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Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study (Bruneck study)

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7064.1040 (Published 26 October 1996) Cite this as: BMJ 1996;313:1040
  1. Stefan Kiechl, lecturer in neurologya,
  2. Johann Willeit, associate professora,
  3. Werner Poewe, professora,
  4. Georg Egger, consultant cardiologistb,
  5. Friedrich Oberhollenzer, head of hospitalb,
  6. Michele Muggeo, professorc,
  7. Enzo Bonora, associate professorc
  1. a Department of Neurology, University of Innsbruck, Innsbruck, Anichst 35, A-6020 Innsbruck, Austria
  2. b Department of Internal Medicine, Bruneck Hospital, I-39031 Bruneck, Italy
  3. c Department of Endocrinology and Metabolism, Ospedale Civile Maggiore, I-37126 Verona, Italy
  1. Correspondence to: Dr Kiechl.
  • Accepted 6 September 1996

Abstract

Objectives: To assess the relation between regular alcohol consumption and insulin sensitivity, and to estimate the importance of insulin in the association of alcohol with multiple vascular risk factors and cardiovascular disease.

Design: Prospective and cross sectional study of a large randomly selected population sample.

Setting: Part of the Bruneck study 1990–5 (Bolzano province, Italy).

Subjects: 820 healthy non-diabetic women and men aged 40–79 years.

Main outcome measure: Concentrations of fasting and post-glucose insulin, cholesterol, apolipoproteins, triglycerides, Lp(a) lipoprotein, glucose, fibrinogen, and antithrombin III; blood pressure; insulin resistance estimated by the homeostasis model assessment.

Results: Fasting insulin concentrations in those who did not drink alcohol and subjects reporting low (1–50 g/day), moderate (51–99 g/day), and heavy (>/=100 g/day) alcohol intake were 12.4, 10.0, 8.7, and 7.1 mU/l (P<0.001). Likewise, post-glucose insulin concentrations and estimates for insulin resistance assessed by the homeostasis model assessment decreased significantly with increasing amounts of regular alcohol consumption. These trends were independent of sex, body mass index, physical activity, cigarette smoking, medication, and diet (P<0.001). Regular alcohol intake predicted multiple changes in vascular risk factors over a five year period including increased concentrations of high density lipoprotein cholesterol and apolipoprotein A I; higher blood pressure; and decreased concentration of antithrombin III. These associations were in part attributable to the decrease in insulin concentrations observed among alcohol consumers.

Conclusions: Low to moderate amounts of alcohol, when taken on a regular basis, improve insulin sensitivity. Insulin is a potential intermediate component in the association between alcohol consumption and vascular risk factors (metabolic syndrome).

Key messages

  • Regular alcohol consumption predicted multiple changes of vascular risk factors over a five year period

  • This alcohol associated metabolic syndrome is in part attributable to the decline in insulin concentrations

Footnotes

  • Funding Pustertaler Verein zur Pravention der Herz und Hirngefaßerkrankungen, Sanitatseinheit Ost, Assessorat fur Gesundheit, province of Bozen, Italy.

  • Conflict of interest None.

  • Accepted 6 September 1996
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