title: Reduced plasma homocysteine in obese red wine consumers: a potential contributor to reduced cardiovascular risk status.
abstract: BACKGROUND
  Moderate alcohol consumption is associated with improved vascular risk profile and decreased mortality in the middle aged. An elevated homocysteine concentration is an independent risk factor for cardiovascular disease.
  
  
  OBJECTIVE
  To examine the relationship between alcohol consumption and homocysteine concentrations in severely obese patients (body mass index (BMI)>35).
  
  
  METHODS
  A careful alcohol history was obtained from 350 (male:female 1:5) consecutive patients as part of preoperative assessment for surgical treatment of obesity. Data were obtained concerning amount, frequency, timing and type of alcohol consumption. Fasting homocysteine, serum folate and vitamin B(12) concentrations were measured. Differences between groups were assessed using Student t-test, and ANOVA. Linear regression was used to assess factors influencing homocysteine concentration.
  
  
  RESULTS
  There is a U-shaped relationship between alcohol consumption and homocysteine concentrations, with light to moderate consumption being associated with lower concentrations. Those consuming <100 g/week (n=165) of alcohol had geometric mean (95% CI of mean) serum homocysteine concentrations of 8.5 (8.2-8.9) micromol/l compared with 9.5 (9.1-9.9) micromol/l for non or rare consumers (n=153; P=0.001). The lower concentrations of homocysteine in regular consumers were associated with higher folate concentrations of 9.4 (8.6-10.2) ng/ml when compared with non-consumers 7.5 (7.1-7.8) ng/ml (P=0.001). Red wine consumers (n=42) had lower fasting concentrations of homocysteine 7.8 (7.5-8.1) micromol/l compared with 153 non-consumers 9.4 (9.0-9.8) micromol/l (P<0.001), 82 beer and spirit consumers 9.0 (8.4-9.7) micromol/l (P=0.005) and 73 white wine consumers 8.8 (8.2-9.4 micromol/l (P=0.013). Red wine consumption was an independent predictor for lower homocysteine concentrations.
  
  
  CONCLUSIONS
  Mild to moderate alcohol consumption, especially red wine consumption, in obese subjects is associated with lower fasting homocysteine concentrations. This may reduce cardiovascular risk and help explain the 'French paradox'.
authors.affiliation: Monash University Department of Surgery, Alfred Hospital, Melbourne, Victoria, Australia. john.dixon@med.monash.edu.au
authors.forename: J B
authors.initials: JB
authors.lastname: Dixon
authors.forename: M E
authors.initials: ME
authors.lastname: Dixon
authors.forename: P E
authors.initials: PE
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000097:blood*; D000434:Alcoholic Beverages; D001515:Beer; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D005215:Fasting; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D012306:Risk; D014805:Vitamin B 12 / Q000097:blood; D014920:Wine
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12