Influence of Facial Flushing on Pre- or Type 2 Diabetes Risk according to Alcohol Consumption in Korean Male

다국어 초록 (Multilingual Abstract)

Background: This study aims to examine the association between alcohol consumption and the risk of pre- or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI).
Methods: This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre- or T2DM.
Results: In both the normal-weight group (BMI <23 kg/m2) and the overweight group (BMI ≥23 kg/m2 and <25 kg/ m2), the flushers had a higher risk of pre- or T2DM (odds ratio, 95% confidence interval) when consuming more than 8 drinks of alcohol per week than the non-drinkers (normal-weight group: 3.43, 1.06–11.07; overweight group: 4.94, 1.56–15.67). But in the non-flushers among the normal-weight group and the overweight group, there was no significant difference compared to non-drinkers regarding the risk of pre- or T2DM. Obese flushers had a significantly higher risk of pre- or T2DM when consuming more than 4 drinks of alcohol per week than the non-drinkers (>4 and ≤8 drinks: 2.64, 1.10–6.36; >8 drinks: 2.42, 1.11–5.27). However, obese non-flushers had only a significant higher risk of pre- or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39–5.30) Conclusion: These results suggest that obese flushers have an increased risk of developing pre- or T2DM even with less alcohol consumption.

참고문헌 (Reference)

1 Jung JG, "The role of the flushing response in the relationship between alcohol consumption and insulin resistance" 34 : 1699-1704, 2010

2 DeMarco VG, "The pathophysiology of hyperten-sion in patients with obesity" 10 : 364-376, 2014

3 World Health Organization, "The Asia-Pacific perspective: redefining obesity and its treatment" Health Communications Australia 2000

4 Kim NH, "Risk of the development of diabetes and cardiovascular disease in metabolically healthy obese people: the Korean genome and epidemiology study" 95 : e3384-, 2016

5 Yokoyama A, "Reliability of a flushing questionnaire and the ethanol patch test in screening for inactive aldehyde dehydrogenase-2 and alcohol-related cancer risk" 6 : 1105-1107, 1997

6 김민영, "Relationship between Alcohol Consumption and Metabolic Syndrome according to Facial Flushing in Korean Males" 대한가정의학회 33 (33): 211-218, 2012

7 Agarwal DP, "Racial differences in biological sensitivity to ethanol : the role of alcohol dehydrogenase and aldehyde dehydrogenase isozymes" 5 : 12-16, 1981

8 Haskell WL, "Physical activity and public health : updated recommendation for adults from the American College of Sports Medicine and the American Heart Association" 39 : 1423-1434, 2007

9 Eckel RH, "Obesity and type 2 diabetes : what can be unified and what needs to be individualized?" 96 : 1654-1663, 2011

10 Gallagher EJ, "Obesity and diabetes : the increased risk of cancer and cancer-related mortality" 95 : 727-748, 2015

11 Frohnert BI, "Increased adipose protein carbonylation in human obesity" 19 : 1735-1741, 2011

12 Chandrasekaran K, "In vitro evidence for chronic alcohol and high glucose mediated increased oxidative stress and hepatotoxicity" 36 : 1004-1012, 2012

13 International Diabetes Federation, "IDF Diabetes Atlas" International Diabetes Federation 2015

14 Jung JG, "Hypertension associated with alcohol consumption based on the facial flushing reaction to drinking" 38 : 1020-1025, 2014

15 Willenbring ML, "Helping patients who drink too much : an evidence-based guide for primary care clinicians" 80 : 44-50, 2009

16 Kuwahara K, "Flushing response modifies the association of alcohol consumption with markers of glucose metabolism in Japanese men and women" 38 : 1042-1048, 2014

17 Zhang J, "Facial flushing after alcohol consumption and the risk of cancer: a meta-analysis" 96 : e6506-, 2017

18 Wolff PH, "Ethnic differences in alcohol sensitivity" 175 : 449-450, 1972

19 Crabb DW, "Ethanol oxidizing enzymes : roles in alcohol metabolism and alcoholic liver disease" 13 : 151-172, 1995

20 Mizuno Y, "East Asian variant of aldehyde dehydrogenase 2 is associated with coronary spastic angina : possible roles of reactive aldehydes and implications of alcohol flushing syndrome" 131 : 1665-1673, 2015

21 Garg SK, "Diabetes and cancer : two diseases with obesity as a common risk factor" 16 : 97-110, 2014

22 Ohsawa I, "Deficiency in a mitochondrial aldehyde dehydrogenase increases vulnerability to oxidative stress in PC12 cells" 84 : 1110-1117, 2003

23 Li XH, "Association between alcohol consumption and the risk of incident type 2 diabetes : a systematic review and dose-response meta-analysis" 103 : 818-829, 2016

24 Knott C, "Alcohol consumption and the risk of type 2diabetes : a systematic review and dose-response meta-analysis of more than 1. 9 million individuals from 38 observational studies" 38 : 1804-1812, 2015

25 Cullmann M, "Alcohol consumption and risk of pre-diabetes and type 2 diabetes development in a Swedish population" 29 : 441-452, 2012

26 Roh WG, "Alcohol consumption and higher incidence of impaired fasting glucose or type 2 diabetes in obese Korean men" 43 : 643-648, 2009

27 Masaoka H, "Alcohol consumption and bladder cancer risk with or without the flushing response : the Japan Public Health Center-based Prospective Study" 141 : 2480-2488, 2017

28 American Diabetes Association, "2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2017" 40 (40): S11-S24, 2017