Long-term alcohol consumption and incident health risk conditions related to cardiometabolic risk markers: A 20-year prospective cohort study

Background and aims: Amid questions about a perceived association between low-to-moderate alcohol consumption and reduced cardiovascular risk from recent studies, research examining the impact of alcohol consumption on cardiometabolic risk markers has reported inconsistent results. We measured the association between long-term alcohol consumption and incident health risk conditions related to cardiometabolic risk markers. Design, setting and participants: A prospective cohort analysis was conducted using data from a population-based cohort (2001–2020) of 4708 Koreans aged 40–69 years who were free of chronic diseases, including metabolic syndrome, at baseline. Measurements: Alcohol consumption and incident cases related to cardiometabolic risk markers were assessed biennially using interviewer-administered questionnaires or health examinations. The average alcohol intake was calculated to reflect long-term consumption. Alcohol consumption was categorized as none or rarely (0–2 g/day), light (2 < −16 g/day, within guideline limits), medium (16 < −32 g/day) and heavy (>32 g/day). Findings: After full adjustment for covariates, light, medium or heavy alcohol consumption was positively associated with metabolic syndrome [hazard ratio (HR) = 1.55, 95% confidence interval (CI) = 1.32–1.83], abdominal obesity (HR = 1.41, 95% CI = 1.17–1.70), hyperglycemia (HR = 1.91, 95% CI = 1.62–2.26), high blood pressure (HR = 2.04, 95% CI = 1.72–2.41) and hypertriglyceridemia (HR = 1.59, 95% CI = 1.30–1.93), with the results presented for heavy alcohol consumption only (p-values for trend <0.001 for all cases). By sex, positive associations between light alcohol intake and hyperglycemia and high blood pressure were observed only in women (p-values for interaction and p-values for trend <0.05 for all cases). Conclusions: Long-term light (within guideline limits), medium or heavy alcohol consumption appears to be positively and linearly associated with incident health risk conditions related to cardiometabolic risk markers. The threshold dose of alcohol for developing hyperglycemia and high blood pressure appears to be lower in women.