| BackgroundDrinking is part of Chinese culture. With economic development and the continuous improvement of people's living standards in China, the drinking population is expanding sharply. According to the2002National Nutrition and Health Survey of China, the proportion of drinking in the residents (age>15years) were39.6%of men and4.5%of women. The proportion of urban and rural residents drinking was20.9%and21.1%, respectively.In2011, the World Health Organization (WHO) published the Global status report on alcohol and health reported that alcohol abuse was the third leading cause of death and disability in the world. The report also showed especially the men and the young people were at risk. Six percent of the cause of men's death worldwide was related to alcohol consumption and people between the ages of fifteen and twenty-nine died from alcohol related causes was nine percent of all deaths in that age group. In all countries and regions, the probability of men addicted to alcohol was higher than women.The relationship between alcohol intake and health was concerned by scholars from various countries.Since the reform and opening up, the morbidity of diabetes and cardiovascular disease in China showed a rapid upward trend. Now China has become the countries with the highest incidence of diabetes in the world. According to the latest epidemiological studies, the age-standardized prevalence of total diabetes and prediabetes in China were9.7%and15.5%, respectively, which added up to about a quarter of the total population.The situation is very serious. Diabetes is a major public health problem with long-term consequences including loss of vision, kidney failure, amputations, gastrointestinal, sexual dysfunction and cardiovascular symptons. Insulin resistance and insulin secretion defect is the cornerstone of type2diabetes. The risk factors include family history, obesity, overnutrition and inactivity. In recent years, it was discovered that alcohol intake and diabetes are closely related. Alcoholics have two to three times the rate of admission to hospitals for diabetes as nonalcoholics, and conversely, diabetics have a higher risk of dying of alcohol-related causes than nondiabetics.The relationship between alcohol consumption and IR, type2diabetes has been widespread concerned. Some studies showed there was a "U" or "J" relationship between them. But other studies did not observed the "U" or "J" curve. Currently, the study of the Chinese population is less, so it needs to be further studied.Previous studies including domestic and international studies have shown that the β-cell function of type2diabetic patients in Chinese is impaired earlier and more prominent performance. Even that, some studies have shown that insulin secretion dysfunction existed in the pre-diabetic status. Therefore, it is more important to concern about the pancreatic β cell function in the development of type2diabetes in Chinese. In the world, studies about the effects of alcohol intake on the islet β-cell function are less, and there was no related report in china.The aim of this study was to evaluate whether alcohol consumption was associated with β-cell function, and the association may be further confounded by an increase in obesity among community-dwelling men in urban area of China.Objective:1. To explore the relationship between alcohol intake and the β-cell function among Chinese men.2. To explore the relationship between alcohol intake and the insulin resistance among Chinese men.3. To explore the effects of alcohol intake on China's urban male common metabolic indicators such as blood sugar, blood lipids, blood uric acid levels.Methods:1. Subject:The study sample was drawn from the central population register (≧5years) aged20-75years living in Shungen, Shunya and Shunyu community of Jinan City, China. We included1865subjects and all subjects signed a written informed consent.Because the prevalence of alcohol drinkers among women was low (<5%), we only selected the men into our study. A total of675men were finally successfully recruited in this study.2. Methods:All subjects were divided into five groups:never, abstain, light (0.1-19.9g/day), moderate (20.0-39.9g/day) and heavy drinkers (≧40.0g/day) and then further divided into overweight (BMI=25kg/m2) and non-overweight (BMI<25kg/m2) groups.According to fasting blood glucose (FBG), the subjects were divided into two groups:FBG=6.1mmol/1and FBG<6.1mmol/1. Body weight, height, waist circumference (WC) and blood pressure were measured, respectively. BMI was calculated as weight (kg)/height2(m2). The plasma levels of fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and blood uric acid were detected by automatic biochemical analyzer (OlympusAU5400), respectively. The fasting insulin (Fins) was assessed by radioimmunoassay. The β-cell function (HOMA-(3) and insulin resistance (the homeostasis model assessment of insulin resistance, HOMA-IR) were calculated by the homeostasis model using Levy's computer model.(HOMA-IR=FBG×Fins/22.5; HOMA-β=20×FIns/FBG-3.5).3. Statistic analysis:Statistic analysis was performed using SPSS17.0. All values were expressed as mean±tandard deviation. Study characteristics were compared between categories of alcohol intake using variance, chi-square and covariance. Multiple regression analysis was used to evaluate the contribution of each confounding factors for FBG, HOMA-β and HOMA-IR of subjects categorized by BMI. A value of p<0.05was considered significant. Results1. The characteristics of the participants.Among the subjects, current drinkers were58.8%and15.4%of them consumed alcohol more than40g/day. The abstainers were5%. Most of the heavy drinkers were young men (average age37years). Non-smokers were reported by48.7%, former smokers by12.9%and still smokers by38.4%. The percent of current smokers were46.5%,53.7%and36.1%in light, moderate and heavy groups, respectively. There were significant differences among groups (p<0.001). Adjusting for both age and smoke, the levels of FBG were higher in moderate-to-heavy drinkers (p'<0.001). TG, TC and HDL-C were observed higher in moderate drinkers and there was significant difference among groups (p' was0.035,0.018,0.049, respectively). HOMA-β was lower in drinkers compared with non-drinkers indecently of alcohol intake dose (p'<0.001)The proportion of FBG≧6.1mmol/L in the subjects was11.4%, which was highest in the abstainers (22.9%) and lowest in the light drinkers (8.9%). More than half of the subjects (58.1%) were overweight and there were more overweight subjects in moderate drinkers than never drinkers (69.1%vs.53.1%).2. Association between alcohol and FBG, HOMA-IR or HOMA-β categorized by BMI excluding the abstainers.Adjusting for age and smoke, the FBG was found highest in moderate drinkers independently of BMI. There was a downward trend in heavy drinkers but was still higher than non-drinkers. There were statistic defferences in total and BMI≧25kg/m2subjects(p<0.05or0.01), while in BMI<25kg/m2subjects, the difference didn't reach statistically significant.Adjusting for age and smoke, there was a approximate "U" shaped curve between HOMA-IR and alcohol intake dose in all and BMI≧25kg/m2subjects. While in BMI<25kg/m2subjects, there was a negative relationship between them. But no significant difference was observed.Adjusting for age and smoke, HOMA-β was found decreased in any dose of alcohol consumption groups independent of BMI. Significant difference still existed between moderate-to-heavy drinkers and light drinkers (p<0.05or0.01). These indicate that HOMA-β was decreased with increased alcohol intake dose shown negative correlation.3. The multiple stepwise regression analysis using FBG, HOMA-IR and HOMA-β as objective variables and various confounding factors as explanatory variables.In all subjects, after adjusting the other confounders, alcohol consumption dose, TG and TC were significantly associated with increased FBG (β was0.059,0.153and0.245, respectively; p was0.050,0.001and<0.001, respectively); alcohol history, blood uric acid and WC were significantly associated with HOMA-IR. Alcohol history was negatively correlated with HOMA-IR (β=-0.116; p=0.010), while blood uric acid and WC were positively with it (β was0.004and0.079; p was0.006and<0.001). Age, alcohol consumption, blood uric acid and WC were significantly associated with HOMA-β. Age and alcohol consumption were negatively correlated with HOMA-β (β was-1.602and-11.566;p was<0.001and<0.001), while blood uric acid and WC were positively with it (β was0.109and2.802;p was0.020and0.001).In BMI<25kg/m2subjects, after adjusting the other confounders, TC and age were significantly associated with increased FBG (β was0.008and0.133;p was0.006and0.010). Alcohol history, TG, blood uric acid and smoke were significantly associated with HOMA-IR. Alcohol history and smoke were negatively correlated with HOMA-IR (β was-0.021and-0.183;p was0.004and0.001), while blood uric acid and TG were positively with it (β was0.002and0.248; p was0.024and0.001).Age, alcohol consumption dose, TC and WC were significantly associated with HOMA-p. Age, alcohol consumption dose and TC were negatively correlated with HOMA-β (β was-0.757,-6.671and-6.826, respectively; p was<0.001,<0.001and0.042, respectively), while WC was positively with it (β=1.050;p=0.010).In BMI≧25kg/m2subjects, after adjusting the other confounders, TG and TC were significantly associated with increased FBG (β was0.168and0.276; p was<0.001and<0.001). Age, alcohol consumption dose, blood uric acid and WC were significantly associated with HOMA-IR. Age and alcohol consumption were negatively correlated with HOMA-IR (β was-0.030and-0.312; p was0.026and0.015), while blood uric acid and WC were positively with it (β was0.005and0.073; p was0.040and0.002). Age, alcohol consumption dose and WC were significantly associated with HOMA-β. Age and alcohol consumption dose were negatively correlated with HOMA-β (β was-2.203and-16.091; p was <0.001and<0.001), while WC were positively with it (β=2.212; p=0.001).4. The multiple stepwise regression analysis using HOMA-IR and HOMA-β as objective variables and various confounding factors as explanatory variables categorized by FBG.In the subject with FBG≧6.1mmol/L, after adjusting the other confounders, age and alcohol consumption dose were significantly associated with decreased HOMA-IR (β was-0.209and-1.193; p was0.002and0.039). Age, alcohol consumption dose and BMI were significantly associated with HOMA-p. Age and alcohol consumption was significantly associated with decreased HOMA-β (β was-1.278and-8.885; p was<0.001and0.001), while, BMI was significantly associated with increased HOMA-β (β=9.297;p<0.001).In the subject with FBG<6.1mmol/L, after adjusting the other confounders, alcohol history, blood uric acid and BMI were significantly associated with HOMA-IR. Alcohol history was negatively correlated with HOMA-IR (β was-0.084; p<0.001), while blood uric acid and BMI were positively with it (β was0.003and0.197; p was<0.001and<0.001). Age, alcohol consumption dose and WC were significantly associated with HOMA-β. Age and alcohol consumption dose were negatively correlated with HOMA-β (β was-1.366and-9.248; p was <0.001and<0.001), while WC were positively with it (β=3.126;p<0.001). Conclusion1. A long-term chronic alcohol intake is closely related to islet β cell dysfunction independently of BMI.2. There may be an approximate "U" curve between the HOMA-IR, fasting blood glucose levels and alcohol consumption for all and overweight men. Light alcohol intake may help to ameliorated fasting plasma glucose and insulin resistance.3. HOMA-IR was negatively associated with the alcohol dose in overweight men while alcohol history played a greater role in non-overweight men. |
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