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Effect of Moderate Alcohol Consumption on Plasma Dehydroepiandrosterone Sulfate, Testosterone, and Estradiol Levels in Middle‐Aged Men and Postmenopausal Women: A Diet‐Controlled Intervention Study

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Abstract

Moderate alcohol consumption is inversely associated with cardiovascular diseases. Changes in hormone levels might in part help explain the positive health effect. This study was performed to examine the effect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate (DHEAS), testosterone, and estradiol levels. In a randomized, diet-controlled, crossover study, 10 middle-aged men and 9 postmenopausal women, all apparently healthy, nonsmoking, and moderate alcohol drinkers, consumed beer or no-alcohol beer with dinner during two successive periods of 3 weeks. During the beer period, alcohol intake equaled 40 and 30 g per day for men and women, respectively. The total diet was supplied and had essentially the same composition during these 6 weeks. Before each treatment there was a 1 week washout period, in which the subjects were not allowed to drink alcoholic beverages. At the end of each of the two experimental periods, fasting blood samples were collected in the morning. Moderate alcohol consumption increased plasma DHEAS level by 16.5% (95% confidence interval, 8.0-24.9), with similar changes for men and women. Plasma testosterone level decreased in men by 6.8% (95% confidence interval, -1.0- -12.5), but no effect was found in women. Plasma estradiol level was not affected. Serum high-density lipoprotein cholesterol level increased by 11.7% (95% confidence interval, 7.3-16.0), with similar changes for men and women. The overall alcohol-induced relative changes in DHEAS, testosterone, and estradiol correlated positively with the relative increase in high-density lipoprotein cholesterol (adjusted for the relative change in body weight); however, findings were only borderline significant for DHEAS and estradiol (r = 0.44, p = 0.08; r = 0.32, p = 0.21; and r = 0.46, p = 0.06, respectively). A protective effect of moderate alcohol consumption for cardiovascular disease risk may in part be explained by increased plasma DHEAS level.
Effect of Moderate Alcohol Consumption on Plasma
Dehydroepiandrosterone Sulfate, Testosterone, and
Estradiol Levels in Middle-Aged Men and
Postmenopausal Women: A Diet-Controlled
Intervention Study
Aafje Sierksma, Taisto Sarkola, C. J. Peter Eriksson, Martijn S. van der Gaag,* Diederick E. Grobbee, Henk F. J. Hendriks
Background: Moderate alcohol consumption is inversely associated with cardiovascular diseases.
Changes in hormone levels might in part help explain the positive health effect. This study was performed
to examine the effect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate
(DHEAS), testosterone, and estradiol levels.
Methods: In a randomized, diet-controlled, crossover study, 10 middle-aged men and 9 postmenopausal
women, all apparently healthy, nonsmoking, and moderate alcohol drinkers, consumed beer or no-alcohol
beer with dinner during two successive periods of 3 weeks. During the beer period, alcohol intake equaled
40 and 30 g per day for men and women, respectively. The total diet was supplied and had essentially the
same composition during these 6 weeks. Before each treatment there was a 1 week washout period, in which
the subjects were not allowed to drink alcoholic beverages. At the end of each of the two experimental
periods, fasting blood samples were collected in the morning.
Results: Moderate alcohol consumption increased plasma DHEAS level by 16.5% (95% confidence interval,
8.0–24.9), with similar changes for men and women. Plasma testosterone level decreased in men by 6.8% (95%
confidence interval, 1.0 – 12.5), but no effect was found in women. Plasma estradiol level was not affected.
Serum high-density lipoprotein cholesterol level increased by 11.7% (95% confidence interval, 7.3–16.0), with
similar changes for men and women. The overall alcohol-induced relative changes in DHEAS, testosterone, and
estradiol correlated positively with the relative increase in high-density lipoprotein cholesterol (adjusted for the
relative change in body weight); however, findings were only borderline significant for DHEAS and estradiol (r
0.44, p0.08; r0.32, p0.21; and r0.46, p0.06, respectively).
Conclusions: A protective effect of moderate alcohol consumption for cardiovascular disease risk may
in part be explained by increased plasma DHEAS level.
Key Words: Alcohol, Dehydroepiandosterone Sulfate (DHEAS), Testosterone, Estradiol, HDL Cho-
lesterol.
MODERATE ALCOHOL CONSUMPTION is in-
versely associated with cardiovascular diseases
(CVD) (Colditz et al., 1985; Grobbee et al., 1999;
Stampfer et al., 1988). Mechanisms proposed to explain
a positive health effect of moderate alcohol consumption
involve prevention of atherogenesis through changes in
lipoprotein metabolism (Hendriks et al., 1998; Van der
Gaag et al., 1999), hemostasis (Dimmitt et al., 1998;
Hendriks et al., 1994), and inflammation (Imhof et al.,
2001; Koenig et al., 1999; Sierksma et al., 2002b).
There is accumulating evidence suggesting the involve-
ment of sex hormones in atherogenesis. Studies suggest a
protective effect of high levels of dehydroepiandrosterone
sulfate (DHEAS) against atherosclerosis (Barrett-Connor
et al., 1986; Feldman et al., 2001; Leowattana, 2001). This
is further supported by an observed inverse correlation
between DHEAS levels and pulse wave velocity (Ishihara
et al., 1992) and carotid wall thickness (Bernini et al., 1999).
An independent inverse association between levels of tes-
tosterone and aortic atherosclerosis in men aged 55 years
and over has been reported (Hak et al., 2002). In addition,
studies in older men have shown an inverse association
between testosterone levels and aortic stiffness (Dockery et
From the Department of Nutritional Physiology, TNO Nutrition and Food
Research (AS, MSvdG, HFJH), Zeist, The Netherlands; Julius Center for Health
Sciences and Primary Care, University Medical Center Utrecht (AS, DEG),
Utrecht, The Netherlands; and Department of Mental Health and Alcohol Re-
search, National Public Health Institute (TS, CJPE), Helsinki, Finland.
Received for publication October 30, 2003; accepted January 7, 2004.
Supported by the Dutch Foundation for Alcohol Research (SAR).
Reprint requests: Henk F. J. Hendriks, PhD, TNO Nutrition and Food
Research, Department of Nutritional Physiology, PO Box 360, 3700 AJ Zeist,
The Netherlands; Fax: 31 30 6944928; E-mail: hendriks@voeding.tno.nl.
*Deceased.
DOI: 10.1097/01.ALC.0000125356.70824.81
0145-6008/04/2805-0780$03.00/0
ALCOHOLISM:CLINICAL AND EXPERIMENTAL RESEARCH
Vol. 28, No. 5
May 2004
780 Alcohol Clin Exp Res, Vol 28, No 5, 2004: pp 780–785
al., 2002) and intima-media thickness (Van den Beld et al.,
2003). Premenopausal women may be protected from
CVD, relative to men, due to high circulating estrogen
levels (Matthews, 1992).
Changes in hormone levels may in part explain the health
benefits of moderate alcohol consumption. Two long-term
diet-controlled intervention studies in pre- and postmeno-
pausal women showed increases in DHEAS and plasma
estrogen/estrone sulfate levels after moderate alcohol in-
take (Dorgan et al., 2001; Reichman et al., 1993). Effects of
alcohol on hormone levels may depend on age and gender
(Orentreich et al., 1984; Zumoff et al., 1980). To further
investigate the effect of moderate alcohol consumption on
plasma DHEAS, testosterone, and estradiol levels and
their correlation with alcohol-induced changes in high-
density lipoprotein (HDL) cholesterol, we performed an
intervention study in both middle-aged men and postmeno-
pausal women. Diet was controlled during the study, as
nutrition might influence sex hormone variability (Tamimi
et al., 2001; Ukkola et al., 2001).
METHODS
Subjects
The study was conducted at TNO Nutrition and Food Research (Zeist,
The Netherlands). The trial was performed according to the ICH Guide-
lines for Good Clinical Practice, complied with the Declaration of Hel-
sinki, and was approved by the TNO Medical Ethics Committee. Ten
middle-aged men and 10 postmenopausal women, all nonsmoking, were
recruited from the pool of volunteers of TNO Nutrition and Food Re-
search and through an advertisement in a local newspaper. The volunteers
received all information about the study (including aim; medical, ethical,
and practical aspects; and insurance) by verbal briefing and received the
same information in writing and subsequently signed for informed con-
sent. Subjects were eligible if they fulfilled the following inclusion criteria:
consumption of 28 alcohol-containing beverages per week for men and
21 for women, body mass index between 20 and 31 kg/m
2
, and no family
history of alcoholism. Subjects were healthy as indicated by the values of
the prestudy laboratory tests, which all were within the normal range. In
addition, they were healthy as indicated by their medical history and a
physical examination by the medical investigator. The postmenopausal
women did not have menses for at least a year, were not ovariectomized,
and did not use hormone replacement therapy. One postmenopausal
woman dropped out because of a treatment-unrelated cause. The remain-
ing 19 subjects completed the study successfully. Characteristics of the
study population are given in Table 1.
Study Design
The subjects entered an open randomized crossover trial consisting of
two periods of 3 weeks. Five men and five women were randomly allocated
to the sequence beer (Amstel Bier, Amsterdam, The Netherlands; 5 vol%
alcohol) followed by no-alcohol beer (Amstel Malt Bier, Amsterdam, The
Netherlands; 0.1 vol% alcohol). The other half of the subjects consumed
no-alcohol beer first followed by beer. In this way, any bias due to the
beverage order and a possible drift of variables over time was eliminated.
There was a 1 week washout period before each treatment period in which
participants were not allowed to drink alcoholic beverages, to limit pos-
sible carryover effects.
Four glasses of each beverage for men and three glasses of each
beverage for women were consumed daily during the evening dinner.
During the beer period, alcohol intake equaled 40 and 30 g per day for
men and women, respectively. The total diet was supplied to exclude
dietary confounding. Subjects consumed all foods at home, except for
evening dinner, which was served at TNO Nutrition and Food Research,
together with the beer or no-alcohol beer. Subjects were not allowed to eat
or drink anything but the foods supplied, except for tap water and coffee
(limited amount of creamer was supplied), and they were asked to main-
tain their habitual physical activity pattern.
We considered the energy provided by alcohol to be 19.6 kJ/g, assuming
the net usable energy content of alcohol is 70% of the theoretically present
28 kJ/g (Rumpler et al., 1996; Westerterp, 1996). Taking this into account,
no-alcohol beer contained approximately 90 kJ/100 ml, and beer contained
approximately 130 kJ/100 ml. The source of energy in no-alcohol beer was
almost 100% carbohydrates; in beer approximately 40% of energy was
derived from carbohydrates and 60% of energy was derived from alcohol.
The diets, including beer or no-alcohol beer, were comparable in such a
way that the macronutrient composition and total energy were the same
during the beer and no-alcohol beer period. The macronutrient compo-
sition of the diet was based on the national Dutch food consumption
survey of 1998 (Anonymous, 1998). Diets during the beer and no-alcohol
beer period consisted of approximately 17% energy from protein, 39%
energy from fat, and 44% energy from carbohydrate, for both males and
females. Daily energy requirement was estimated for each subject accord-
ing to Schofield (1985). The diet was provided in nine different levels of
energy intake per day; 7, 8, 9, 10, 11, 12, 13, 14, and 15 MJ, depending on
the body weight of the subject. Body weight was determined every 3 or 4
days with the subjects wearing indoor clothing, without shoes, wallet, and
keys. When a subjects body weight deviated more than 1.5 kg from his or
her weight at the first experimental day, energy supply was adjusted (1
MJ), without changing the macronutrient composition, to maintain body
weight. Compliance to the protocol, physical adverse events, and medicine
use were checked by a daily questionnaire.
Table 1. Characteristics of the Volunteers Included in the Data Analysis
Men (n10) Women (n9)
Age (yr) 55 (6) 45–64 57 (4) 49–62
Body weight (kg) 79.2 (9.2) 62.7–93.7 74.0 (7.3) 66.0–85.1
BMI (kg/m
2
)24.9 (2.2) 20.1–28.6 26.8 (2.9) 22.0–30.7
Hemoglobin (mmol/liter) 9.4 (0.5) 8.7–10.7 8.5 (0.4) 7.7–9.3
Triglycerides (mmol/liter) 1.2 (0.4) 0.8–1.9 0.9 (0.4) 0.5–1.6
Total cholesterol (mmol/liter) 6.2 (1.1) 4.5–7.6 6.9 (1.3) 5.4–8.6
HDL cholesterol (mmol/liter) 1.5 (0.4) 0.9–2.3 2.0 (0.4) 1.6–2.6
LDL cholesterol (mmol/liter) 4.3 (0.9) 2.9–5.8 4.5 (1.2) 3.3–6.3
ASAT (units/liter) 25 (5) 19–34 19 (3) 15–24
ALAT (units/liter) 21 (4) 17–29 14 (3) 10–19
GGT (units/liter) 22 (7) 11–34 16 (4) 11–23
Glucose (mmol/liter) 5.4 (0.5) 4.9–6.3 5.5 (0.4) 5.0–6.1
Values are expressed as mean (SD) and range.
BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; ASAT, aspartate aminotransferase; ALAT, alanine aminotransferase; GGT,
-glutamyltransferase.
ALCOHOL AND SEX HORMONES 781
Blood Sampling and Analysis
Fasting blood samples were collected in the morning after the last day
of each experimental period. Blood was taken from the anticubital vein
and collected in a tube containing citrate theophylline, adenosine, and
dipyridamole and in a tube containing gel and clot activator (Becton
Dickinson, Vacutainer Systems, Plymouth, UK). To obtain plasma and
serum, the blood was centrifuged for 15 min at 2000 gand 4°C, between
15 and 30 min after collection. All aliquots were stored at 80°C until
analysis.
Plasma DHEAS, testosterone, and estradiol levels were determined by
standard radioimmunoassay reagent sets (Cout-a-Count DHEA-SO4
from Diagnostic Products Corporation, Los Angeles, CA, for DHEAS;
Orion Diagnostica, Finland, for testosterone; Estradiol-2 from DiaSorin,
Italy, for estradiol). Within- and between-assay variabilities were 7.8% (n
12) and 7.9% (n4) at the level of 4.5
mol/liter for plasma DHEAS
(detection limit 0.05
mol/liter), 6.6% and 7.0% at the level of 0.96
nmol/liter (n10) for plasma testosterone (detection limit 0.1 nmol/liter),
and 9.0% (n12) and 4.7% (n4) at the level of 40 pmol/liter for
plasma estradiol (detection limit about 20 pmol/liter). Serum HDL cho-
lesterol level was determined using an enzymatic method (Roche Diag-
nostics GmbH, Mannheim, Germany), with a detection limit 0.08 mmol/
liter and a between-assay variability of about 3%.
One hour after dinner on the last evening of each of the two experi-
mental periods, blood was collected in tubes containing gel and clot
activator (Becton Dickinson, Vacutainer Systems; airtight system) for
blood alcohol concentration determination. Between 15 and 30 min after
collection, blood was centrifuged for 15 min at 2000 gand 4°C, and
serum samples were stored at 20°C until analysis. Blood alcohol con-
centrations were measured enzymatically (Roche Diagnostics GmbH,
Mannheim, Germany; within- and between-assay variability 0.5% and
2.3%, respectively, detection limit 2.17 mmol/liter).
All samples were analyzed in one run after the finish of the study. Staff
members who conducted the laboratory analyses were blind to the group
assignments.
Statistical Methods
Data were analyzed using the SAS statistical software package (SAS/
STAT version 6.12, SAS Institute, Cary, NC). The outcome measures were
tested for normality. Treatment effects were assessed by analysis of vari-
ance, by use of general linear modeling, using as factors gender, beverage,
and gender in combination with beverage. To test for carryover effects, the
factor treatment order was also added to this model. We calculated 95%
confidence intervals (CI) according to Mood et al. (1974) and Finney
(1964). Pearson correlation coefficients were computed to assess associa-
tions between relative alcohol-induced changes in sex hormones and HDL
cholesterol. Two-sided pvalues were considered statistically significant at
p0.05.
RESULTS
The compliance to the supplied foods and drinks was
good, and average body weight did not differ between beer
and no-alcohol beer treatment periods (data not shown).
The overall mean blood alcohol concentration at 1 hr after
dinner with beer was 10.5 mmol/liter (range 6.015.9 mmol/
liter), and the mean blood alcohol concentrations for men
and women separately did not differ (11.2 [SD 3.0] and 9.7
[SD 1.6] mmol/liter, p0.20; ttest). No carryover effects
in outcome measures were seen.
Plasma DHEAS level
Plasma DHEAS level increased by 16.5% (95% CI,
8.024.9) after beer consumption compared with no-
alcohol beer consumption. No gender differences were
observed (Table 2).
Plasma Testosterone Level
Three weeks of beer consumption decreased plasma tes-
tosterone level by 6.8% in men (95% CI, 1.0 12.5)
compared with no-alcohol beer consumption. In women no
effect on plasma testosterone level was observed (Table 2).
Plasma Estradiol Level
Plasma estradiol level was not affected after 3 weeks of
beer consumption compared with no-alcohol beer con-
sumption (Table 2).
Serum HDL Cholesterol Level
After 3 weeks of daily beer consumption, serum HDL
cholesterol level significantly increased by 11.7% (95% CI,
7.316.0) compared with no-alcohol beer consumption. Sim-
ilar changes in men and women were observed (Table 2).
Correlations Between Relative Alcohol-Induced HDL
Cholesterol and Sex Hormone Changes
The overall alcohol-induced relative changes in DHEAS,
testosterone, and estradiol correlated positively with the
relative increase in HDL cholesterol (adjusted for the rel-
ative change in body weight); however, these changes were
only borderline significant for DHEAS and estradiol (r
0.44, p0.08; r0.32, p0.21; and r0.46, p0.06,
respectively).
DISCUSSION
To our knowledge, this is the first diet-controlled study to
examine the effects of moderate alcohol consumption on
Table 2. Mean (SD) serum HDL cholesterol and plasma DHEAS, testosterone, and estradiol levels in 10 middle-aged men and 9 postmenopausal women after 3
weeks consumption of beer and no-alcohol beer
Men (n10) Women (n9)
Beer No-alcohol beer Beer No-alcohol beer
HDL cholesterol (mmol/liter) 1.34 (0.24)* 1.18 (0.16) 1.70 (0.33)* 1.55 (0.32)
DHEAS (micromol/liter) 4.0 (1.8)# 3.5 (1.7) 3.9 (2.7) 3.3 (2.2)
Testosterone (nmol/liter) 15.3 (3.6)* 16.4 (2.9) 1.1 (0.6) 1.1 (0.6)
Estradiol (pmol/liter) 66.6 (11.7) 65.2 (8.9) 28.2 (16.3) 28.0 (13.0)
*p0.05; # p0.001; significantly different from the no-alcohol beer period.
782 SIERKSMA ET AL.
sex hormone levels in middle-aged men and postmeno-
pausal women. A moderate daily dose of alcohol consumed
with evening dinner increased plasma DHEAS level.
Plasma testosterone level was decreased in men, and there
was no effect on plasma estradiol level in both men and
women. The volunteers were maintained on adequate nu-
tritional regimen, and average body weight did not differ
between beer and no-alcohol beer treatment periods. Con-
sequently, the findings are unlikely to have been con-
founded by concomitant nutritional changes.
The increased plasma DHEAS level after moderate al-
cohol consumption agrees with observational data (Field et
al., 1994; Kiechl et al., 2000; Ravaglia et al., 2002) and the
two intervention studies in women (Dorgan et al., 2001;
Reichman et al., 1993). With our study design, we cannot
differentiate a chronic effect of moderate alcohol consump-
tion from a possible acute effect of last evening drink. The
increase in plasma DHEAS level in part could be a conse-
quence of increased adrenal secretion and in part could be
derived by ethanol-mediated inhibition of the isomerase-
dehydrogenase reaction of dehydroepiandrosterone
(DHEA) to androstenedione (Frias et al., 2002). We could
previously not disclose similar effects of moderate alcohol
intake in a study in middle-aged men (Sierksma et al.,
2002a). The reason for this discrepancy could be the
shorter treatment period (17 days) and the more liberal
dietary control (only evening dinner) compared with the
current study. The increase in plasma DHEAS level in the
current study would be compatible with an approximate
10% decrease in mortality from CVD (Barrett-Connor et
al., 1986). However, doubts have been raised regarding the
proposed inverse association between DHEAS and athero-
sclerosis risk (Kiechl et al., 2000). Some could not confirm
this relationship (Barrett-Connor and Goodman-Gruen,
1995), whereas others found a positive rather than an in-
verse relationship (Johannes et al., 1999). Ravaglia et al.
(2002) have suggested that low DHEAS levels are probably
a nonspecific indicator of aging and health status. DHEAS
is measured, because it is the stable form of DHEA. De-
spite the high correlation between DHEA and DHEAS
levels (Nafziger et al., 1991) and their biological linkage, it
cannot be ruled out that an association exists between
DHEA and atherosclerosis risk, which could be missed by
measuring its sulfated form. In addition, DHEA(S) may
beneficially affect certain age-related disorders, such as
cognitive impairment and dementia (Kalmijn et al., 1998;
Watson et al., 1996). This would explain data suggesting
that moderate alcohol consumption may protect against
dementia (Mukamal et al., 2003; Ruitenberg et al., 2002).
Heavy alcohol intake decreases testosterone in men
(Van Thiel and Lester, 1979; Ylikahri et al., 1974). This
could reflect decreased plasma binding capacity and in-
creased hepatic testosterone A-ring reductase activity
(rate-limiting enzyme for the metabolism of testosterone in
the liver) (Gordon et al., 1976) and/or an inhibited testos-
terone synthesis in the testis (Van Thiel and Lester, 1979).
Possibly these changes already occur with moderate alcohol
consumption, explaining the decrease in plasma testoster-
one levels in the middle-aged men in our study. The clinical
relevance of this change is unclear, as reproductive distur-
bances such as decreased libido, impotence, and infertility
are found in long-term heavy alcohol drinkers (Van Thiel
and Lester, 1979). In postmenopausal women, no effect of
moderate alcohol intake on plasma testosterone level was
found, which is in agreement with earlier increases in tes-
tosterone only in long-term female heavy drinkers (Cigolini
et al., 1996; Pettersson et al., 1990; Välimäki et al., 1990,
1995). The testosterone reduction in men and the absence
of an effect in women might well be a consequence of the
last evening drink instead of a chronic effect of moderate
alcohol consumption. Studies in women have shown that
testosterone was elevated acutely by a low dose of alcohol
(Eriksson et al., 1994; Sarkola et al., 2001).
The lack of effect of moderate alcohol consumption on
plasma estradiol level is consistent with other studies (Cau-
ley et al., 1989; Ginsburg et al., 1996; Hankinson et al.,
1995; Newcomb et al., 1995). There are indications that the
hops and barm in beer contain substances with estrogenic
activity (Lapcík et al., 1998). Because both beer and no-
alcohol beer contain these substances, we assume that this
will not have influenced the alcohol effect on plasma es-
tradiol level. In women, substantial evidence exists for a
protective role of endogenous sex hormones (Matthews,
1992). It has been discussed whether in postmenopausal
women estrogen therapy may prevent the development of
atherosclerosis (Grady et al., 2002; Hodis et al., 2003;
Manson et al., 2003). Estradiol levels have been positively
associated with breast cancer risk (Thomas et al., 1997).
The lack of an alcohol-induced effect on plasma estradiol
level in our study would suggest that moderate alcohol
consumption does not operate through this pathway.
The alcohol-induced increase in serum HDL cholesterol
level of about 12% in the present study is similar to that
observed in other diet-controlled studies of our group (Van
der Gaag et al., 1999, 2000). A 2% increase in HDL cho-
lesterol has been estimated to translate to a 2% to 4%
decrease in coronary heart disease risk (Kinosian et al.,
1995).
The correlations between the alcohol-induced relative
changes in HDL cholesterol and sex hormones suggest that
sex hormones may affect CVD risk indirectly via an effect
on lipoproteins (Kiel et al., 1989; Okamoto, 1998; Zmuda
et al., 1997).
CONCLUSIONS
Alcohol intake seems to decrease testosterone in men
already at a moderate consumption level. In addition, the
results of this randomized trial in healthy middle-aged men
and postmenopausal women support the view that moder-
ate intake of alcohol may increase plasma DHEAS level.
This small endocrine effect of alcohol is consistent with a
ALCOHOL AND SEX HORMONES 783
protective effect of moderate alcohol consumption with
respect to CVD risk and possibly also the risk for dementia.
ACKNOWLEDGMENTS
We acknowledge all those involved in the conduct of the study
and thank the volunteers for their enthusiastic participation.
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ALCOHOL AND SEX HORMONES 785
... Substantial association with lifestyle (e.g., BMI, smoking, diet, physical activity) and physiological factors (e.g., age, time since the onset of menopause) could account for the absence of clear hormonal differences [46][47][48]. Reporting similar results, Sierksma et al. (2004) did not detect any differences in plasma E2 and T-total in postmenopausal women after a 3-week crossover random controlled trial comparing AB (30 g alcohol/day) and NAB consumption [49]. Other studies have observed lower levels of LH and FSH, and higher levels of SHBG after 4 weeks of beer consumption [50] and a 16.7% decrease in LH concentration (95% IC 0.5, 30.2) 24 h after the administration of a single 750 mg dose of 8-PN [51]. ...
... Substantial association with lifestyle (e.g., BMI, smoking, diet, physical activity) and physiological factors (e.g., age, time since the onset of menopause) could account for the absence of clear hormonal differences [46][47][48]. Reporting similar results, Sierksma et al. (2004) did not detect any differences in plasma E2 and T-total in postmenopausal women after a 3-week crossover random controlled trial comparing AB (30 g alcohol/day) and NAB consumption [49]. Other studies have observed lower levels of LH and FSH, and higher levels of SHBG after 4 weeks of beer consumption [50] and a 16.7% decrease in LH concentration (95% IC 0.5, 30.2) 24 h after the administration of a single 750 mg dose of 8-PN [51]. ...
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The menopausal transition can be a challenging period for women’s health and a trigger of uncomfortable symptoms. Beer is the main food source of isoxanthohumol, a precursor of 8-prenylnaringenin, the strongest phytoestrogen identified to date. As phytoestrogens are reported to reduce perimenopausal symptoms, we evaluated if a daily moderate consumption of beer with (AB) and without alcohol (NAB) could improve menopausal symptoms and modify cardiovascular risk factors. A total of 37 postmenopausal women were enrolled in a parallel controlled intervention trial and assigned to three study groups: 16 were administered AB (330 mL/day), 7 NAB (660 mL/day), and 14 were in the control group. After a 6-month follow-up of the 34 participants who finished the trial, both interventions (AB and NAB) significantly reduced the severity of the menopause-related symptoms (p-value AB vs. Control: 0.009; p-value NAB vs. Control: 0.033). Moreover, AB had a beneficial net effect on psychological menopausal discomforts compared to the control group. As the sex hormone profile did not differ significantly between the study groups, the effects of both types of beers (AB and NAB) are attributed to the non-alcoholic fraction of beer. Furthermore, moderate NAB consumption improved the lipid profile and decreased blood pressure in postmenopausal women.
... In Italy, a RCT with 131 patients with myocardial infarction and diabetes (Mediterranean-type diet with or without the addition of four daily ounces of red wine in a 1:1 ratio) reported higher levels of HDL for red wine, lower levels of oxidation markers, reductions in several inflammatory biomarkers, lower fasting insulin levels, and improved left ventricular function after one year [106]. Other small RCTs also tested the intermediate effects of alcohol including counseling to reduce intake [107][108][109][110][111][112][113][114][115][116][117][118][119]. ...
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This review discusses the inconsistent recommendations on alcohol consumption and its association with chronic disease, highlighting the need for an evidence-based consensus. Alcohol is an addictive substance consumed worldwide, especially in European countries. Recommendations on alcohol consumption are controversial. On one hand, many nonrandomized studies defend that moderate consumption has a beneficial cardiovascular effect or a lower risk of all-cause mortality. On the other hand, alcohol is associated with an increased risk of cancer, neurological diseases, or injuries, among others. For years, efforts have been made to answer the question regarding the safe amount of alcohol intake, but controversies remain. Observational studies advocate moderate alcohol consumption following a Mediterranean pattern (red wine with meals avoiding binge drinking) as the best option for current drinkers. However, agencies such as the IARC recommend abstention from alcohol as it is a potent carcinogen. In this context, more randomized trial with larger sample size and hard clinical endpoints should be conducted to clarify the available evidence and provide clinicians with support for their clinical practice.
... Alcohol has been reported to reduce serum/plasma testosterone level in experimental animals [23,24,25,26]. In men, low androgen level has also been reportedly associated with both moderate consumptions with chronic alcohol consumption [27,28,29,30]. This study corroborates these reports as testosterone level were significantly reduced with the consumption pito, burukutu, ogogoro and goskolo in rats. ...
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Locally brewed alcoholic beverages have become part of the socioeconomic life of the Nigerian and West African communities. The negative effect of the use of the beverages on both health, economic and social life is worth exploring amidst the increasing challenges of poverty, inadequate health facilities, lack of basic social amenities amongst many others. This study aimed at evaluating the effect of some selected locally brewed Nigerian alcoholic beverage on the hormonal profile of male and female albino rats. A total of 60 screened rats (spaque Dawley strain) of body weight 180-200g and comprising 30 males and females each were randomly divided into five groups of six animals of same sex per cage and administered with various doses of local alcoholic beverages-goskolo, burukutu, pito and ogogoro per oral for a period of 21 days. Serum hormonal assays were carried out with the use of the respective EIA Kit, ELISA microwells and microplate immunoassay. Results revealed significant decrease (p < 0.05) in the sex hormones (estrogen, progesterone, and testosterone) in all the male treated with these alcoholic beverages, while LH and FSH were not significantly affected. The toxicological evaluation of traditional alcoholic beverages pito, burukutu, ogogorogo and goskolo revealed significant decrease in the sex hormonal profile of male and female albino rats. This buttressed the toxicological effect by way of decrease in the activity of the sex hormones necessary for fertility and reproduction the rats.
... 14,24 Regarding the mechanism of alcohol consumption with LUTS, the sympathetic nerve activity, insulin sensitivity and serum testosterone metabolism might explain the association. It is plausible that light to moderate alcohol intake may help to make a diuretic effect, 26 decrease testosterone concentration 27 and increase sympathetic nervous activity. 28 All these results may produce an inverse effect on LUTS which is concurrent with the present results, however administration of alcohol in these studies were all fixed quantity, so it could not be excluded the alternative explanation that inverse association of moderate frequency of alcohol consumption (1-2 times per week drinking) with obstructive symptoms of LUTS observed in our study was caused by avoidance of diuretic effect. ...
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Objective: To evaluate the effect of the drinking frequency and years on lower urinary tract symptoms (LUTS) in a large Chinese male population. Methods: The current data were obtained from a consecutive series of 3,229 men aged 18-79 who participated in a routine physical examination in Fangchenggang First People's Hospital, Guangxi, China. During a face-to-face interview, the detailed demographic variables about alcohol consumption, potential confounding factors were collected. LUTS were assessed by International Prostate Symptom Score (IPSS) and defined as total LUTS, irritative (IRR) and obstructive (OBS) symptoms, respectively. Multivariate logistic regression analysis was used to evaluate the risk of total LUTS, IRR and OBS symptoms affected by alcohol consumption. Results: The prevalence of moderate to severe LUTS was 8.3% and apparently increased with age (P<0.001). A significant distribution presented in age, alcohol consumption, BMI, cigarette smoking, education attainment and hypertension among different strata of LUTS severity (P<0.05). Men who drank 1-2 times per week were less likely to have OBS symptoms (OR=0.45, 95%CI=0.29-0.70) regardless of age (OR=0.52, 95%CI=0.33-0.82) or multivariate adjusted (OR=0.52, 95%CI=0.33-0.83). Nevertheless, we did not observe a significant negative or positive association presented between drinking years and the risk of total LUTS, OBS and IRR symptoms. Conclusion: The current results imply that moderate drinking frequency may be protective against LUTS, and drinking years did not relate to worsening or improving LUTS.
... Early studies found a reduction in testosterone levels following heavy acute alcohol consumption in males (Mendelson et al., 1977), but not in females (Härkönen and Ylikahri, 1983;Mendelson et al., 1981). These results have been confirmed by more recent studies by showing that acute alcohol intoxication (AAI) reduces testosterone levels in male adults (Frias et al., 2002;Sierksma et al., 2004). Interestingly, these effects found in adults could be extended to male adolescents (Diamond Jr et al., 1986;Frias et al., 2000). ...
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Previous studies have established a role of sex hormones in alcohol use disorder (AUD).Only few clinical investigations with low numbers of patients with AUD have focused on the sulphated form of dehydroepiandrosterone (DHEA-S), despite its function as a neuromodulating sex steroid on receptors in the central nervous system (γ-aminobutyric acid type A, N-methyl-D-aspartate, sigma-1 receptors). DHEA-S serum levels were compared between 200 inpatients with AUD (44% women) admitted for withdrawal treatment and 240 healthy controls (45% women) and analysed longitudinally in patients from early abstinence (baseline) to a median of 5 days later. We also correlated DHEA-S levels with craving, liver enzyme activities, and prospective alcohol-related readmissions during a 24-month follow-up. DHEA-S concentrations were lower in female patients than in female healthy controls during baseline (70%) and decreased from baseline to follow-up in the female and male patients groups (down to: women, 92%; men, 76%). Baseline DHEA-S concentrations correlated with the total and obsessive subscales of the Obsessive–Compulsive Drinking Scale and with maximum visual analogue scale craving scores in female patients (Rho ≤ −0.240) and gamma-glutamyl transferase activity in female (Rho = −0.292) and male (Rho = −0.391) patients. DHEA-S did not significantly predict outcome. We found interactions with smoking behaviour and age. This is the first study based on large cohorts of inpatients with AUD undergoing a qualified detoxification treatment to provide sex-separated evidence for associations of DHEA-S serum concentrations with AUD and related phenotypes. The results stimulate further investigations whether DHEA-S directly influences alcohol craving building a basis to develop sex-sensitive prevention and treatment strategies.
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Background: Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and its use can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This review aimed to quantify the acute effects of different doses of alcohol over time on blood pressure and heart rate in an adult population. Objectives: Primary objective To determine short-term dose-related effects of alcohol versus placebo on systolic blood pressure and diastolic blood pressure in healthy and hypertensive adults over 18 years of age. Secondary objective To determine short-term dose-related effects of alcohol versus placebo on heart rate in healthy and hypertensive adults over 18 years of age. Search methods: The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to March 2019: the Cochrane Hypertension Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), in the Cochrane Library; MEDLINE (from 1946); Embase (from 1974); the World Health Organization International Clinical Trials Registry Platform; and ClinicalTrials.gov. We also contacted authors of relevant articles regarding further published and unpublished work. These searches had no language restrictions. Selection criteria: Randomised controlled trials (RCTs) comparing effects of a single dose of alcohol versus placebo on blood pressure (BP) or heart rate (HR) in adults (≥ 18 years of age). Data collection and analysis: Two review authors (ST and CT) independently extracted data and assessed the quality of included studies. We also contacted trial authors for missing or unclear information. Mean difference (MD) from placebo with 95% confidence interval (CI) was the outcome measure, and a fixed-effect model was used to combine effect sizes across studies. MAIN RESULTS: We included 32 RCTs involving 767 participants. Most of the study participants were male (N = 642) and were healthy. The mean age of participants was 33 years, and mean body weight was 78 kilograms. Low-dose alcohol (< 14 g) within six hours (2 RCTs, N = 28) did not affect BP but did increase HR by 5.1 bpm (95% CI 1.9 to 8.2) (moderate-certainty evidence). Medium-dose alcohol (14 to 28 g) within six hours (10 RCTs, N = 149) decreased systolic blood pressure (SBP) by 5.6 mmHg (95% CI -8.3 to -3.0) and diastolic blood pressure (DBP) by 4.0 mmHg (95% CI -6.0 to -2.0) and increased HR by 4.6 bpm (95% CI 3.1 to 6.1) (moderate-certainty evidence for all). Medium-dose alcohol within 7 to 12 hours (4 RCTs, N = 54) did not affect BP or HR. Medium-dose alcohol > 13 hours after consumption (4 RCTs, N = 66) did not affect BP or HR. High-dose alcohol (> 30 g) within six hours (16 RCTs, N = 418) decreased SBP by 3.5 mmHg (95% CI -6.0 to -1.0), decreased DBP by 1.9 mmHg (95% CI-3.9 to 0.04), and increased HR by 5.8 bpm (95% CI 4.0 to 7.5). The certainty of evidence was moderate for SBP and HR, and was low for DBP. High-dose alcohol within 7 to 12 hours of consumption (3 RCTs, N = 54) decreased SBP by 3.7 mmHg (95% CI -7.0 to -0.5) and DBP by 1.7 mmHg (95% CI -4.6 to 1.8) and increased HR by 6.2 bpm (95% CI 3.0 to 9.3). The certainty of evidence was moderate for SBP and HR, and low for DBP. High-dose alcohol ≥ 13 hours after consumption (4 RCTs, N = 154) increased SBP by 3.7 mmHg (95% CI 2.3 to 5.1), DBP by 2.4 mmHg (95% CI 0.2 to 4.5), and HR by 2.7 bpm (95% CI 0.8 to 4.6) (moderate-certainty evidence for all). AUTHORS' CONCLUSIONS: High-dose alcohol has a biphasic effect on BP; it decreases BP up to 12 hours after consumption and increases BP > 13 hours after consumption. High-dose alcohol increases HR at all times up to 24 hours. Findings of this review are relevant mainly to healthy males, as only small numbers of women were included in the included trials.
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This study explores the effects of chronic alcohol and cannabinol exposure on the testosterone levels and the histomorphological integrity/cytoarchitecture of the rats’ testes. Adults male Wistar rats were randomly divided into control (distilled water), methanol (2mg/kg bw), alcohol (3g/kg bw), cannabinol (10mg/kg bw) and alcohol (3g/kg bw) plus cannabinol (10mg/kg bw) groups respectively. Alcohol and cannabinol were administered orally twice daily for 52 days (spermatogenic cycle in rats) and at the end of treatment, male reproductive organ (testis) was removed and cleared of adherent tissue and then fixed for histological examination. Blood samples were collected via retro-orbital sinus for hormone (testosterone) assay. Serum testosterone levels were measured using the enzyme immuno assay (E.I.A.) technique. Hormonal assay showed significant reductions in the levels of testosterone (T) (p < 0.05) in the alcohol alone, cannabinol alone and in the alcohol plus cannabinol treated groups. The Histological analysis of the treated groups showed severe reduction of the spermatogenic cells. The present study showed that following chronic alcohol and/or cannabinol administration the results showed significant reduction (p<0.05) in testosterone levels and a detrimental effect on the histomorphology of the testes. Alcohol and/or cannabinol therefore exhibit inhibitory effects causing inhibition of testosterone as observed in this study.
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Context Alcohol consumption has been associated with complex changes in cerebral vasculature and structure in older adults. How alcohol consumption affects the incidence of dementia is less clear.Objective To determine the prospective relationship of alcohol consumption and risk of dementia among older adults.Design, Setting, and Participants Nested case-control study of 373 cases with incident dementia and 373 controls who were among 5888 adults aged 65 years and older who participated in the Cardiovascular Health Study, a prospective, population-based cohort study in 4 US communities. The controls were frequency-matched on age, death before 1999, and their attendance of a 1998-1999 clinic. Participants in this study underwent magnetic resonance imaging (MRI) of the brain and cognitive testing between 1992 and 1994 and were followed up until 1999.Main Outcome Measures Odds of incident dementia, ascertained by detailed neurological and neuropsychological examinations according to average alcohol consumption, assessed by self-reported intake of beer, wine, and liquor at 2 visits prior to the date of the MRI.Results Compared with abstention, the adjusted odds for dementia among those whose weekly alcohol consumption was less than 1 drink were 0.65 (95% confidence interval [CI], 0.41-1.02); 1 to 6 drinks, 0.46 (95% CI, 0.27-0.77); 7 to 13 drinks, 0.69 (95% CI, 0.37-1.31); and 14 or more drinks, 1.22 (95% CI, 0.60-2.49; P for quadratic term = .001). A trend toward greater odds of dementia associated with heavier alcohol consumption was most apparent among men and participants with an apolipoprotein E ∊4 allele. We found generally similar relationships of alcohol use with Alzheimer disease and vascular dementia.Conclusions Compared with abstention, consumption of 1 to 6 drinks weekly is associated with a lower risk of incident dementia among older adults.
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Objective. —To determine if moderate alcohol drinking increases circulating estradiol levels in postmenopausal women who are taking estrogen replacement.Design. —Randomized, double-blind, placebo-controlled crossover study of the effects of alcohol ingestion on plasma estradiol and estrone.Setting. —Inpatient Clinical Research Center.Participants. —Twelve healthy postmenopausal women receiving oral estrogen (estradiol, 1 mg/day) and progestin (medroxyprogesterone acetate) replacement therapy were compared with 12 postmenopausal women who were not using estrogen replacement therapy (ERT).Intervention. —Each group drank alcohol (0.7 g/kg) and an isoenergetic (isocaloric) placebo (randomized sequence) on consecutive days. Women who were taking ERT were studied during the estrogen-only portion of their replacement cycle, and estrogen was administered each evening at 2100 hours.Main Outcome Measure. —The impact of alcohol ingestion on plasma estradiol and estrone levels.Results. —Alcohol ingestion lead to a 3-fold increase in circulating estradiol in women on ERT; however, alcohol did not change estradiol significantly in control women who were not on ERT. In women using ERT, estradiol levels increased from 297 to 973 pmol/L (81 to 265 pg/mL) within 50 minutes (P<.001) during the ascending limb of the blood alcohol curve and remained significantly above baseline for 5 hours (P<.001). No significant increase in circulating estrone was detected in either group. However, estrone levels decreased after alcohol and placebo in women on ERT (P<.05). Blood alcohol levels did not differ significantly in women who used ERT and those who did not. Peak blood alcohol levels of 21 mmol/L were attained in each of the 2 groups within 50 to 60 minutes after drinking began. Changes in estradiol were significantly correlated with changes in blood alcohol levels on both the ascending (P<.001) and descending (P<.001) limb of the blood alcohol curve.Conclusions. —Acute alcohol ingestion may lead to significant and sustained elevations in circulating estradiol to levels 300% higher than those targeted in clinical use of ERT. Potential health risks and benefits of the interactions between acute alcohol ingestion and ERT should be further evaluated.
Article
Plasma testosterone, estradiol, estrone and luteinizing hormone concentrations were measured by radioimmunoassay in healthy volunteers who after fasting for 10 h consumed 1.5 g ethanol/kg body wt. Of this group five suffered from severe hangover while another five had essentially no hangover. Ten to twenty hours after drinking, the testosterone concentrations were significantly decreased in all subjects, but in the 5 subjects with severe hangover the decrease was more pronounced. Estradiol values decreased during the hangover period, but were normal at the time of acute intoxication, whereas estrone values, in the few cases determined, showed a tendency to increase during acute intoxication. A compensatory increase in the plasma concentration of luteinizing hormone was found in all subjects.