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THE RENAUD SOCIETY MEMBER BULLETIN BOARD
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| Subject: Journal Watch: Alcohol & Health |
Author: R. Curtis Ellison, MD
Date: 11/23/2008 7:29 am MST
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Review of Recent Publication November 22, 2008
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Article: Beulens JWJ, Kruidhof JS, Grobbee DE, Chaturvedi N, Fuller JH, Soedamah-Muthu SS. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Diabetologia 2008;51:1631–1638.
Summary: The authors state that the aim of this study was to investigate the association between alcohol consumption and risk of microvascular complications (retinopathy, neuropathy, nephropathy) in type 1 diabetes mellitus patients in the EURODIAB Prospective Complications Study. The EURODIAB Prospective complications Study is a follow-up study including 3,250 type 1diabetes mellitus patients from 16 different European countries. The authors investigated the cross-sectional association between moderate alcohol consumption and risk of retinopathy, neuropathy and nephropathy among 1,857 of these patients.
The authors documented 304 cases of proliferative retinopathy, 660 cases of neuropathy and 157 cases of nephropathy (macroalbuminuria). Alcohol consumption was associated with risk of proliferative retinopathy, neuropathy and macroalbuminuria in a U-shaped fashion. Moderate consumers (30–70 g alcohol per week) had a lower risk of microvascular complications with odds ratios of 0.60 (95% CI 0.37–0.99) for proliferative retinopathy, 0.61 (0.41–0.91) for neuropathy and 0.36 (0.18–0.71) for macroalbuminuria in multivariate-adjusted models. These results were similar when excluding patients who had been advised to drink less alcohol because of their health. The relation was most pronounced for alcohol consumption from wine. Drinking frequency was significantly, inversely associated with risk of neuropathy, and a similar trend was visible for proliferative retinopathy and macroalbuminuria. Alcohol consumption was not associated with occurrence of ketoacidosis or hypoglycaemic attacks. The authors conclude that consistent with its effects on macrovascular complications, moderate alcohol consumption is associated with a lower risk of all microvascular complications among type 1 diabetes patients.
Comments: Data from most prospective epidemiologic studies have shown that healthy moderate drinkers have an approximately 30% lower risk of developing type 2 (adult-onset) diabetes. Further, it is clear that diabetics who drink moderately are at a much lower risk of the macrovascular complications of diabetes, those involving major arteries (such as coronary heart disease, stroke, and peripheral vascular disease).
This is one of few studies of early-onset (type 1) diabetes that is large enough to evaluate whether microvascular complications (those involving the eyes, kidneys, nerves) are also lower among moderate drinkers. The main findings are that moderate drinking, especially of wine and to some extent of beer, was associated with lower occurrence of these complications of type 1 diabetes. The effect was especially seen for wine drinkers of between about 3 and 18 drinks per week. There was a tendency for frequent drinkers (5-7 days/week) to have fewer complications than those drinking less frequently. Thus, this study suggests that the microvascular, as well as the macrovascular, complications of diabetes are lower among moderate drinkers.
Lay Summary: This cross-sectional analysis from a large study of subjects with early-onset (type 1) diabetes, the type generally not associated with obesity, showed a considerably lower occurrence of common microvascular complications of diabetes -- retinopathy, neuropathy, and kidney abnormalities-- among those individuals who consumed alcohol moderately. The association was strongest among wine drinkers, and to some extent among beer drinkers, but not among those consuming spirits.
R. Curtis Ellison, MD
Yuqing Zhang, MD, DSc Institute on Lifestyle & Health
Boston University School of Medicine
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Journal Watch: Alcohol & Health |
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R. Curtis Ellison, MD |
11/23/2008 7:29 am MST |
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R. Curtis Ellison, MD |
11/23/2008 7:30 am MST |
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R. Curtis Ellison, MD |
11/23/2008 7:32 am MST |
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R. Curtis Ellison, MD |
12/12/2008 4:07 pm MST |
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R. Curtis Ellison, MD |
1/11/2009 7:27 am MST |
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R. Curtis Ellison, MD |
1/11/2009 7:13 am MST |
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