Alcohol consumption in the severely obese: relationship with the metabolic syndrome.
OBJECTIVE
The aim of this study was to examine the association between the clinical and biochemical features of the metabolic syndrome and quantity and type of alcohol intake in the severely obese.


METHODS
A cross-sectional study was performed in 486 consecutive severely obese subjects. Data on alcohol consumption was collected by serial clinical interviews and a questionnaire. The relationship between alcohol intake and the clinical and serum chemistry features of the metabolic syndrome was analyzed by multiple statistical techniques. Laboratory measures included lipid profile, fasting blood glucose, hemoglobin A1c, and fasting serum insulin. An indirect index of insulin resistance was calculated using the log-transformed fasting insulin and glucose product.


RESULTS
There were 486 subjects, 84% women, with a mean age of 40.6 +/- 10 years (range, 16 to 71 years) and a body mass index of 45.3 +/- 7 kg/m(2) (range, 34 to 77 kg/m(2)). Alcohol consumers (N = 276) showed a marked reduction in the adjusted odds ratio of type 2 diabetes (odds ratio = 0.29; 95% confidence interval, 0.16 to 0.55) compared with rare or nonconsumers (N = 210). There was a U-shaped relationship between the amount and frequency of alcohol consumption and fasting triglyceride, fasting glucose, hemoglobin A1c, and index of insulin resistance measurements. Consumers of < 100 g/wk had more favorable measures. The effect was attenuated when diabetics were excluded from the analysis. Timing of alcohol consumption did not influence outcome measures.


CONCLUSIONS
Light-to-moderate alcohol consumption is associated with a lower prevalence of type 2 diabetes, reduced insulin resistance, and more favorable vascular risk profile in the severely obese. We would propose that light to moderate alcohol consumption should not be discouraged in the severely obese.
Dixon
John B
JB
Monash University Department of Surgery, Alfred Hospital, Melbourne, Victoria, Australia. john.dixon@med.monash.edu.au
Dixon
Maureen E
ME
O'Brien
Paul E
PE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001515:Beer; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D009765:Obesity; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014920:Wine
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D014280:Triglycerides