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Alcohol Consumption, High-Density Lipoprotein Particles and Subspecies, and Risk of Cardiovascular Disease: Findings
Setor K Kunutsor1, Atanu Bhattacharjee2, Margery A Connelly3
1Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester LE5 4WP, UK.
Insights
Moderate alcohol consumption is linked to increased high-density lipoprotein (HDL) particle and subspecies levels. However, the association between alcohol intake and cardiovascular disease (CVD) risk is largely independent of these HDL changes.
Area of Science:
- Cardiovascular Health
- Lipid Metabolism
- Alcohol Research
Background:
- The relationship between alcohol consumption, high-density lipoprotein (HDL) particle concentrations, and cardiovascular disease (CVD) risk requires further clarification.
- HDL parameters, including particle number (HDL-P) and subspecies, play a role in cardiovascular health, but their interaction with alcohol intake is not fully understood.
Purpose of the Study:
- To investigate the interplay between alcohol consumption patterns, various HDL parameters (HDL-P, HDL subspecies, HDL size), and the risk of incident cardiovascular disease (CVD).
- To determine if HDL parameters mediate or modify the association between alcohol consumption and CVD risk.
Main Methods:
- Utilized data from the PREVEND study, including 5151 participants, assessing self-reported alcohol consumption and HDL parameters via nuclear magnetic resonance spectroscopy.
- Employed multivariable linear regression to analyze associations between alcohol intake and HDL metrics, and Cox proportional hazards models to estimate hazard ratios (HRs) for CVD events during a median follow-up of 8.3 years.
Main Results:
- Increased alcohol consumption was dose-dependently associated with higher levels of HDL-C, HDL-P, large and medium HDL particles, and specific HDL subspecies (H3P, H4P, H6, H7).
- Alcohol consumption showed a potential inverse association with CVD risk, with HRs of 0.72, 0.74, and 0.65 for occasional/light, moderate, and heavy drinkers, respectively, compared to abstainers.
- These associations between alcohol consumption and CVD risk remained largely consistent even after adjusting for HDL parameters. Only HDL-C showed a statistically significant inverse association with overall CVD risk in fully adjusted models.
Conclusions:
- Higher alcohol consumption is associated with favorable changes in HDL parameters, including increased HDL-P and specific subspecies.
- The observed associations between alcohol consumption and reduced CVD risk appear to be largely independent of HDL parameters.
- While HDL parameters like HDL-C, HDL size, and H4P can improve CVD risk prediction models, their relationship with CVD risk is generally not significantly modified by alcohol consumption levels.
Abstract:
The associations of HDL particle (HDL-P) and subspecies concentrations with alcohol consumption are unclear. We aimed to evaluate the interplay between alcohol consumption, HDL parameters and cardiovascular disease (CVD) risk. In the PREVEND study of 5151 participants (mean age, 53 years; 47.5% males), self-reported alcohol consumption and HDL-P and subspecies (small, medium, and large) by nuclear magnetic resonance spectroscopy were assessed. Hazard ratios (HRs) with 95% CIs for first CVD events were estimated. In multivariable linear regression analyses, increasing alcohol consumption increased HDL-C, HDL-P, large and medium HDL, HDL size, and HDL subspecies (H3P, H4P, H6 and H7) in a dose-dependent manner. During a median follow-up of 8.3 years, 323 first CVD events were recorded. Compared with abstainers, the multivariable adjusted HRs (95% CIs) of CVD for occasional to light, moderate, and heavy alcohol consumers were 0.72 (0.55-0.94), 0.74 (0.54-1.02), and 0.65 (0.38-1.09), respectively. These associations remained consistent on additional adjustment for each HDL parameter. For CVD, only HDL-C was associated with a statistically significant decreased risk of CVD in a fully adjusted analysis (HR 0.84, 95% CI 0.72-0.97 per 1 SD increment). For coronary heart disease, HDL-C, HDL-P, medium HDL, HDL size, and H4P showed inverse associations, whereas HDL-C and HDL size modestly increased stroke risk. Except for H6P, alcohol consumption did not modify the associations between HDL parameters and CVD risk. The addition of HDL-C, HDL size, or H4P to a CVD risk prediction model containing established risk factors improved risk discrimination. Increasing alcohol consumption is associated with increased HDL-C, HDL-P, large and medium HDL, HDL size, and some HDL subspecies. Associations of alcohol consumption with CVD are largely independent of HDL parameters. The associations of HDL parameters with incident CVD are generally not attenuated or modified by alcohol consumption.
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