Relationship among Alcohol Consumption, Facial Flushing Response and Dyslipidemia in Male

Article information

Korean J Health Promot. 2016;16(3):153-161

Publication date (electronic) : 2016 January 20

doi : https://doi.org/10.15384/kjhp.2016.16.3.153

Kyu Pill Kim , Jong Sung Kim , Sung Soo Kim , Jin Kyu Jung , Seok Joon Yoon , Chang Jung Wei

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

Received 2016 January 12; Accepted 2016 September 01.

Abstract

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.

Keywords: Alcohol drinking; Flushing; Dyslipidemias; High density lipoprotein cholesterol; Triglycerides

Figure 1.

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

Figure 2.

Prevalence of hypercholesterolemia according to weekly drinking amount.

Figure 3.

Prevalence of hypertriglyceridemia according to weekly drinking amount.

Figure 4.

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

Table 1.

Characteristics of f the subjects

Table 2.

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

Table 3.

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

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Figure 1.

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

Figure 2.

Prevalence of hypercholesterolemia according to weekly drinking amount.

Figure 3.

Prevalence of hypertriglyceridemia according to weekly drinking amount.

Figure 4.

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

Table 1.

Characteristics of f the subjects

Variables	Non-drinkers	Drinkers
Variables	(n=261)	Flushers (n=470)	P^a	Non-flushers (n=712)	P^a
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
Smoking^b			<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)
Exercise^b			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)
Hypertension^b	88 (16.6)	193 (36.5)	0.050	248 (46.9)	0.746
Type 2 diabetes mellitus^b	19 (15.1)	37 (29.4)	0.773	70 (55.6)	0.221
Drinks/week^c	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.

Table 2.

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

Drinks/wk^a	Flushers (n=470)			Non-flushers (n=712)
Drinks/wk^a	Odds ratio	95% confidence interval	P^b	Odds ratio	95% confidence interval	P^b
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.

Table 3.

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

Drinks/wk^b	P^a	Odds	95% confidence
Drinks/wk^b	P^a	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.