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Alcohol Consumption and Lipoprotein Subclasses in Older Adults

Divisions of General Medicine and Primary Care (K.J.M.) and Cardiology (M.A.M.), Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215; Department of Epidemiology (R.H.M., L.H.K.), University of Pittsburgh, Pittsburgh, Pennsylvania 15213; Department of Pathology (R.P.T.), University of Vermont, Burlington, Vermont 05405; Department of Epidemiology (M.A.M.), Harvard School of Public Health, Boston, Massachusetts 02115; and Departments of Biostatistics (R.A.K.), Epidemiology (D.S.S.), and Medicine (D.S.S.), University of Washington, Seattle, Washington 98195

Address all correspondence and requests for reprints to: Kenneth J. Mukamal, M.D., M.P.H., M.A., Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, RO-114, Boston, Massachusetts 02215. E-mail: kmukamal{at}pidmc.harvard.edu.

Context: Limited evidence suggests that alcohol intake may be associated with lipoprotein subclass distribution, which could mediate its relationship with coronary heart disease.

Objectives: The objective was to determine the relationship of alcohol intake with lipoprotein particle subclasses.

Design, Setting, and Participants: The study included a cross-sectional analysis of 1850 participants of the Cardiovascular Health Study aged 65 yr and older and free of clinical cardiovascular disease.

Main Outcome Measure: Lipoprotein subclass distribution was measured with nuclear magnetic resonance spectroscopy, according to self-reported alcohol intake.

Results: Alcohol intake was associated with total low-density lipoprotein (LDL) particles in a U-shaped manner. Consumers of one or more drinks per week had the highest number of large LDL particles, whereas consumers of 7–13 drinks per week had the lowest number of small LDL particles. Alcohol intake was strongly positively associated with large- and medium-sized high-density lipoprotein (HDL) particles but had an inverse relationship with concentrations of small HDL particles and small- and medium-sized very-low-density lipoprotein particles. Average particle sizes of all three lipoproteins were positively associated with alcohol intake. Associations were generally stronger among women than men but in similar directions. Beverage type did not consistently modify these findings.

Conclusions: Alcohol intake is associated with less total LDL particles, lower levels of small LDL, HDL, and very-low-density lipoprotein particles, and higher levels of large LDL and medium- and large-sized HDL particles in older adults free of prevalent clinical cardiovascular disease.

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