The effect of alcohol intake on insulin sensitivity in men: a randomized controlled trial.
OBJECTIVE
Population data suggest that alcohol consumption may influence the risk of diabetes in a biphasic manner, but this has not been tested by any controlled interventions. The object of this study was to determine whether reducing alcohol intake in moderate-to-heavy drinkers (40-110 g/day) results in improvement in insulin sensitivity.


METHODS
A 4-week run-in period where subjects maintained their usual drinking pattern was followed by randomization to a two-way cross-over intervention study. In each of two 4-week treatment interventions, subjects either substituted their usual alcohol intake with a 0.9% alcohol beer or maintained their usual alcohol intake. At the end of each 4-week period, insulin sensitivity as determined by the low-dose insulin glucose infusion test and the homeostasis model assessment (HOMA) score, and biomarkers of alcohol consumption (gamma-glutamyl transpeptidase [gamma-GT] and HDL cholesterol) were measured.


RESULTS
A total of 16 healthy men aged 51.0 +/- 2.7 (mean +/- SEM) years with a BMI of 26.4 +/- 0.61 kg/m(2) completed the study. There was a large reduction in alcohol intake (72.4 +/- 5.0 vs. 7.9 +/- 1.6 g/day, P < 0.001) and significant reductions in gamma-GT (geometric mean 24.4 units/l [95% CI 19.7-30.2] vs. 18.6 units/l [15.5-22.2], P < 0.01) and HDL cholesterol (1.36 +/- 0.07 vs. 1.13 +/- 0.07 mmol/l, P < 0.001). There was no effect of alcohol on insulin sensitivity index (ISI), fasting insulin, glucose, or HOMA score.


CONCLUSIONS
A substantial reduction in alcohol intake from 7.2 to 0.8 standard drinks per day in healthy men did not change insulin sensitivity as measured by ISI or HOMA score.
Zilkens
Renate R
RR
University of Western Australia, Department of Medicine, Royal Perth Hospital, Perth, Western Australia, Australia. renate@cyllene.uwa.edu.au
Burke
Valerie
V
Watts
Gerald
G
Beilin
Laurence J
LJ
Puddey
Ian B
IB
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001515:Beer; D001835:Body Weight; D002492:Central Nervous System Depressants / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control*; D000431:Ethanol / Q000008:administration & dosage*; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D002492:Central Nervous System Depressants; D000431:Ethanol