21(4):942–949
Lecomte E, Herbeth B, Paille F, Steinmetz J, Artur Y, Siest G (1996) Changes in serum apolipoprotein and lipoprotein profile induced by chronic alcohol consumption and withdrawal: determinant effect on heart disease? Clin Chem 42(10):1666–1675
De Oliveira E Silva ER, Foster D, McGee Harper M et al (2000) Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins A-I and A-II. Circulation 102(19):2347–2352
Gottrand F, Beghin L, Duhal N et al (1999) Moderate red wine consumption in healthy volunteers reduced plasma clearance of apolipoprotein AII. Eur J Clin Invest 29(5):387–394
Wehr H, Bednarska-Makaruk M, Szacka E (1995) Apolipoprotein E in alcoholics. Alcohol Alcohol 30(1):27–30
Gueguen S, Herbeth B, Pirollet P, Paille F, Siest G, Visvikis S (2002) Changes in serum apolipoprotein and lipoprotein profile after alcohol withdrawal: effect of apolipoprotein E polymorphism. Alcohol Clin Exp Res 26(4):501–508
Braeckman L, De Bacquer D, Rosseneu M, De Backer G (1998) The effect of age and lifestyle factors on plasma levels of apolipoprotein E. J Cardiovasc Risk 5(3):155–159
Sun Z, Larson IA, Ordovas JM, Barnard JR, Schaefer EJ (2000) Effects of age, gender, and lifestyle factors on plasma apolipoprotein A-IV concentrations. Atherosclerosis 151(2):381–388
Cushman P Jr, Barboriak J, Kalbfleisch J (1986) Alcohol: high density lipoproteins, apolipoproteins. Alcohol Clin Exp Res 10(2):154–157
Rao MN, Liu QH, Marmillot P, Seeff LB, Strader DB, Lakshman MR (2000) High-density lipoproteins from human alcoholics exhibit impaired reverse cholesterol transport function. Metabolism 49(11):1406–1410
Branchi A, Rovellini A, Tomella C et al (1997) Association of alcohol consumption with HDL subpopulations defined by apolipoprotein A-I and apolipoprotein A-II content. Eur J Clin Nutr 51(6):362–365
Malmendier CL, Delcroix C (1985) Effect of alcohol intake on high and low density lipoprotein metabolism in healthy volunteers. Clin Chim Acta 152(3):281–288
Amarasuriya RN, Gupta AK, Civen M, Horng YC, Maeda T, Kashyap ML (1992) Ethanol stimulates apolipoprotein A-I secretion by human hepatocytes: implications for a mechanism for atherosclerosis protection. Metabolism 41(8):827–832
Tam SP (1992) Effect of ethanol on lipoprotein secretion in two human hepatoma cell lines, HepG2 and Hep3B. Alcohol Clin Exp Res 16(6):1021–1028
Dashti N, Franklin FA, Abrahamson DR (1996) Effect of ethanol on the synthesis and secretion of apoA-I- and apoB-containing lipoproteins in HepG2 cells. J Lipid Res 37(4):810–824
Goto A, Sasai K, Suzuki S et al (2003) Plasma concentrations of LPL and LCAT are in putative association with females and alcohol use which are independent negative risk factors for coronary atherosclerosis among Japanese. Clin Chim Acta 329(1-2):69–76
Hendriks HF, Veenstra J, van Tol A, Groener JE, Schaafsma G (1998) Moderate doses of alcoholic beverages with dinner and postprandial high density lipoprotein composition. Alcohol Alcohol 33(4):403–410
van Der Gaag MS, van Tol A, Vermunt SH, Scheek LM, Schaafsma G, Hendriks HF (2001) Alcohol consumption stimulates early steps in reverse cholesterol transport. J Lipid Res 42(12):2077–2083
Riemens SC, van Tol A, Hoogenberg K et al (1997) Higher high density lipoprotein cholesterol associated with moderate alcohol consumption is not related to altered plasma lecithin:cholesterol acyltransferase and lipid transfer protein activity levels. Clin Chim Acta 258(1):105–115
Hannuksela M, Marcel YL, Kesaniemi YA, Savolainen MJ (1992) Reduction in the concentration and activity of plasma cholesteryl ester transfer protein by alcohol. J Lipid Res 33:737–744
Tsujita Y, Nakamura Y, Zhang Q et al (2007) The association between high-density lipoprotein cholesterol level and cholesteryl ester transfer protein TaqIB gene polymorphism is influenced by alcohol drinking in a population-based sample. Atherosclerosis 191(1):199–205
Fumeron F, Betoulle D, Luc G et al (1995) Alcohol intake modulates the effect of a polymorphism of the cholestery ester transfer protein gene on plasma high density lipoprotein and the risk of myocardial infarction. J Clin Invest 96:1664–1671
Boekholdt SM, Sacks FM, Jukema JW et al (2005) Cholesteryl ester transfer protein TaqIB variant, high-density lipoprotein cholesterol levels, cardiovascular risk, and efficacy of pravastatin treatment: individual patient meta-analysis of 13, 677 subjects. Circulation 111(3):278–287
Taskinen MR, Nikkila EA, Valimaki M et al (1987) Alcohol-induced changes in serum lipoproteins and in their metabolism. Am Heart J 113(2 Pt 2):458–464
Goldberg CS, Tall AR, Krumholz S (1984) Acute inhibition of hepatic lipase and increase in plasma lipoproteins after alcohol intake. J Lipid Res 25(7):714–720
Senault C, Betoulle D, Luc G, Hauw P, Rigaud D, Fumeron F (2000) Beneficial effects of a moderate consumption of red wine on cellular cholesterol efflux in young men. Nutr Metab Cardiovasc Dis 10(2):63–69
Makela SM, Jauhiainen M, Ala-Korpela M et al (2008) HDL2 of heavy alcohol drinkers enhances cholesterol efflux from raw macrophages via phospholipid-rich HDL 2b particles. Alcohol Clin Exp Res 32(6):991–1000
Marmillot P, Munoz J, Patel S, Garige M, Rosse RB, Lakshman MR (2007) Long-term ethanol consumption impairs reverse cholesterol transport function of high-density lipoproteins by depleting high-density lipoprotein sphingomyelin both in rats and in humans. Metabolism 56(7):947–953
Hoang A, Tefft C, Duffy SJ et al (2008) ABCA1 expression in humans is associated with physical activity and alcohol consumption. Atherosclerosis 197(1):197–203
Liinamaa MJ, Hannuksela ML, Kesaniemi YA, Savolainen MJ (1997) Altered transfer of cholesteryl esters and phospholipids in plasma from alcohol abusers. Arterioscler Thromb Vasc Biol 17(11):2940–2947
Liinamaa MJ, Kesaniemi YA, Savolainen MJ (1998) Lipoprotein composition influences cholesteryl ester transfer in alcohol abusers. Ann Med 30(3):316–322
Kashyap ML, Tavintharan S, Kamanna VS (2003) Optimal therapy of low levels of high density lipoprotein-cholesterol. Am J Cardiovasc Drugs 3(1):53–65
van der Gaag MS, van Tol A, Scheek LM et al (1999) Daily moderate alcohol consumption increases serum paraoxonase activity; a diet-controlled, randomised intervention study in middle-aged men. Atherosclerosis 147:405–410
Sierksma A, van der Gaag MS, van Tol A, James RW, Hendriks HF (2002) Kinetics of HDL cholesterol and paraoxonase activity in moderate alcohol consumers. Alcohol Clin Exp Res 26(9):1430–1435
Rao MN, Marmillot P, Gong M et al (2003) Light, but not heavy alcohol drinking, stimulates paraoxonase by upregulating liver mRNA in rats and humans. Metabolism 52(10):1287–1294
Wang X, Huang J, Fan Z et al (2004) Genetic and environmental factors associated with plasma paraoxonase activity in healthy Chinese. Int J Mol Med 13(3):445–450
Sierksma A, van der Gaag MS, Kluft C, Hendriks HF (2002) Moderate alcohol consumption reduces plasma C-reactive protein and fibrinogen levels; a randomized, diet-controlled intervention study. Eur J Clin Nutr 56(11):1130–1136
Oei HH, van der Meer IM, Hofman A et al (2005) Lipoprotein-associated phospholipase A2 activity is associated with risk of coronary heart disease and ischemic stroke: the Rotterdam Study. Circulation 111(5):570–575
Mukamal KJ, Cushman M, Mittleman MA, Tracy RP, Siscovick DS (2004) Alcohol consumption and inflammatory markers in older adults: the Cardiovascular Health Study. Atherosclerosis 173(1):79–87
Djousse L, Pankow JS, Arnett DK, Eckfeldt JH, Myers RH, Ellison RC (2004) Apolipoprotein E polymorphism modifies the alcohol-HDL association observed in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr 80(6):1639–1644
Hines LM, Stampfer MJ, Ma J et al (2001) Genetic variation in alcohol dehydrogenase and the beneficial effect of moderate alcohol consumption on myocardial infarction. N Engl J Med 344(8):549–555
Hines LM, Hunter DJ, Stampfer MJ et al (2005) Alcohol consumption and high-density lipoprotein levels: the effect of ADH1C genotype, gender and menopausal status. Atherosclerosis 182(2):293–300
Corella D, Tucker K, Lahoz C et al (2001) Alcohol drinking determines the effect of the APOE locus on LDL-cholesterol concentrations in men: the Framingham Offspring Study. Am J Clin Nutr 73(4):736–745
Kondo I, Berg K, Drayna D, Lawn R (1989) DNA polymorphism at the locus for human cholesteryl ester transfer protein (CETP) is associated with high density lipoprotein cholesterol and apolipoprotein levels. Clin Genet 35(1):49–56
Jensen MK, Mukamal KJ, Overvad K, Rimm EB (2008) Alcohol consumption, TaqIB polymorphism of cholesteryl ester transfer protein, high-density lipoprotein cholesterol, and risk of coronary heart disease in men and women. Eur Heart J 29(1):104–112
Corbex M, Poirier O, Fumeron F et al (2000) Extensive association analysis between the CETP gene and coronary heart disease phenotypes reveals several putative functional polymorphisms and gene-environment interaction. Genet Epidemiol 19(1):64–80
Isaacs A, Sayed-Tabatabaei FA, Njajou OT, Witteman JC, van Duijn CM (2004) The -514 C->T hepatic lipase promoter region polymorphism and plasma lipids: a meta-analysis. J Clin Endocrinol Metab 89(8):3858–3863
Fan YM, Lehtimaki T, Rontu R et al (2007) The hepatic lipase gene C-480T polymorphism in the development of early coronary atherosclerosis: the Helsinki Sudden Death Study. Eur J Clin Invest 37(6):472–477
Fan YM, Raitakari OT, Kahonen M et al (2009) Hepatic lipase promoter C-480T polymorphism is associated with serum lipids levels, but not subclinical atherosclerosis: the Cardiovascular Risk in Young Finns Study. Clin Genet 76(1):46–53
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Brinton, E.A., Nanjee, M.N. (2010). Effects of Ethanol Intake on High Density Lipoprotein Metabolism in Humans. In: Schaefer, E. (eds) High Density Lipoproteins, Dyslipidemia, and Coronary Heart Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1059-2_16
Download citation
DOI: https://doi.org/10.1007/978-1-4419-1059-2_16
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-1058-5
Online ISBN: 978-1-4419-1059-2
eBook Packages: MedicineMedicine (R0)