Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of interventional studies
PubMed 21343206 · doi:10.1136/bmj.d636
What was done
A systematic review and meta-analysis of interventional studies evaluated the effect of alcohol intake versus non-intake on 21 biological markers of coronary heart disease risk in adults without known cardiovascular disease. Databases (Medline and Embase through October 2009) were searched without limits. Of 4,690 screened articles, 63 eligible studies were identified and 44 studies covering 13 biomarkers were meta-analyzed using fixed- or random-effects models, with sensitivity analyses grouped by study design (crossover and before-after studies) and stratified by beverage type (wine, beer, spirits).
What was found
Alcohol intake significantly increased high-density lipoprotein (HDL) cholesterol (pooled mean difference 0.094 mmol/L, 95% CI 0.064 to 0.123; dose-response trend P = 0.013), apolipoprotein A1 (0.101 g/L, 95% CI 0.073 to 0.129), and adiponectin (0.56 mg/L, 95% CI 0.39 to 0.72). Alcohol significantly decreased fibrinogen (-0.20 g/L, 95% CI -0.29 to -0.11), but did not significantly affect triglyceride levels. Findings remained consistent across study designs (crossover vs. before-and-after) and beverage types.
Why it matters
These findings provide mechanistic support from experimental human intervention trials showing that moderate alcohol consumption favorably alters intermediate biomarkers linked to coronary heart disease risk.
Limits
The analysis evaluated surrogate intermediate biomarkers rather than hard clinical cardiovascular events or mortality. Only 44 of the 63 eligible studies had data suitable for meta-analysis, and details regarding participant numbers, study durations, and background diet were not reported in the abstract.
Cited by
- supports Moderate alcohol consumption increases high-density lipoprotein (HDL) cholesterol levels.