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High-density lipoprotein functionality, cardiovascular health, and patterns of alcohol consumption: new insights and
Marta Trius-Soler1, Kenneth J Mukamal2, Marta Guasch-Ferré1,3
1Department of Public Health and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Insights
Low-to-moderate alcohol consumption may improve high-density lipoprotein (HDL) functionality and reduce cardiovascular disease (CVD) risk. Further research is needed to confirm these associations.
Area of Science:
- Cardiovascular Science
- Lipid Metabolism
- Nutritional Epidemiology
Background:
- Cardiovascular diseases (CVD) represent a major global health burden.
- The relationship between high-density lipoproteins (HDL) and alcohol consumption requires clarification.
- Understanding HDL's role in CVD risk is crucial for public health.
Approach:
- Comprehensive narrative review of existing literature.
- Analysis of HDL functionality beyond HDL-cholesterol (HDL-c).
- Examination of alcohol consumption patterns and their impact on HDL.
Key Points:
- HDL phenotypes, including subspecies and particle abundance, are key indicators of atherosclerotic CVD risk.
- Low-to-moderate alcohol intake may enhance HDL functionality and reverse cholesterol transport.
- Potential cardiovascular benefits are observed primarily in middle-aged men and postmenopausal women.
Conclusions:
- Low-to-moderate alcohol consumption may positively influence HDL concentration and function.
- Further intervention trials are necessary to establish causal links between alcohol, HDL, and cardiovascular outcomes.
- Advancements in understanding HDL biology may lead to improved cardiovascular risk prediction.
Purpose Of Review:
Cardiovascular diseases (CVD) pose a significant public health challenge, contributing to 422 million disability-adjusted life years in 2021. The role of high-density lipoproteins (HDL) and alcohol consumption, one of their major modifiable determinants, remains controversial. The objective of this review is to provide a comprehensive narrative overview of HDL functionality and its predictive value for CVD in relation to patterns of alcohol consumption.
Recent Findings:
HDL phenotypes beyond HDL-cholesterol (HDL-c) such as distribution of HDL subspecies, HDL particle abundance, and reverse cholesterol transport capacity are promising indicators of atherosclerotic CVD risk. Low-to-moderate alcohol consumption seems to improve HDL functionality and reduce the incidence of CVD among primarily middle-aged men and postmenopausal women. Advancements in our understanding of HDL biogenesis, structure, and function hold promise for improving HDL-related measures and their predictive value for cardiovascular health.
Summary:
Low-to-moderate alcohol consumption appears to not only increase HDL-c concentration found in the HDL fraction of plasma but also enhance HDL functionality, providing insights into the underlying mechanisms linking alcohol exposure and cardiovascular health benefits. However, rigorous, well designed intervention trials of alcohol consumption on hard cardiovascular outcomes are needed to identify robust causal associations of HDL phenotypes and alcohol consumption with cardiovascular risk.
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