Alcohol intake, insulin resistance, and abdominal obesity in elderly men.
OBJECTIVE
Moderate and high alcohol intake have been associated with decreased and increased risk of type 2 diabetes, respectively. Insulin resistance, insulin secretion, and abdominal obesity are major predictors of diabetes, but the links with alcohol intake remain contradictory because of limited data.


METHODS
In a population-based cohort of 807 men (age, 70 years), we studied whether alcohol intake was related to insulin sensitivity, measured with the gold standard technique (euglycemic clamp), insulin secretion (early insulin response), or adiposity [BMI, waist circumference (WC), waist-to-hip ratio]. Alcohol intake was self-reported (questionnaire) and was assessed from a validated 7-day dietary record. The cross-sectional associations were evaluated using multivariable linear regression, adjusting for smoking, education level, physical activity, dietary total energy intake, hypertension, diabetes, triglycerides, and cholesterol.


RESULTS
In multivariable models, self-estimated alcohol intake was not related to insulin sensitivity, early insulin response, or BMI, but was positively related to WC (beta-coefficient, 0.77; 95% confidence interval, 0.15 to 1.39; p=0.02) and waist-to-hip ratio (0.006 [0.002-0.009], p=0.003). The association with WC and waist-to-hip ratio was most pronounced in men in the lowest tertile of BMI. The results using dietary records were similar.


CONCLUSIONS
Evaluated in a large sample in elderly men, neither insulin sensitivity measured by clamp technique nor insulin secretion was significantly associated with alcohol intake. However, high alcohol intake was associated with abdominal obesity, which might explain the higher diabetes risk previously observed in high alcohol consumers.
Risérus
Ulf
U
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism/Geriatrics, Uppsala Science Park, 751 85 Uppsala, Sweden. ulf.riserus@pubcare.uu.se
Ingelsson
Erik
E
D000368:Aged; D000428:Alcohol Drinking / Q000503:physiopathology*; D000434:Alcoholic Beverages; D001515:Beer; D015992:Body Mass Index; D049628:Body Size; D015331:Cohort Studies; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009765:Obesity / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D014920:Wine
D007328:Insulin