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Though atherosclerosis may have its origins in childhood, intervention studies on coronary heart disease risk factors have usually begun in older adults. Whether young adults exhibit similar relationships of lifestyle to coronary heart disease risk factors, and therefore might be suitable candidates for appropriate intervention, is poorly understood. The Beaver County Lipid Study is a 9-year follow-up study of a free-living young adult population (mean age 22 years) who were initially screened for hypercholesterolemia as seventh grade school children. This report focuses upon cross-sectional correlates of lipid and lipoprotein concentrations in 561 individuals (males n = 262; females n = 299) in 1981-1982. Body mass index was positively related to low density lipoprotein (LDL) cholesterol and triglycerides in men (r = 0.21; p less than 0.001 and r = 0.41; p less than 0.001) and women (r = 0.16; p less than 0.001 and r = 0.20; p less than 0.001). Cigarette smoking was inversely associated with high density lipoprotein (HDL) cholesterol in men (r = -0.11; p less than 0.001) and women (r = -0.20; p less than 0.001) but positively related to triglycerides in both sexes (r = 0.10; p = 0.05 for men and r = 0.19; p less than 0.01 for women). Alcohol consumption was positively related to HDL cholesterol and triglycerides only among men (r = 0.19; p less than 0.001 and r = 0.12; p less than 0.05, respectively). Educational achievement was also positively related to HDL cholesterol in men (p less than 0.01) and women (p less than 0.001). Multivariate analyses indicate that the sex difference in LDL cholesterol was largely eliminated by controlling for body mass index while significant sex differences in both HDL cholesterol and triglycerides remained after controlling for covariates. Results suggest that the known associations in older adults of body mass index and health-related behavior with lipoproteins are well established by young adulthood. Early intervention particularly for obesity may help ameliorate some of the male excess in cardiovascular disease risk.
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PMID:Lipids and lipoproteins in a young adult population. The Beaver County Lipid Study. 402 95

A predominantly upper-middle-class white population of 279 men and 345 women with an average age of 66 years was evaluated to determine correlates of high- and low-density lipoprotein cholesterol (HDL and LDL), since these may be the only cholesterol measurements predictive of cardiovascular disease after age 50. Associations of HDL and LDL with age, alcohol use, obesity, smoking, diet, exercise, and medication use were examined using multiple linear regression. Alcohol, average and above-average exercise, postmenopausal estrogen use (women), B vitamin intake, and corticosteroid use were all positively related to HDL levels, and obesity (men only), cigarette smoking, and thyroid hormone use were inversely related. The only statistically significant correlates of LDL were an increase with age (women only) and lower levels in women using thyroid hormone. However, the associations of several behavioral variables with LDL, although not statistically significant, were in the expected direction. These results may suggest the continuing potential for preventive intervention even in an elderly population.
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PMID:High- and low-density lipoprotein cholesterol: correlates in an older population. 404 78

The effect of chronic alcohol intoxication on metabolic disturbances and fatty infiltration and degeneration was studied in genetically obese, hyperlipoproteinaemic, fa/fa Zucker rats. Sixteen obese Zucker (fa/fa) rats, sixteen lean Zucker rats (Fa/-) and sixteen Wistar rats, all male rats aged 7-8 weeks, were given either a control (C) diet (13% of energy from protein, 37% from fat, 50% from carbohydrate) or an ethanol (E) diet (13% of energy from protein, 37% from fat, 14% from carbohydrate, 36% from ethanol) for 4 weeks. The fa/fa rats given diet E consumed more energy than those given diet C, but after 4 weeks the weight gains and degrees of obesity were similar for both groups. With both diets, the developed hyperlipidaemia could be explained by the hyperinsulinaemia. Both hypertriglyceridaemia and hypercholesterolaemia were lower in fa/fa rats eating diet E than in those given diet C. Fatty infiltration of the liver, as assessed by hepatic triacyglycerol and cholesterol contents, was observed with both diets, but for fa/fa rats it was less extreme in those given diet E.
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PMID:Influence of chronic ethanol intake on obesity, liver steatosis and hyperlipidaemia in the Zucker fa/fa rat. 406 15

Alcohol may provoke reactive hypoglycaemia when drunk with a sucrose mixer (gin and tonic) but not in the form of a starch-based beverage. In the present study alcohol-potentiated reactive hypoglycaemia was shown to depend on the nature of the carbohydrate ingested together with the alcohol. When 14 men (9 normal weight and 5 obese) aged between 20 and 50 years consumed a 50 g glucose load together with 50 g ethanol over an hour, their early plasma insulin response was significantly higher and their later fall in plasma glucose significantly lower than after drinking the same amount of a starch solution (maize meal) and alcohol. In four subjects (3 of them non-obese) plasma glucose concentrations dropped below 2.8 mmol/l after drinking the glucose-alcohol solution. Obesity seemed to be associated with features of peripheral insulin resistance. We conclude that the common social custom of drinking alcohol together with a simple sugar mixer should probably be modified.
Alcohol Alcohol 1984
PMID:Alcohol-potentiated reactive hypoglycaemia depends on the nature of the carbohydrate ingested at the same time. 638 88

Mechanisms by which alcohol consumption might cause hypertension were examined in 30 pairs of healthy drinking (greater than 275 g ethanol per week) and teetotal men closely matched for age and obesity. Both systolic and diastolic blood pressures were significantly higher in the drinkers. Plasma calcium levels correlated with diastolic blood pressures (r = 0.51, P = 0.004) in drinkers only. After adjusting for plasma albumin, diastolic pressures increased by 6.9 mmHg for each 0.1 mM increment of plasma calcium. It is proposed that regular alcohol consumption predisposes to hypertension by facilitating calcium accumulation in cells involved in blood pressure regulation. In the combined population of drinkers and teetotallers plasma cortisol correlated positively with diastolic pressure (r = 0.35, P = 0.012) and negatively with plasma potassium (r = -0.38, P = 0.006); this suggests a role for the pituitary/adrenal axis as a significant determinant of blood pressure differences between healthy subjects.
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PMID:Plasma calcium and cortisol as predisposing factors to alcohol related blood pressure elevation. 639 34

It has become evident from a series of epidemiologic studies that an association exists between regular use of large amounts of alcoholic beverages and hypertension. In most studies, regular intake of smaller amounts of alcohol is not associated with hypertension but a possible threshold cannot be precisely defined at present. The relationship between alcohol and blood pressure is not attributable to demographic characteristics, obesity, reported salt use, smoking, or coffee use nor can it be explained by underreporting of alcohol consumption. If the relationship is causal then the pathogenesis is not yet firmly established. Multiple mechanisms, including direct effects of alcohol or of withdrawal from alcohol, are possible explanations. Alcohol shows a positive association with some sequelae of hypertension, but not to others. The most important exception is CHD, which is negatively associated with alcohol intake. Health professionals should not ignore the role of alcohol intake as a possible factor raising blood pressure in a certain proportion of hypertensive persons.
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PMID:The role of alcohol in the epidemiology of hypertension--is alcohol associated hypertension a common preventable disease? 639 87

The association between alcohol intake and blood pressure has been known for nearly 70 years. It was postulated that the alcohol blood pressure association was not causal but linked to common factors such as stress, obesity or salt intake. Recently large population studies have shown that the association is independent of these factors. Alcohol dependent persons have a high incidence of hypertension which is a common clinical problem. It is probably due to alcohol withdrawal and is mediated via increased cortisol and catecholamine production. Alcohol has also a direct effect causing arteriolar vasoconstriction. This direct effect may result from an alcohol associated alteration of intracellular Ca in arteriolar smooth muscle leading to supersensitivity to circulating pressor agents.
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PMID:The possible mechanisms of alcohol associated hypertension. 639 88

In a five year prospective study clinical features associated with the development and progress of retinopathy were sought in 296 randomly selected diabetic men aged 20-59. None had ophthalmoscopically detectable retinopathy initially, but during follow up 66 developed the condition (47 background, 10 exudative, 9 proliferative). Linear logistic analyses (two tailed tests) showed that the initial features independently predictive of retinopathy were duration of diabetes, poor glycaemic control, impotence, and--unexpectedly--heavy alcohol consumption. Poor glycaemic control in the interim and proteinuria at review were also associated with the development of retinopathy. No relation was found with smoking or obesity. Glycaemic control and alcohol consumption were therefore the only aetiologically relevant associations identified. The development of severe retinopathy (exudative and proliferative) showed a particular association with heavy alcohol consumption, occurring in nine of the 70 heavy drinkers (13%) compared with 10 (4.4%) of the rest. Alcohol consumption may be an important independent factor associated predictively with sight threatening diabetic retinopathy.
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PMID:Alcohol: another risk factor for diabetic retinopathy? 642 83

Several previous studies have demonstrated an increased prevalence of gout in New Zealand Maoris. The aetiology of the hyperuricaemia and its effect on morbidity, apart from gout, are unknown. A survey of 115 Maori men of working age revealed a history of gout in 10 (8%) and asymptomatic hyperuricaemia in 26 (23%). The relationship of hyperuricaemia with obesity was confirmed. Alcohol did not make an obvious contribution to the prevalence of hyperuricaemia. Hypertension was more common and creatinine clearance lower amongst those with gout, but not significantly so. The frequency of hypertension and mean creatinine clearance were similar to that seen in asymptomatic hyperuricaemia and normouricaemia. Urate clearance was lower in the gouty and hyperuricaemic subjects. The normouricaemic Maoris had a reduced fractional urate clearance compared with normal men elsewhere. They also excreted a relatively small proportion of hydrogen as ammonium. Both these features are characteristic of gout, and suggest that the Maoris' susceptibility to hyperuricaemia has a renal mechanism. Obesity is common amongst the Maoris and accentuates their natural tendency to hyperuricaemia.
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PMID:Hyperuricaemia, gout and kidney function in New Zealand Maori men. 648 33

The associations of obesity and alcohol consumption with blood pressure and the prevalence of hypertension were studied in 5550 male and female subjects aged 25 to 64 years, surveyed in the National Heart Foundation of Australia 1980 Risk Factor Prevalence Study. Body mass index was significantly and independently associated with blood pressure levels in both sexes. A maximum of 30% of hypertension in the study population could be attributed to overweight. The association between body mass index and hypertension was greater in men under 45 years in whom a maximum of 60% of hypertension could be attributed to overweight. In both men and women receiving antihypertensive treatment, body mass index was positively associated with blood pressure. Overweight hypertensives were less likely to achieve normal blood pressure on treatment. Alcohol consumption was significantly and independently associated with blood pressure levels in males. A similar trend in females failed to reach statistical significance because of the lesser consumption of alcohol by females. A maximum of 11% of hypertension in males and 1% in females could be attributed to alcohol consumption. These estimates were reduced when age and body mass were taken into account.
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PMID:Obesity, alcohol consumption and blood pressure in Australian men and women. The National Heart Foundation of Australia Risk Factor Prevalence Study. 653 May 40


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