Changes in Alcohol Consumption and Subsequent Risk of Type 2 Diabetes in Men

Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Diabetes (Impact Factor: 8.1). 09/2010; 60(1):74-9. DOI: 10.2337/db10-1052
Source: PubMed


The objective of this study was to investigate the association of 4-year changes in alcohol consumption with a subsequent risk of type 2 diabetes.
We prospectively examined 38,031 men from the Health Professionals Follow-Up Study who were free of diagnosed diabetes or cancer in 1990. Alcohol consumption was reported on food frequency questionnaires and updated every 4 years.
A total of 1,905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (approximately half a glass) increase in alcohol consumption over 4 years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard ratio [HR] 0.78; 95% CI: 0.60-1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI: 0.83-0.96), but not among men initially drinking ≥15 g/day (HR 0.99; 95% CI: 0.95-1.02; P(interaction) < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin A(1c), with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared with stable light drinkers (0-4.9 g/day), light drinkers who increased their intake to moderate levels (5.0-29.9 g/day) had a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI: 0.62-0.90).
Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light drinkers. This lower risk was evident within a 4-year period following increased alcohol intake.

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    • "Recent meta-analyses have concluded that there is either a U-shaped [7, 8], J-shaped [9], or inverse association [10] between T2DM incidence and alcohol consumption. Furthermore, one prospective study reported that increased alcohol consumption over time was associated with lower risk of T2DM among initially rare and light drinkers [11]. "
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    ABSTRACT: Objective . To examine the association between alcohol consumption and risk of type 2 diabetes mellitus (T2DM) overall and by body mass index. Methods . Cross-sectional study of employed individuals. Daily alcohol intakes were calculated from a self-administered food frequency questionnaire by 5,512 Maori, Pacific Island, and European workers (3,992 men, 1520 women) aged 40 years and above. Results . There were 170 new cases of T2DM. Compared to the group with no alcohol consumption and adjusting for age, sex, and ethnicity, the group consuming alcohol had relative risks of T2DM of 0.23 (95% CI: 0.08, 0.65) in normal weight individuals, 0.38 (0.18, 0.81) in overweight individuals, and 0.99 (0.59, 1.67) in obese individuals. After further adjusting for total cholesterol, HDL-cholesterol, triglycerides, smoking habit, physical activity, socioeconomic status, body mass index, and hypertension, the relative risks of T2DM were 0.16 (0.05, 0.50) in normal weight individuals, 0.43 (0.19, 0.97) in overweight individuals, and 0.92 (0.52, 1.60) in overweight individuals. Across the categories of alcohol consumption, there was an approximate U-shaped relationship for new cases of T2DM. There was no significant association between alcohol consumption and IGT. Conclusions . Alcohol consumption was protective against diagnosis of T2DM in normal and overweight individuals but not in the obese.
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    • "Several prospective studies have reported positive associations between circulating fetuin-A and type 2 diabetes risk and, concomitantly, observed inverse relations between alcohol consumption and fetuin-A [3-5]. More importantly, a recent case-control study suggested that fetuin-A may partially explain the reduced risk of type 2 diabetes [6] that has consistently been observed with moderate alcohol consumption [7-9]. However, the cross-sectional and observational nature of these alcohol-fetuin-A associations may raise concern about potential confounding. "
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    ABSTRACT: Fetuin-A, a liver-derived glycoprotein that impairs insulin-signalling, has emerged as a biomarker for diabetes risk. Although moderate alcohol consumption has been inversely associated with fetuin-A, data from clinical trials are lacking. Thus, we evaluated whether moderate alcohol consumption decreases circulating levels of fetuin-A. We analyzed data of three separate open-label, randomized, crossover trials: 1) 36 postmenopausal women consuming 250 ml white wine (25 g alcohol) or white grape juice daily for 6 weeks, 2) 24 premenopausal women consuming 660 ml beer (26 g alcohol) or alcohol-free beer daily for 3 weeks, and 3) 24 young men consuming 100 ml vodka (30 g alcohol) orange juice or only orange juice daily for 4 weeks. After each treatment period fasting blood samples were collected. Circulating fetuin-A concentrations decreased in men after vodka consumption (Mean +/- SEM: 441 +/- 11 to 426 +/- 11 mug/ml, p = 0.02), but not in women after wine (448 +/- 17 to 437 +/- 17 mug/ml, p = 0.16) or beer consumption (498 +/- 15 to 492 +/- 15 mug/ml, p = 0.48) compared to levels after each corresponding alcohol-free treatment. Post-hoc power analyses indicated that the statistical power to detect a similar effect as observed in men was 30% among the postmenopausal women and 31% among the premenopausal women. In these randomized crossover trials, moderate alcohol consumption decreased fetuin-A in men but not in women. This sex-specific effect may be explained by the relatively short intervention periods or the low statistical power in the trials among women.Trials registration: ID no's: NCT00285909, NCT00524550, NCT00918918.
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    • "In neonates this syndrome is known as microcephaly associating characteristic face made of short palpebral fissures, sunken nasal bridge, short nose, flattening of the cheekbones and midface, smoothing and elongation of the ridged area (the philtrum) between the nose and lips, and smooth, thin upper lip. Previously, it has been suggested that moderate drinking would increase insulin sensitivity [6], but no study questioned it as protective or adverse factor on either detection or survey of Gestational Diabetes Mellitus (GDM) which is known as a situation of low insulin sensitivity. This study aims at three issues: to evaluate the importance of alcohol consumption by pregnant women in our milieu; to determine whether alcohol consumption during pregnancy influences GDM detection; to determine its influences on maternal and infant's outcomes among GDM women. "
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    ABSTRACT: Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol con-sumption during pregnancy, and seeing whether this consumption influences GDM detection and mater-nal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pre-gnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O'Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and ge-neral characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Met-formin, and if necessary with insulin. For other (nor-mal) women data remained blinded until confinement. Maternal and infant's adverse outcomes such as ma-ternal urinary infection, preeclampsia, cesarean sec-tion, intrauterine growth retardation, birth weight < 2500 g, birth weight ≥ 3800 g (as stated > percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hy-poglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol con-sumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more fre-quent (p = 0.02) among drinkers. GDM's prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alco-hol consumers than in abstainers. Risk of this out-come was three times higher when history of family hypertension was present (odds ratio 2.694; CI: 0.536 -13.544). Conclusions: The prevalence of alcohol con-sumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. In-fluence of alcohol consumption on birth weight mo-stly in setting of familial history of hypertension re-mains to be addressed.
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