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19-05-2010 | Cardiometabolic | Article

HDL changes may underpin alcohol’s cardioprotective effect


Free abstract

MedWire News: The putative cardioprotective effect of moderate alcohol consumption may be mediated by a beneficial effect of alcohol on high-density lipoprotein (HDL) cholesterol concentration and size, research suggests.

“The size of alcohol-associated HDL changes reported here are equivalent to those of niacin, the current treatment of choice to raise HDL cholesterol,” comment Elizabeth Barrett-Connor (University of California, San Diego, USA) and colleagues.

The team’s findings are based on an analysis of 2171 community-dwelling adults, aged at least 50 years, who were participating in the Rancho Bernardo Study.

Among men, HDL cholesterol levels rose from 48 mg/dl (1.24 mmol/l) in those who abstained from alcohol, to 51, 52, and 57 mg/dl (1.32, 1.34, and 1.47 mmol/l) in those who drank alcohol less than 3, 3–4, and 5 or more times per week, respectively, a significant linear trend.

Large HDL particles comprised 35.3% of total HDL among men who drank 5 or more times per week, compared with 30.7% among alcohol abstainers. Conversely, small HDL particles comprised 48.3% and 53.6% of total HDL, respectively.

Similar, also significant, relationships between alcohol intake and HDL particles were obtained for women.

The number of alcoholic drinks per week remained significantly associated with HDL cholesterol levels and HDL particle size in both men and women after accounting for factors including body mass index (BMI), diabetes, smoking, exercise, age, and estrogen therapy (in women).

BMI was negatively associated with HDL concentration and size, as was diabetes. Smoking negatively impacted HDL cholesterol levels, but not HDL particle size.

Although HDL cholesterol is generally thought to be cardioprotective, recent research has indicated that very large, abundant HDL particles could increase people’s risk for cardiovascular disease (CVD).

“Importantly, the latter results are from studies conducted primarily in individuals with prevalent CVD or CVD risk,” say Barrett-Connor et al in the British Journal of Nutrition.

“Perhaps a pro-inflammatory state such as CVD or consumption of alcohol, which has anti-inflammatory effects, alters the functionality of HDL subclasses.”

They conclude: “More research is needed to better understand the role of HDL size in CVD risk.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Eleanor McDermid