Associations between lung function and alcohol consumption--assessed by both a questionnaire and a blood marker.
BACKGROUND
Studies on the influence of alcohol consumption on lung function have shown conflicting results. Self-reported alcohol consumption may be inaccurate. This study used both a validated alcohol questionnaire and a blood marker of heavy alcohol consumption, and examined potential associations with different lung physiological variables.


METHODS
The study population (450 subjects) answered an alcohol questionnaire (AUDIT-C) and performed spirometry, body plethysmography and a test for diffusing capacity for CO (DL,CO). Carbohydrate deficient transferrin (CDT), a clinically used blood marker for identifying heavy alcohol consumption, and C-reactive protein (CRP), a marker of systemic inflammation were analysed.


RESULTS
Using AUDIT-C, 407 subjects were alcohol drinkers and 29 non-drinkers. Of the alcohol drinkers, 224 subjects were "hazardous drinkers" and 183 "moderate drinkers". Thirty-four subjects had a CDT ≥2.0% (=heavy drinkers). There was no difference in lung function between hazardous and moderate drinkers. Heavy drinkers had lower DL,CO (74% vs 83% PN, p = 0.003), more symptoms of chronic bronchitis (p = 0.001) and higher AUDIT-C scores (p < 0.001) than non-heavy drinkers. After adjustments (pack years and CRP) the difference in DL,CO (p = 0.037) remained. Multiple regression showed an association between CDT and both FEV1 (p = 0.004) and DL,CO (p = 0.012) in all alcohol drinkers, but not in never-smokers. The AUDIT-C score was associated with CDT (also after adjustments, p < 0.001) but not with any lung function variable.


CONCLUSIONS
The results from this study suggest that alcohol and particularly heavy drinking has an independent additive negative effect on lung function in smokers.
Clinical Physiology and Nuclear Medicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden. Electronic address: sophia.frantz@med.lu.se.
S
S
Frantz
Clinical Physiology and Nuclear Medicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
P
P
Wollmer
Clinical Physiology and Nuclear Medicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
M
M
Dencker
Cardiovascular Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden.
G
G
Engström
Respiratory Medicine and Allergology Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
U
U
Nihlén
D000368:Aged; D000428:Alcohol Drinking; D015415:Biomarkers / Q000097:blood; D029481:Bronchitis, Chronic / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010993:Plethysmography, Whole Body; D011653:Pulmonary Diffusing Capacity; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000503:physiopathology*; D011656:Pulmonary Emphysema / Q000503:physiopathology; D012129:Respiratory Function Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013548:Sweden; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism
D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D002097:C-Reactive Protein
Airflow obstruction; Diffusion capacity for CO; Pulmonary function tests; Smoking