Alcohol Consumption And The Incidence Of Metabolic Syndrome In Chinese Cohort Study

BACKGROUD AND OBJECTIVE:There is a long history of alcohol consumption in China, and the prevalence of drinking has been remarkablely increased in recent decades. Metabolic syndrome (MS) is an important risk factor for cardiovascular disease in general population, and it has aroused wide public concern. We analyzed data from a cohort study to examine the relationship between alcohol consumption and incidence of MS in China.DESIGN AND METHODS:Study CohortBaseline surveys of two study cohort were conducted in China between1998and2001. A total of27020Chinese adults aged35-74years at the baseline were followed up in2007-2008, with14572participants met the requirements completing follow-up survey for an average of8.1years.Baseline ExaminationAll baseline data were obtained using a standard questionnaire by trained research staff. Demographic data and other risk, factors, such as frequency and type of alcohol consumption, were collected according to the same protocol. Alcohol consumption was defined as drinking alcohol at least once/week in the past year of the baseline survey. MS was defined by the International Diabetes Federation (IDF). Fasting blood samples overnight were drawn for measuring serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and fasting blood glucose (FBG).Follow-Up ProceduresThe follow-up investigation included tracking study participants or their proxies to ascertain disease status and vital information by interview and obtaining hospital records and death certificates. Overnight fasting serum lipids and FBG were measured by the same method used at the baseline survey.Statistical MethodsLogistic regression models were used to adjust for baseline covariables, and compute odds ratio (OR) of MS associated with alcohol consumption. OR can be equal to relative risk (RR), because of the annual incidence of MS is low (2.00%). The population attributable risk percent (PARP) was used to estimate the proportion of MS explained by drinking behavior.RESULTS:The multivariable-adjusted RRs of MS associated with drinking were obtained separately for men and women. After adjustment for age, geographic variation (north vs. south), urbanization (urban vs. rural), education, physical activity, cigarette smoking, body mass index and the number of MS components, compared with nondrinkers, RR (95%confidence interval, CI) and the PARP of the MS was1.24(1.06～1.45) and10.13%for male drinkers, respectively. The RR (95%CI) of MS was1.36(1.02～1.82),1.34(1.03～1.74) and1.41(1.13～1.77) for male drinkers consuming alcohol10.1-20g/day,20.1-40g/day, and>40g/day, respectively. The RR (95%CI) of MS was1.25(1.01～1.55) for males drinking6-25times/month and1.26(1.04～1.52) for males drinking>25times/month. The RR (95%CI) of MS was1.60(1.05～2.45),1.30(1.02-1.65) and1.27(1.06-1.52) for beer-only, liquor-only and the beer and liquor combination male consumers, respectively. The corresponding RR (95%CI) was2.67(1.26～5.66) and3.10(1.54～6.22) for female drinkers consuming alcohol10.1-20g/d and20.1～40g/d, respectively.Components of MS study indicated that male drinkers consuming alcohol>40g/day,> once/week, and the beer or/and liquor combination with other type alcohol drinking as well as female drinkers consuming alcohol20g/day,>25times/month, and liquor-only had central obesity, compared with nondrinkers. Female drinkers consuming alcohol0.1～10g/day and6-25times/month had lower TG, compared with nondrinkers. With the increasing of quantity and frequency of alcohol consumption, male drinkers had a higher level of HDL-C compared with nondrinkers. This phenomenon could be also found in male drinkers consuming liquor-only, rice wine-only, and the beer or/and liquor combination with other type drinkers as well as female drinkers consuming0.1～10g/day and the beer or/and liquor combination with other type drinkers. However, women consuming alcohol20.1-40g/day had a lower level of HDL-C, compared with nondrinkers. With the increasing of quantity and frequency of alcohol consumption, male drinkers could more likely have a higher level of blood pressure and FBG compared with nondrinkers. CONCLUSIONS:Adults drinking alcohol more than lOg/day is associated with an increased risk of MS in the general population, especially in women. Drinking more than six times per month, beer and, or liquor consumption can substantially increase the risk of MS in men. To control the prevalent of MS, it is suggested to limit the excessive alcohol consumption (<10g/day), especially in women.