[J-curve between alcohol consumption and carotid atherosclerosis in patients with dyslipidemia].
BACKGROUND
Cerebrovascular disease is the leading cause of death in Portugal and carotid disease is responsible for 20 to 50% of strokes. As dyslipidaemias and alcoholism are frequent problems in our country, we planned to examine the relationship of alcohol consumption and carotid disease in dyslipidaemic patients, a subject that has never been specifically studied, as far as we know.


METHODS
We studied 102 dyslipidaemic patients, 38 females and 64 males. We used the following classification for echo-doppler results; grade 0--normal; grade 1--intimal-medial thickening (> or = 1 mm); grade 2--one plaque; grade 3--two or more plaques; grade 4--haemodynamic disturbance. We measured several biochemical and clinical parameters, including declared alcohol consumption.


RESULTS
In a stepwise regression we found that age had the highest correlation with carotid atherosclerosis, followed by alcohol consumption. Visually we noticed a J-curve between alcohol consumption and carotid atherosclerosis, that we confirmed with a polynomial regression (r = 0.318, p = 0.0114). Carotid atherosclerosis increased only with levels of alcohol consumption over 60 g/day, in spite of even lower levels of alcohol consumption being associated with lower HDL-C and higher triglycerides compared to abstainers. Apo(a) significantly decreased with levels of alcohol consumption over 60 g/day.


CONCLUSIONS
In spite of inducing a more severe dyslipidaemia, a low to moderate alcohol consumption may not be contraindicated in dyslipidaemic patients, with some of the protective effects of alcohol probably counterbalancing the worse lipid profile.
Silva
J M
JM
Servicio de Medicina Interna, Hospital de la Universidad de Coimbra, Coimbra, Portugal.
Méndez
M M
MM
Gonzalo
M
M
Pinto
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000150:complications* / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D012044:Regression Analysis