title: Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies.
abstract: OBJECTIVE
  To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Medline (1950 to October 2009) and Embase (1980 to October 2009) without limits.
  
  
  METHODS
  Two reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected.
  
  
  RESULTS
  Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits). Alcohol significantly increased levels of high density lipoprotein cholesterol (pooled mean difference 0.094 mmol/L, 95% confidence interval 0.064 to 0.123), apolipoprotein A1 (0.101 g/L, 0.073 to 0.129), and adiponectin (0.56 mg/L, 0.39 to 0.72). Alcohol showed a dose-response relation with high density lipoprotein cholesterol (test for trend P = 0.013). Alcohol decreased fibrinogen levels (-0.20 g/L, -0.29 to -0.11) but did not affect triglyceride levels. Results were similar for crossover and before and after studies, and across beverage types.
  
  
  CONCLUSIONS
  Favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, Calgary Institute for Population and Public Health, University of Calgary, Alberta, Canada T2N 4Z6.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Brien
authors.forename: Paul E
authors.initials: PE
authors.lastname: Ronksley
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Turner
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
mesh_terms: D054392:Adipokines / Q000378:metabolism; D000328:Adult; D000428:Alcohol Drinking / Q000097:blood*; D015415:Biomarkers / Q000378:metabolism*; D003327:Coronary Disease / Q000097:blood*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006490:Hemostatics / Q000378:metabolism; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D012307:Risk Factors
chemical_list: D054392:Adipokines; D015415:Biomarkers; D016207:Cytokines; D006490:Hemostatics