Association Between Alcohol Intake and Lipids in Diabetes
Association Between Alcohol Intake and Lipids in Diabetes
Table 1 shows the results of comparison of the alcohol groups by a univariate analysis. Body weight and waist circumference were significantly lower and smaller, respectively, in light and moderate drinkers than in nondrinkers. The percentage of smokers was significantly higher in moderate and heavy drinkers than in nondrinkers, while there was no significant difference in the percentage of subjects doing regular exercise among the alcohol groups. The triglyceride level was significantly lower in light drinkers than in nondrinkers and was higher with a marginal significance (p = 0.053) in heavy drinkers than in nondrinkers. The HDL cholesterol level was significantly higher in light, moderate and heavy drinkers than in nondrinkers, while the LDL cholesterol level was significantly lower in moderate and heavy drinkers than in nondrinkers. The LDL-C/HDL-C ratio was significantly lower in light, moderate and heavy drinkers than in nondrinkers and tended to be lower with an increase in alcohol intake. The TG/HDL-C ratio was significantly lower in light and moderate drinkers than in nondrinkers. The LAP was significantly lower in light drinkers and significantly higher in heavy drinkers when compared with that in nondrinkers.
The hemoglobin A1c levels (means with standard errors) were 7.83 ± 0.06%, 7.78 ± 0.12%, 7.50 ± 0.07% and 7.64 ± 0.09% in nondrinkers, light drinkers, moderate drinkers and heavy drinkers, respectively. Hemoglobin A1c was significantly lower in moderate drinkers than in nondrinkers, and there was a tendency of an inverted J-shaped relationship between the alcohol intake and hemoglobin A1c level, although there were no significant differences in hemoglobin A1c between light drinkers and nondrinkers and between heavy drinkers and nondrinkers.
Figure 1 shows the means of each variable determining the lipid indices calculated with adjustment for age, smoking, exercise and drug therapy for diabetes. Body weight was also adjusted to calculate the means of the variables other than waist circumference. Waist circumference was significantly smaller in moderate drinkers than in nondrinkers (Figure 1A). The log-transformed triglyceride levels were significantly higher in heavy drinkers than in nondrinkers and light drinkers (Figure 1B). The HDL cholesterol level was significantly higher in light, moderate and heavy drinkers than in nondrinkers and tended to be higher with an increase in alcohol intake (Figure 1C). The LDL cholesterol level was significantly lower in moderate and heavy drinkers than in nondrinkers and light drinkers (Figure 1D).
(Enlarge Image)
Figure 1.
Comparison of the variables determining the lipid indices among non-, light, moderate and heavy drinkers in patients with diabetes. The mean levels of variables (A, waist circumference; B, log-transformed triglycerides; C, HDL cholesterol; D, LDL cholesterol) were calculated after adjustment for age, smoking, regular exercise and drug therapy for diabetes. Body weight was also added to covariates to calculate the means of the variables other than waist circumference. Symbols denote significant differences from nondrinkers (*, p < 0.05; **, p < 0.01) and light drinkers (†, p < 0.05; ††, p < 0.01).
The mean levels of each lipid index calculated with adjustment for the aforementioned confounders are shown in Figure 2. The LDL-C/HDL-C ratio was significantly lower in light, moderate and heavy drinkers than in nondrinkers and tended to be lower with an increase in alcohol intake (Figure 2A). The log-transformed TG/HDL-C ratio was significantly lower in light and moderate drinkers than in nondrinkers (Figure 2B). Log-transformed LAP was significantly higher in heavy drinkers than in light drinkers. Log-transformed LAP tended to be lower in light drinkers and higher in heavy drinkers compared with that in nondrinkers, although the differences were not significant (Figure 2C).
(Enlarge Image)
Figure 2.
Comparison of the lipid indices among non-, light, moderate and heavy drinkers in patients with diabetes. The mean levels of variables (A, LDL-C/HDL-C ratio; B, log-transformed TG/HDL-C ratio; C, log-transformed LAP) were calculated after adjustment for age, smoking, regular exercise and drug therapy for diabetes. Body weight was also added to covariates to calculate the means of the variables other than LAP. Symbols denote significant differences from nondrinkers (**, p < 0.01) and light drinkers (†, p < 0.05; ††, p < 0.01).
Table 2 shows the odds ratios vs. nondrinkers for the high lipid indices. Both the crude and adjusted odds ratios for a high LDL-C/HDL-C ratio were significantly lower in moderate and heavy drinkers compared with a reference level of 1.00 and tended to be lower with an increase in alcohol intake. Both the crude and adjusted odds ratios for a high TG/HDL-C ratio were significantly lower in the light, moderate and heavy drinker groups compared with a reference level of 1.00, except for the crude odds ratio of heavy drinkers, which was marginally significant (p = 0.077). The crude odds ratios for a high LAP were significantly lower in light and moderate drinkers compared with a reference level of 1.00, and the corresponding adjusted odds ratio also tended to be lower than the reference level. On the other hand, the crude and adjusted odds ratios for a high LAP of heavy drinkers vs. nondrinkers tended to be higher than the reference level, although the differences were not significant.
As shown in Table 3 , both the crude and adjusted odds ratios of light and moderate drinkers vs. nondrinkers for ≥ one high lipid index, ≥ two high lipid indices or three high lipid indices were significantly lower than a reference level of 1.00, except for a marginal significance of the adjusted odds ratio of light drinkers vs. nondrinkers for three high lipid indices (p = 0.091). The crude and adjusted odds ratios of heavy drinkers vs. nondrinkers for three high lipid indices were also significantly lower than the reference level ( Table 3 ), and these very low odds ratios may reflect the very low odds ratios for the high LDL-C/HDL-C ratio of heavy drinkers vs. nondrinkers ( Table 2 ).
Results
Characteristics of the Subject Groups
Table 1 shows the results of comparison of the alcohol groups by a univariate analysis. Body weight and waist circumference were significantly lower and smaller, respectively, in light and moderate drinkers than in nondrinkers. The percentage of smokers was significantly higher in moderate and heavy drinkers than in nondrinkers, while there was no significant difference in the percentage of subjects doing regular exercise among the alcohol groups. The triglyceride level was significantly lower in light drinkers than in nondrinkers and was higher with a marginal significance (p = 0.053) in heavy drinkers than in nondrinkers. The HDL cholesterol level was significantly higher in light, moderate and heavy drinkers than in nondrinkers, while the LDL cholesterol level was significantly lower in moderate and heavy drinkers than in nondrinkers. The LDL-C/HDL-C ratio was significantly lower in light, moderate and heavy drinkers than in nondrinkers and tended to be lower with an increase in alcohol intake. The TG/HDL-C ratio was significantly lower in light and moderate drinkers than in nondrinkers. The LAP was significantly lower in light drinkers and significantly higher in heavy drinkers when compared with that in nondrinkers.
Comparison of Hemoglobin A1c Among Alcohol Groups by the Multivariate Analysis
The hemoglobin A1c levels (means with standard errors) were 7.83 ± 0.06%, 7.78 ± 0.12%, 7.50 ± 0.07% and 7.64 ± 0.09% in nondrinkers, light drinkers, moderate drinkers and heavy drinkers, respectively. Hemoglobin A1c was significantly lower in moderate drinkers than in nondrinkers, and there was a tendency of an inverted J-shaped relationship between the alcohol intake and hemoglobin A1c level, although there were no significant differences in hemoglobin A1c between light drinkers and nondrinkers and between heavy drinkers and nondrinkers.
Comparison of the Variables Determining the Lipid-Related Indices Among Alcohol Groups by the Multivariate Analysis
Figure 1 shows the means of each variable determining the lipid indices calculated with adjustment for age, smoking, exercise and drug therapy for diabetes. Body weight was also adjusted to calculate the means of the variables other than waist circumference. Waist circumference was significantly smaller in moderate drinkers than in nondrinkers (Figure 1A). The log-transformed triglyceride levels were significantly higher in heavy drinkers than in nondrinkers and light drinkers (Figure 1B). The HDL cholesterol level was significantly higher in light, moderate and heavy drinkers than in nondrinkers and tended to be higher with an increase in alcohol intake (Figure 1C). The LDL cholesterol level was significantly lower in moderate and heavy drinkers than in nondrinkers and light drinkers (Figure 1D).
(Enlarge Image)
Figure 1.
Comparison of the variables determining the lipid indices among non-, light, moderate and heavy drinkers in patients with diabetes. The mean levels of variables (A, waist circumference; B, log-transformed triglycerides; C, HDL cholesterol; D, LDL cholesterol) were calculated after adjustment for age, smoking, regular exercise and drug therapy for diabetes. Body weight was also added to covariates to calculate the means of the variables other than waist circumference. Symbols denote significant differences from nondrinkers (*, p < 0.05; **, p < 0.01) and light drinkers (†, p < 0.05; ††, p < 0.01).
Comparison of the Lipid-Related Indices Among Alcohol Groups by the Multivariate Analysis
The mean levels of each lipid index calculated with adjustment for the aforementioned confounders are shown in Figure 2. The LDL-C/HDL-C ratio was significantly lower in light, moderate and heavy drinkers than in nondrinkers and tended to be lower with an increase in alcohol intake (Figure 2A). The log-transformed TG/HDL-C ratio was significantly lower in light and moderate drinkers than in nondrinkers (Figure 2B). Log-transformed LAP was significantly higher in heavy drinkers than in light drinkers. Log-transformed LAP tended to be lower in light drinkers and higher in heavy drinkers compared with that in nondrinkers, although the differences were not significant (Figure 2C).
(Enlarge Image)
Figure 2.
Comparison of the lipid indices among non-, light, moderate and heavy drinkers in patients with diabetes. The mean levels of variables (A, LDL-C/HDL-C ratio; B, log-transformed TG/HDL-C ratio; C, log-transformed LAP) were calculated after adjustment for age, smoking, regular exercise and drug therapy for diabetes. Body weight was also added to covariates to calculate the means of the variables other than LAP. Symbols denote significant differences from nondrinkers (**, p < 0.01) and light drinkers (†, p < 0.05; ††, p < 0.01).
Odds Ratios for High Lipid Indices in Each Drinker Group vs. the Nondrinker Group
Table 2 shows the odds ratios vs. nondrinkers for the high lipid indices. Both the crude and adjusted odds ratios for a high LDL-C/HDL-C ratio were significantly lower in moderate and heavy drinkers compared with a reference level of 1.00 and tended to be lower with an increase in alcohol intake. Both the crude and adjusted odds ratios for a high TG/HDL-C ratio were significantly lower in the light, moderate and heavy drinker groups compared with a reference level of 1.00, except for the crude odds ratio of heavy drinkers, which was marginally significant (p = 0.077). The crude odds ratios for a high LAP were significantly lower in light and moderate drinkers compared with a reference level of 1.00, and the corresponding adjusted odds ratio also tended to be lower than the reference level. On the other hand, the crude and adjusted odds ratios for a high LAP of heavy drinkers vs. nondrinkers tended to be higher than the reference level, although the differences were not significant.
Odds Ratios for Accumulation of High Lipid Indices in Each Drinker Group vs. the Nondrinker Group
As shown in Table 3 , both the crude and adjusted odds ratios of light and moderate drinkers vs. nondrinkers for ≥ one high lipid index, ≥ two high lipid indices or three high lipid indices were significantly lower than a reference level of 1.00, except for a marginal significance of the adjusted odds ratio of light drinkers vs. nondrinkers for three high lipid indices (p = 0.091). The crude and adjusted odds ratios of heavy drinkers vs. nondrinkers for three high lipid indices were also significantly lower than the reference level ( Table 3 ), and these very low odds ratios may reflect the very low odds ratios for the high LDL-C/HDL-C ratio of heavy drinkers vs. nondrinkers ( Table 2 ).
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