This study reviews recent developments concerning the effects of alcohol on plasma triglycerides. The focus will be on population, intervention and metabolic studies with respect to alcohol and plasma triglycerides.
Alcohol consumption and fat ingestion are closely associated and stimulated by each other via hypothalamic signals and by an elevated cephalic response. A J-shaped relationship between alcohol intake and plasma triglycerides has been described. A normal body weight, polyphenols in red wine and specific polymorphisms of the apolipoprotein A-V and apolipoprotein C-III genes may protect against alcohol-associated hypertriglyceridemia. In contrast, obesity exaggerates alcohol-associated hypertriglyceridemia and therefore the risk of pancreatitis.
High alcohol intake remains harmful since it is associated with elevated plasma triglycerides, but also with cardiovascular disease, alcoholic fatty liver disease and the development of pancreatitis. Alcohol-induced hypertriglyceridemia is due to increased very-low-density lipoprotein secretion, impaired lipolysis and increased free fatty acid fluxes from adipose tissue to the liver. However, light to moderate alcohol consumption may be associated with decreased plasma triglycerides, probably determined by the type of alcoholic beverage consumed, genetic polymorphisms and lifestyle factors. Nevertheless, patients should be advised to reduce or stop alcohol consumption in case of hypertriglyceridemia.
aDepartment of Internal Medicine, Sint Franciscus Gasthuis Rotterdam, the Netherlands
bDepartment of Internal Medicine, Institute for Health Research
cHGU, Gregorio Maraňón, Madrid, Spain
Correspondence to M. Castro Cabezas, MD, PhD, Internist-Endocrinologist/Vascular Specialist, St Franciscus Gasthuis Rotterdam, Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, P.O. Box 10900, 3004 BA Rotterdam, The Netherlands. Tel: +31 10 4617267; fax: +31 10 4612692; e-mail: email@example.com