Effect of a moderate alcohol intake on the lipoproteins of normotriglyceridemic obese subjects compared with normoponderal controls

doi:10.1016/0026-0495(92)90167-9

Metabolism

Volume 41, Issue 8, August 1992, Pages 856-861

https://doi.org/10.1016/0026-0495(92)90167-9 Get rights and content

Abstract

Moderate alcohol intake is frequently associated with an elevated concentration of high-density lipoprotein (HDL), which is one of the potential causes for the relative decrease in cardiovascular risk reported in moderate drinkers. Conversely, low HDL concentrations, particularly HDL₂, in obese subjects may be a risk factor. The effect of 30 g alcohol daily (wine) during 14 days following a period of abstinence was studied in seven normolipidemic obese subjects (body mass index [BMI], 30 ± 1.7 kg/m²) compared with seven normoponderal controls (BMI, 22 ± 1.2 kg/m²). Alcohol caused apolipoprotein (apo) AI and apo AII concentrations to increase in all controls by 12% and 16% (P < .05), but not in obese subjects. Lipoprotein (Lp) AI HDL particles (without AII) were initially in the same proportions in the two groups. Their increase in controls only (P < .03) was not matched by an increase in HDL₂ in all subjects. In obese subjects, neither Lp AI nor HDL₂ were increased by alcohol, but their HDL-triglyceride (TG) contents, initially elevated, were normalized. Cholesterol ester (CE) transfer activity was not different in controls and obese subjects during abstinence (105.7 ± 40.8 v 104.8 ± 34.5 mmol/mg protein/h). It was notably depressed by alcohol in controls (74.2 ± 27.4, P < .002), but not in obese subjects. It is concluded that (1) The reduced pool of HDL₂ in obese subjects is not due to insufficient Lp AI nor to excess CE transfer; (2) Alcohol acts on HDL both by an increase of the HDL apoprotein pool and by a decrease of cholesterol ester transfer protein (CETP); (3) Obesity inhibits both effects.

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Cited by (46)

Alcohol and Stroke
2005, Comprehensive Handbook of Alcohol Related Pathology
The French paradox: Possible involvement of ethanol in the protective effect against cardiovascular diseases
2002, Nutrition
Citation Excerpt :
Lipoprotein lipase activity generally is not modified with moderate doses of alcohol46,58 but may be increased,47 leading to enhanced formation of HDL-C. Hepatic lipase is inhibited by alcohol,38 and no change was observed in lecithin:cholesterol acyltransferase activity47 but that activity can be increased38 or decreased59 with moderate alcohol intake. Alternatively, cholesterol ester transfer protein (CETP) activity, which transfers cholesteryl esters from HDL2 to very-LDL and LDL and, reciprocally, triacylglycerol from these lipoproteins to HDL, may be significantly reduced due to alcohol consumption, as shown in studies in moderate drinkers.60,61 CETP activity is inhibited in moderate drinkers,60,62,63 but according to Senault et al.64 alcohol intake does not modify CETP concentration.
OBJECTIVES: This review surveyed the literature on the cardioprotective effects of moderate alcohol consumption.
METHODS: The putative cardioprotective effects of alcohol and other substances in alcoholic beverages are discussed by taking “the French paradox” as a starting point. A survey of the literature highlighted various hypotheses explaining the protective effects of moderate alcohol consumption.
RESULTS: The positive effects of moderate quantities of alcohol have been attributed in part to increased plasma levels of high-density lipoprotein, an inhibition of platelet aggregation, and improved endothelial function. Many investigators have claimed that wine is the significant factor explaining the French paradox. Red wine has been shown ex vivo to inhibit low-density lipoprotein oxidation, increase antioxidant capacity in humans, and reduce susceptibility of human plasma to lipid peroxidation. The non-alcoholic fraction of wine, represented mainly by phenolic compounds, may be the primary factor responsible for this protective effect. However, the protective effects are not restricted to a particular type of alcoholic drink, suggesting that alcohol per se rather than compounds specific to certain beverages reduces mortality risk.
CONCLUSIONS: It is difficult to explain the effect of alcohol on risk factors associated with cardiovascular diseases by a uniform biochemical mechanism. Moreover, its protective effects are counterbalanced by its addictive properties.
Basal and postprandial serum-promoted cholesterol efflux in normolipidemic subjects: Importance of fat mass distribution
2001, Metabolism: Clinical and Experimental
Excess of adipose tissue may affect the reverse cholesterol transport mediated by high-density lipoprotein (HDL). Impairments in this system may be one possible factor favoring atherosclerosis development in obesity. To investigate if gender and regional fat mass distribution independently influence reverse cholesterol transport (RCT), we studied in vitro the capacity of serum to promote the cell cholesterol efflux. Measurements were performed both in the fasting state and in the postprandial state, a setting known to stimulate cholesterol transport and altered in obesity. Thirteen obese women with an android phenotype, waist-to-hip ratio (WHR): 0.98 to 0.85 and 51 normal-weight subjects: 25 women and 26 men, with a similar WHR range: 0.96 to 0.67, were recruited. All the participants were normolipoproteinemic in the fasting state and were given an oral fat load. Blood samples were taken before giving the oral fat load and after every 2 hours. The measurements of the ability of serum to promote cholesterol efflux from cells were performed using ³H-cholesterol labeled Fu5AH hepatoma cells in the fasting state 6 and 8 hours after the lipid rich meal. Incremental serum triglyceride (TG), area under the curve (iAUC) and AUC of retinyl palmitate (RP) for the obese women and nonobese subjects were similar. Basal cholesterol efflux was reduced in obese women compared with normal-weight women (26.75% [plusmn] 3.1% v 30.81% [plusmn] 4.2%, P = .004). However, the magnitude of cholesterol efflux promoted by whole serum increased similarly in all the groups. In the subjects with similar WHR, no gender difference was observed in the postprandial TG response and in the first step of RCT. Multivariate regression analyses indicated that plasma HDL-cholesterol (HDL-C) concentration is the best predictor of cholesterol efflux in the fasting state with an independent mild additive effect of WHR. Conversely, postprandial efflux appeared to be mostly related to the WHR with a mild additive effect of HDL-C. Our results indicate that alterations in the first step of RCT can occur in normolipidemic obese subjects and are tightly associated with the abdominal distribution of fat mass. Android obesity in women brings them to the level of men with respect to RCT.
Metabolic changes in persons after spinal cord injury
2000, Physical Medicine and Rehabilitation Clinics of North America
Persons with chronic spinal cord injury (SCI) have several metabolic perturbations related to paralysis with associated immobilization and body compositional changes. The constellation of metabolic changes has many of the distinctive features of syndrome X, which is characterized by a general state of hyperinsulinemia, insulin resistance, lipid abnormalities, increased adiposity, hypertension, and cardiovascular disease. There is evidence to suggest that endogenous anabolic hormone levels are depressed in at least a subset of individuals, possibly exacerbating the adverse lipid and body compositional changes. Because of immobilization, bone is regionally osteoporotic and is continuously lost. Recognition of the potential occurrence of these metabolic sequelae and of the necessity for appropriate intervention, if available, to correct or ameliorate these abnormalities will improve clinical care in persons with SCI.
Influence of moderate chronic wine consumption on insulin sensitivity and other correlates of syndrome X in moderately obese women
2000, Metabolism: Clinical and Experimental
Epidemiologic studies indicate that alcohol consumption is associated with improved insulin sensitivity; however, scant experimental evidence confirms this observation. To determine the effects of regular moderate wine consumption on insulin sensitivity, 20 overweight women (body mass index [BMI], 29.8 ± 2.2 kg/m²) participated in a 20-week free-living randomized crossover trial. The subjects, serving as their own controls, consumed wine (190 mL red wine, 13% vol/vol ethanol, 5 days per week) for 10 weeks and abstained for 10 weeks or vice versa. The dependent variables (body weight, BMI, percent body fat, blood pressure, fasting blood glucose and insulin, blood lipids, dietary intake, and insulin sensitivity by intravenous glucose tolerance test [IVGTT]) were measured at the pretest, at the 10-week crossover, and at the 20-week completion of the study. Data were analyzed at the pretest and at completion of the wine drinking and abstention periods of the study using ANOVA by order of treatment. Fasting glucose remained unchanged (mean ± SD; P < .05) throughout the experiment (pretest, drinking, and abstention, 91.1 ± 9.2, 91.6 ± 9.1, and 88.5 ± 11.2 mg/dL), as did the measures of insulin sensitivity, fasting insulin (pretest, drinking, and abstention, 8.6 ± 3.3, 8.6 ± 4.1, and 9.1 ± 4.7 μU/mg) and the insulin sensitivity index (3.60 ± 2.96, 3.25 ± 2.17, and 3.30 ± 1.84). Body composition and blood lipids also remained unchanged (P < .05) during treatment. Moderate wine consumption at this dose in overweight women did not improve or impair insulin sensitivity, nor did it change any of the known correlates of insulin sensitivity, including body weight and composition, blood lipids, and blood pressure. Copyright © 2000 by W.B. Saunders Company
Wine and the heart
1998, Revista Espanola de Cardiologia
Numerosos estudios epidemiológicos han demostrado que el consumo de cantidades moderadas de alcohol, de 10 a 30 g de etanol al día, reduce la mortalidad cardiovascular, debida fundamentalmente a cardiopatía isquémica aterosclerótica y a accidentes cerebrales isquémicos, respecto a los abstemios. Este efecto beneficioso sobrepasa los riesgos del consumo de alcohol en los grupos de población con mayor riesgo aterosclerótico: personas de edad, individuos con factores de riesgo y pacientes con eventos coronarios previos. Sin embargo, no está demostrado el beneficio del consumo de alcohol, ni siquiera en cantidades moderadas, sobre la población general, varones con menos de 40 años de edad y mujeres por debajo de los 50, ya que aumenta la mortalidad por otras causas, fundamentalmente por accidentes, cirrosis hepática y algunos tipos de cáncer, sobrepasando los beneficios sobre la enfermedad coronaria, por lo que no se puede recomendar el consumo de alcohol como medida preventiva general. Por lo tanto el consejo de continuar, iniciar, modificar o abandonar el hábito de consumir bebidas alcohólicas debe hacerse exclusivamente de forma individual, valorando los riesgos y beneficios posibles en cada paciente.
El beneficio ejercido por el consumo moderado de etanol sobre el sistema cardiovascular parece estar mediado fundamentalmente por su efecto sobre las lipoproteínas plasmáticas, principalmente elevando el colesterol ligado a lipoproteínas de alta densidad (HDL) y en menor medida disminuyendo el colesterol ligado a lipoproteínas de baja densidad (LDL). El otro efecto cardioprotector importante parece ejercerlo disminuyendo la agregabilidad plaquetaria y produciendo cambios en la coagulación y la fibrinólisis.
Aunque se ha discutido sobre la superioridad relativa de diferentes tipos de bebidas alcohólicas (vino, cerveza y licores), y más aún, sobre diferentes tipos de vino como protectores del riesgo cardiovascular, no existen actualmente evidencias de que exista un efecto protector de otros componentes de la bebida aparte del etanol. Por lo tanto, no parece apropiado hacer recomendaciones sobre una bebida particular, excepto por hábitos socioculturales. Los beneficios añadidos por algunos componentes con alto poder antioxidante sobre las lipoproteínas plasmáticas, los flavonoides, de algunos tipos de vino, no dejan de ser por el momento una hipótesis atractiva. Mientras, la promoción de un consumo más elevado de alimentos naturales, ricos en flavonoides y otras sustancias saludables (frutas, legumbres, cereales o semillas) en la población general, podría frenar la tendencia actual de los países del sur de Europa al abandono de la dieta mediterránea.
Debido a la naturaleza multifactorial de la enfermedad coronaria, es necesario recordar que la reducción del riesgo aterosclerótico se consigue actuando sobre los múltiples factores de riesgo que puedan estar presentes en un paciente determinado y en la población general. Por lo tanto, las indicaciones referentes al consumo de alcohol deben ir siempre acompañadas por las recomendaciones pertinentes sobre el resto de los factores de riesgo aterosclerótico.
Many epidemiological studies have shown that moderate alcohol intake, from 10 to 30 g of ethanol a day, decreases cardiovascular mortality from atheroesclerotic ischaemic heart disease and ischaemic stroke as compared to non-drinkers. This beneficial effect outweighs the risks of alcohol consumption in subgroups of people with a higher risk of atheroesclerosis: the elderly, people with coronary risk factors and patients with previous coronary events. It has not been demonstrated that alcohol intake, even in moderate amounts, is beneficial for the general population, in particular, men under the age of 40 and women under 50, because it raises mortality due to other causes, especially injury, cirrhosis of the liver and some types of cancer, thereby outweighing the benefits for coronary artery disease. Thus, alcohol consumption should not be recommended as a prophylaxis for the general population. Guidelines on alcohol drinking habits -whether to continue, to start, to modify or to stop- must be given on an individual basis, taking into account the relative risks and benefits for each patient.
The benefits of moderate alcohol consumption on the cardiovascular system seem to be exerted fundamentally through its effects on plasma lipoproteins, principally by raising high density lipoprotein (HDL) cholesterol and to a lesser degree, by decreasing low density lipoprotein (LDL) cholesterol. It appears to exert additional beneficial effects on the heart by decreasing platelet agregability and by bringing about changes in the clotting-fibrinolysis system.
Although there has been some debate about the relative superiority of different types of alcoholic beverages (wine, beer or hard liquor), and to a greater extent, about different types of wine, there is no current evidence of any kind of beneficial effect from other components of the beverage besides ethanol. Thus, it does not seem appropriate to recommend any particular type of alcoholic drink, except for sociocultural reasons. The added benefits from some components of different types of wine with a high antioxidant activity on plasma lipoproteins remain only an interesting hypothesis. Meanwhile, encouraging a healthy diet, flavonoid rich and with a predominance of natural ingredients (fruit, legumes, cereals and seeds), in the general population should stop the current tendency of Southern European countries from abandoning the Mediterranean diet.
Because of the multifactorial nature of coronary heart disease, it is necessary to remember that atheroesclerotic risk reduction is achieved by behavior modification of multiple risk factors present in individual patients and in the general population. Therefore, guidelines regarding alcohol intake should always be linked to pertinent recommendations about other atheroesclerotic risk factors.

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^☆: Supported by Institut de Recherches Scientifiques sur les Boissons (IREB) Grant No. 90-04.

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Effect of a moderate alcohol intake on the lipoproteins of normotriglyceridemic obese subjects compared with normoponderal controls☆

Abstract

Atherosclerosis

Atherosclerosis

Metabolism

Atherosclerosis

Atherosclerosis

Anal Biochem

J Lipid Res

J Lipid Res

Biochem Biophys Res Commun

J Lipid Res

J Biol Chem

Am J Med

J Lipid Res

Metabolism

FEBS Lett

J Biol Chem

The association of plasma high-density lipoprotein cholesterol with dietary intake and alcohol consumption. The Lipid Research Clinics program prevalence study

Circulation

Alcohol consumption before myocardial infarction. Results from the Kaiser permanent epidemiologic study of myocardial infarction

Ann Intern Med

Alcohol and high-density lipoprotein cholesterol: A randomized controlled trial

Br J Nutr

To drink (moderately) or not to drink?

N Engl J Med