In a study sample of women, alcohol consumption was inversely associated with risk for type 2 diabetes, according to the results of a nested case-control study from the Nurses’ Health Study. "Cross-sectional studies and a recent prospective study suggest that moderate alcohol consumption may be associated with lower [body mass index; BMI] and less weight gain over time among women but not men," write Joline W.J. Beulens, PhD, from University Medical Center Utrecht in the Netherlands, and colleagues.
"Whether and to what extent markers of inflammation, endothelial dysfunction, fasting insulin, and adiponectin concentrations explain the inverse association between moderate alcohol consumption and type 2 diabetes has not been investigated to date. To address these questions, we investigated these relations in a nested case-control study from the Nurses’ Health Study."
The adjusted relationship between baseline alcohol consumption and risk for diabetes was evaluated in a sample of 705 women with incident diabetes and 787 matched control patients, both before and after adjustment for fasting insulin, adiponectin concentrations, and markers of inflammation/endothelial dysfunction. These included C-reactive protein, vascular cell adhesion molecule 1, intercellular adhesion molecule 1, E-selectin, tumor necrosis factor-alpha receptor 2, and interleukin 6,
Moderate alcohol consumption was associated with a lower risk for diabetes (odds ratio, 0.58 per 12.5 g/day increment in alcohol use; 95% confidence interval, 0.49 – 0.69; P < .001). None of the markers of inflammation or fasting insulin appeared to account for more than 2% of this association. However, this relationship was attenuated by 25% by adjustment for BMI.
Without adjustment for BMI, these biomarkers individually explained slightly more of the association, but less than 10% for each biomarker. In a fully adjusted model, adiponectin accounted for 25% of the observed association, or for 29% without adjustment for BMI.
"In this population of women, alcohol consumption was inversely associated with risk of type 2 diabetes," the study authors write. "Adiponectin appeared to be a mediator of this association, but circulating biomarkers of inflammation, endothelial dysfunction, and fasting insulin did not explain this association. These results suggest that further research is needed into the potentially mediating roles of other biomarkers affected by alcohol consumption."
"Other studies using more robust markers of insulin sensitivity such as homeostasis model assessment are needed to determine the full degree to which insulin sensitivity mediates the association between alcohol consumption and diabetes," the study authors conclude. "Other biomarkers such as adiponectin, which could potentially mediate a substantial part of the association, should be included in such studies as well."
- Alcohol intake is linked to decrease in risk for type 2 diabetes in women, with an odds ratio of 0.58 per 12.5 g increase in alcohol intake.
- The inverse relationship between alcohol intake and the risk for type 2 diabetes appears to be mediated 25% to 30% by adiponectin, but not significantly mediated by biomarkers of inflammation, endothelial dysfunction, and fasting insulin.
Diabetes Care. 2008;31:2050–2055.
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