kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2016.16.3.153 kjhp-16-153 Original Article Relationship among Alcohol Consumption, Facial Flushing Response and Dyslipidemia in Male KimKyu Pill KimJong Sung KimSung Soo JungJin Kyu YoonSeok Joon WeiChang Jung Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea Corresponding author: Jong Sung Kim, MD, PhD Department of Family Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: +82-42-280-8172, Fax: +82-42-280-7879 E-mail: jskim@cnuh.co.kr 01 2016 20 01 2016 16 3 153 161 12012016 01092016 Copyright © 2016 The Korean Society of Health Promotion and Disease Prevention 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

Facial flushing response to drinking is observed in East Asians with deficient activity of the variant aldehyde dehydrogenase 2 genotype. This study examined the role of flushing response in the relationship between alcohol consumption and dyslipidemia.

 Methods

This cross-sectional study included 1,443 Korean men, including 261 non-drinkers, 470 flushers and 712 non-flushers. Based on a questionnaire, weekly alcohol consumption was assessed and categorized into 4 groups. Dyslipidemia was defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria. After adjusting for confounding factors, we evaluated the relationship between weekly alcoholic drinks and dyslipidemia in flushers and non-flushers by comparing with non-drinkers, using a multi-variable logistic regression analysis.

 Results

Non-flushers had a significant relationship between hypertriglyceridemia and alcohol consumption in two groups (4–8 drinks: adjusted odds ratio [aOR] 1.937, 95% confidence interval [CI] 1.029–3.644; ≥16 drinks: aOR 2.118, 95% CI 1.272–3.527) in contrast to flushers, who showed no significant relationship between hypertriglyceridemia and alcohol consumption. Non-flushers had a significant relationship to low serum high density lipoprotein (HDL) cholesterol levels in four groups (<4 drinks: aOR 0.428, 95% CI 0.277–0.662; 4–8 drinks: aOR 0.409, 95% CI 0.216–0.774; 8–16 drinks: aOR 0.285, 95% CI 0.152–0.536; ≥16 drinks: aOR 0.343, 95% CI 0.207–0.568), and flushers had a significant relationship in two groups (8–16 drinks: aOR 0.234, 95% CI 0.102–0.536; ≥16 drinks: aOR 0.342, 95% CI 0.166–0.705).

 Conclusions

Our results suggest that drinking alcohol increases the risk of hypertriglyceridemia in non-flushers and the risk of low HDL cholesterol flushers.

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Prevalence of high LDL-C according to weekly drinking amount.

Prevalence of hypercholesterolemia according to weekly drinking amount.

Prevalence of hypertriglyceridemia according to weekly drinking amount.

Prevalence of low HDL-C according to weekly drinking amount.

Characteristics of f the subjects

Variables Non-drinkers Drinkers
(n=261) Flushers (n=470) Pa Non-flushers (n=712) Pa
Age, y 49.91±11.77 48.20±11.31 0.054 46.89±10.66 <0.001
BMI, kg/m2 24.47±3.20 25.25±2.92 0.001 24.79±2.96 0.161
WC, cm 85.01±9.33 87.49±8.12 <0.001 85.78±8.07 0.243
LDL-C, mg/dL 111.42±30.83 110.14±30.30 0.586 106.56±30.42 0.028
TC, mg/dL 187.72±35.69 190.63±34.90 0.284 190.72±35.03 0.240
TG, mg/dL 129.15±81.75 137.61±97.73 0.235 153.73±101.21 <0.001
HDL-C, mg/dL 44.26±7.89 46.17±8.00 0.002 47.54±7.93 <0.001
FBS, mg/dL 94.70±29.18 94.01±22.83 0.724 99.91±24.74 0.006
Smokingb     <0.001   <0.001
Non-smoker 124 (47.5) 140 (29.8)   243 (34.1)  
Ex-smoker 89 (34.1) 159 (33.8)   206 (28.9)  
Smoker 48 (18.4) 171 (36.4)   263 (36.9)  
Exerciseb     0.798   0.009
None 91 (34.9) 169 (36.0)   214 (30.1)  
Irregular 117 (44.8) 199 (42.3)   283 (39.7)  
Regular 53 (20.3) 102 (21.7)   215 (30.2)  
Hypertensionb 88 (16.6) 193 (36.5) 0.050 248 (46.9) 0.746
Type 2 diabetes mellitusb 19 (15.1) 37 (29.4) 0.773 70 (55.6) 0.221
Drinks/weekc NA 7.59±11.12   11.81±13.09 <0.001
<4 NA 1.38±1.15   2.00±1.20 <0.001
4–8 NA 5.63±1.44   6.24±1.14 0.006
8–16 NA 11.80±2.14   11.94±1.68 0.662
≥16 NA 27.56±14.84   27.68±13.61 0.950

Abbreviations: BMI, body mass index; WC, waist circumference; LDL-C, low-density lipoprotein cholesterol; TC, total cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; FBS, fasting blood sugar; NA, not availabe. Values are presented as N (%) or mean±SD unless otherwise indicated.

Compared with non-drinkers by t-test.

Compared with non-drinkers by chi-square test.

Compared with non-flushers by t-test. 1 drink = alcohol 14 g.

Relationship dyslipidemia and weekly alcohol drinks in flushers and non-flushers

Drinks/wka Flushers (n=470) Non-flushers (n=712)
Odds ratio 95% confidence interval Pb Odds ratio 95% confidence interval Pb
LDL-C≥160 mg/dL            
Non-drinkers 1.000     1.000    
<4 1.062 0.525–2.149 0.867 0.600 0.266–1.352 0.218
4–8 0.927 0.304–2.823 0.893 0.732 0.253–2.117 0.565
8–16 0.423 0.113–1.583 0.201 0.941 0.382–2.318 0.895
≥16 0.370 0.099–1.839 0.141 0.551 0.229–1.322 0.182
TC≥240 mg/dL            
Non-drinkers 1.000     1.000    
<4 0.967 0.491–1.905 0.922 0.966 0.485–1.922 0.921
4–8 1.014 0.361–2.847 0.979 1.124 0.462–2.735 0.796
8–16 0.679 0.229–2.016 0.486 1.229 0.556–2.718 0.610
≥16 0.485 0.150–1.566 0.226 0.805 0.380–1.707 0.572
TG≥200 mg/dL            
Non-drinkers 1.000     1.000    
<4 1.247 0.744–2.091 0.403 1.118 0.710–1.987 0.512
4–8 1.703 0.788–3.679 0.175 1.937 1.029–3.644 0.040
8–16 0.539 0.213–1.361 0.191 1.438 0.789–2.623 0.236
≥16 0.970 0.428–2.198 0.941 2.118 1.272–3.527 0.004
HDL-C<40 mg/dL            
Non-drinkers 1.000     1.000    
<4 0.770 0.514–1.153 0.204 0.428 0.277–0.662 <0.001
4–8 0.508 0.248–1.040 0.064 0.409 0.216–0.774 0.006
8–16 0.234 0.102–0.536 0.001 0.285 0.152–0.536 <0.001
≥16 0.342 0.166–0.705 0.004 0.343 0.207–0.568 <0.001

Abbreviations: wk, week; LDL-C, low density lipoprotein cholesterol; TC, total cholesterol; TG, triglyceride; HDL-C, high density lipoprotein cholesterol.

1 drink = alcohol 14 g.

Compared with non-drinkers by multivariable logistic regression. Adjusted for age, exercise status, smoking status, body mass index, waist circumference, history of hypertension, and history of type 2 diabetes mellitus.

Relationship dyslipidemia and weekly alcohol drinks in flushers, comparing with non-flushersa,b

Drinks/wkb Pa Odds 95% confidence
ratio interval
Non-flushers   1.000  
LDL-C≥160 mg/dL      
<4 0.162 1.757 0.798–3.866
4–8 0.587 1.492 0.351–6.388
8–16 0.163 0.322 0.065–1.582
≥16 0.422 0.551 0.129–2.358
TC≥240 mg/dL      
<4 0.799 0.915 0.463–1.809
4–8 0.907 0.931 0.283–3.067
8–16 0.459 0.643 0.200–2.070
≥16 0.560 0.697 0.206–2.351
TG≥200 mg/dL      
<4 0.876 0.961 0.585–1.579
4–8 0.770 0.877 0.365–2.110
8–16 0.040 0.360 0.135–0.955
≥16 0.002 0.285 0.128–0.638
HDL-C<40 mg/dL      
<4 0.010 1.819 1.157–2.860
4–8 0.565 1.319 0.514–3.386
8–16 0.763 0.857 0.315–2.331
≥16 0.915 1.044 0.474–2.297

Abbreviations: LDL-C, low density lipoprotein cholesterol; TC, total cholesterol; TG, triglyceride; HDL-C, high density lipoprotein cholesterol.

Adjusted for age, exercise status, smoking status, body mass index, waist circumference, history of hypertension, and history of type 2 diabetes mellitus.

1 drink = alcohol 14 g.