From: Alcohol consumption and microvascular dysfunction: a J-shaped association: The Maastricht Study
Characteristic | Total study population (n = 3107) | Total alcohol consumption | |||
---|---|---|---|---|---|
None (n = 498) | Light (n = 964) | Moderate (n = 620) | High (n = 1,025) | ||
Demographics | |||||
 Age, years | 59.9 ± 8.2 | 59.0 ± 8.6 | 59.1 ± 8.8 | 60.1 ± 8.2 | 61.0 ± 7.2 |
 Men | 1,582 (50.9) | 163 (32.7) | 555 (57.6) | 357 (57.6) | 507 (49.5) |
Lifestyle factors | |||||
 Smoking status | |||||
  Never | 1088 (35.0) | 214 (43.0) | 379 (39.3) | 236 (38.1) | 259 (25.3) |
  Former | 1,624 (52.3) | 196 (39.4) | 480 (49.8) | 313 (50.5) | 635 (62.0) |
  Current | 395 (12.7) | 88 (17.7) | 105 (10.9) | 71 (11.5) | 131 (12.8) |
Body mass index*, kg/m2 | 27.0 ± 4.5 | 28.2 ± 5.5 | 27.5 ± 4.6 | 26.4 ± 3.9 | 26.3 ± 4.0 |
Waist circumference, cm | 95.8 ± 13.7 | 97.4 ± 15.7 | 97.3 ± 14.0 | 94.5 ± 12.7 | 94.2 ± 12.7 |
Physical activity*, hours/day | 2.0 ± 0.7 | 1.9 ± 0.8 | 1.9 ± 0.7 | 2.0 ± 0.6 | 2.1 ± 0.7 |
Dutch Healthy Diet score, points | 83.2 ± 14.7 | 84.8 ± 14.7 | 84.9 ± 14.1 | 85.7 ± 14.4 | 79.4 ± 14.8 |
Cardiovascular risk factors | |||||
 Glucose metabolism status | |||||
  Normal glucose metabolism | 1,760 (56.6) | 209 (42.0) | 538 (55.8) | 385 (62.1) | 628 (61.3) |
  Prediabetes | 460 (14.8) | 59 (11.8) | 137 (14.2) | 90 (14.5) | 174 (17.0) |
  Type 2 diabetes | 854 (27.5) | 225 (45.2) | 282 (29.3) | 137 (22.1) | 210 (20.5) |
  Other types of diabetes | 33 (1.1) | 5 (1.0) | 7 (0.7) | 8 (1.3) | 13 (1.3) |
  Fasting plasma glucose*, mmol/l | 5.5 [5.1–6.5] | 5.8 [5.1–7.3] | 5.5 [5.0–6.7] | 5.5 [5.0–6.4] | 5.5 [5.1–6.2] |
  2-h post load plasma glucose*, mmol/l | 9.3 [6.3–9.3] | 7.4 [5.5–13.0] | 6.3 [5.0–9.4] | 6.1 [4.9–8.3] | 6.1 [5.1–8.4] |
  HbA1c*, % | 5.7 [5.4–6.2] | 5.9 [5.5–6.7] | 5.7 [5.3–6.3] | 5.6 [5.3–6.1] | 5.6 [5.3–6.0] |
  Use of glucose-lowering medication | 697 (22.4) | 196 (39.4) | 244 (25.3) | 102 (16.5) | 155 (15.1) |
  Total/HDL cholesterol ratio | 3.7 ± 1.2 | 3.8 ± 1.2 | 3.8 ± 1.2 | 3.6 ± 1.1 | 3.5 ± 1.2 |
  Use of lipid-modifying medication | 1,137 (36.6) | 231 (46.4) | 347 (36.0) | 222 (35.8) | 337 (32.9) |
  Office systolic blood pressure, mm Hg | 135.0 ± 18.3 | 134.4 ± 18.3 | 134.3 ± 18.1 | 135.9 ± 18.4 | 135.5 ± 18.3 |
  Office diastolic blood pressure, mm Hg | 76.1 ± 9.9 | 75.0 ± 9.2 | 76.4 ± 10.0 | 76.3 ± 10.6 | 76.4 ± 9.8 |
  Ambulatory systolic blood pressure, mm Hg | 118.9 ± 11.7 | 116.7 ± 11.1 | 118.6 ± 11.7 | 119.8 ± 11.8 | 119.7 ± 11.7 |
  Ambulatory diastolic blood pressure, mm Hg | 73.4 ± 7.1 | 71.9 ± 9.0 | 73.7 ± 7.2 | 73.6 ± 7.3 | 73.7 ± 7.1 |
  Use of antihypertensive medication | 1,252 (40.3) | 261 (52.4) | 387 (40.1) | 236 (38.1) | 368 (35.9) |
  History of cardiovascular disease | 522 (16.8) | 115 (23.1) | 175 (18.2) | 101 (16.3) | 131 (12.8) |
  Diabetic retinopathy* | 41 (1.6) | 9 (2.1) | 20 (2.5) | 6 (1.1) | 6 (0.6) |
  eGFR, ml/min/1.732 | 88.0 ± 14.9 | 86.4 ± 17.3 | 87.3 ± 15.5 | 88.6 ± 14.6 | 89.0 ± 13.2 |
Biomarkers of low-grade inflammation* | |||||
 C-reactive protein, µg/ml | 1.2 [6.1–2.8] | 1.7 [0.7–3.8] | 1.4 [0.7–3.0] | 1.2 [0.6–2.5] | 1.0 [0.6–2.3] |
 Serum amyloid A, µg/ml | 3.3 [2.1–5.4] | 3.7 [2.3–6.4] | 3.3 [1.9–5.7] | 3.2 [2.0–5.3] | 3.2 [2.1–5.1] |
 Tumour necrosis factor alpha, pg/ml | 2.2 [1.9–2.6] | 2.3 [1.9–2.7] | 2.2 [1.9–2.6] | 2.2 [1.9–2.5] | 2.1 [1.8–2.5] |
 Interleukin-6, pg/ml | 4.1 [3.3–5.3] | 0.7 [0.5–1.0] | 0.6 [0.4–0.9] | 0.6 [0.4–0.8] | 0.6 [0.4–0.9] |
 Interleukin-8, pg/ml | 4.1 [3.3–5.3] | 4.2 [3.4–5.4] | 4.2 [3.3–5.4] | 3.9 [3.2–5.3] | 4.2 [3.3–5.3] |
Other | |||||
 Educational status | |||||
  Low | 1041 (33.5) | 225 (45.2) | 331 (34.3) | 190 (30.6) | 295 (28.8) |
  Medium | 877 (28.2) | 158 (31.7) | 285 (29.6) | 172 (27.7) | 262 (25.6) |
  High | 1189 (38.3) | 115 (23.1) | 348 (36.1) | 258 (41.6) | 468 (45.7) |
 Occupational status* | |||||
  Low | 801 (31.0) | 177 (46.6) | 265 (32.5) | 151 (28.8) | 208 (20.3) |
  Middle | 922 (35.7) | 130 (34.2) | 289 (35.5) | 198 (37.7) | 305 (35.3) |
  High | 860 (33.3) | 73 (19.2) | 261 (32.0) | 176 (33.5) | 350 (40.6) |
  Income per month*, euros | 2028 ± 818 | 1653 ± 704 | 1919 ± 725 | 2123 ± 823 | 2229 ± 869 |
Alcohol consumption | |||||
 Total alcohol consumption, units/day | 0.85 [0.2–1.9] | 0.0 ± 0.0 | 0.3 [0.1–0.5] | 1.1 [0.8–1.5] | 2.3 [1.8–3.1] |
 Total wine consumption, units/day | 0.3 [0.0–1.1] | 0.0 ± 0.0 | 0.1 [0.0–0.3] | 0.6 [0.3–0.9] | 1.7 [0.9–2.1] |
 Total beer consumption, gram/day | 0.1 [0.0–0.5] | 0.0 ± 0.0 | 0.1 [0.0–0.3] | 0.3 [0.0–0.8] | 0.3 [0.0–1.6] |
 Total spirits consumption, units/day | 0.0 [0.0–0.0] | 0.0 ± 0.0 | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.1] |
Endpoints | |||||
 CSVD features | |||||
  White matter hyperintensity volume, ml†| 0.0 [0.0–0.1] | 0.0 [0.0–0.1] | 0.0 [0.0–0.0] | 0.0 [0.0–0.1] | 0.0 [0.0–0.1] |
  Presence of cerebral microbleeds†| 245 (11.8) | 26 (8.3) | 74 (11.8) | 60 (14.2) | 85 (11.9) |
  Number of cerebral microbleeds | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] |
  Presence of lacunar infarcts†| 114 (5.5) | 20 (6.4) | 37 (5.9) | 21 (5.0) | 36 (5.0) |
  Number of lacunar infarcts | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] | 0.0 [0.0–0.0] |
  Composite score†| 0.0 ± 1.0 | − 0.0 ± 1.0 | − 0.0 ± 1.0 | 0.0 ± 1.0 | 0.0 ± 1.0 |
Retinal microvascular diameters | |||||
 Arteriolar diameter, MU†| 142.3 ± 20.2 | 145.3 ± 19.9 | 143.0 ± 20.1 | 140.9 ± 20.7 | 141.1 ± 20.1 |
 Venular diameter, MU†| 214.6 ± 31.4 | 218.2 ± 31.3 | 215.6 ± 32.2 | 211.0 ± 31.4 | 214.0 ± 30.4 |
 Composite score†| 0.0 ± 1.0 | − 0.0 ± 1.0 | − 0.0 ± 1.0 | 0.1 ± 1.0 | 0.0 ± 1.0 |
Flicker light-induced increase in retinal microvascular diameters | |||||
 Arteriolar flicker light-induced dilation, MU†| 4.4 ± 3.6 | 4.1 ± 3.7 | 4.3 ± 3.4 | 4.8 ± 3.8 | 4.3 ± 3.5 |
 Venular flicker light-induced dilation, MU†| 7.6 ± 4.1 | 7.7 ± 4.2 | 7.5 ± 4.0 | 7.5 ± 4.1 | 7.7 ± 4.1 |
 Composite score†| 0.0 ± 1.0 | 0.0 ± 1.0 | 0.0 ± 1.0 | -0.1 ± 1.0 | -0.0 ± 1.0 |
 Heat-induced skin hyperemia, PU†| 112.1 ± 57.3 | 113.1 ± 61.4 | 107.7 ± 53.0 | 109.9 ± 55.5 | 116.9 ± 59.8 |
 UAE, mg/24 h†| 6.7 [4.0–11.9] | 7.3 [4.4–14.2] | 6.7 [4.2–12.3] | 6.4 [3.8–11.0] | 6.5 [3.9–11.4] |
  ≥ 30 mg/24 h†| 270 (18.7) | 59 (11.8) | 86 (8.9) | 47 (7.6) | 78 (7.6) |
Plasma biomarkers of MVD composite score | |||||
 sICAM-1, ng/ml†| 353.9 ± 99.8 | 390.0 ± 134.2 | 349.2 ± 89.6 | 347.2 ± 95.5 | 344.6 ± 87.2 |
 sVCAM-1, ng/ml†| 428 ± 101.0 | 450.1 ± 125.9 | 432.8 ± 99.2 | 427.8 ± 96.3 | 412.9 ± 88.6 |
 sE-selectin, ng/ml†| 117.8 ± 65.7 | 131.8 ± 90.7 | 117.9 ± 64.2 | 119 ± 58.2 | 114.3 ± 55.0 |
 vWF, %†| 132.6 ± 48.4 | 140.4 ± 52.0 | 133.7 ± 47.1 | 131.5 ± 48.4 | 128.4 ± 47.3 |
 Composite score†| 0.0 ± 1.0 | 0.4 ± 1.3 | 0.0 ± 0.9 | − 0.1 ± 1.0 | − 0.1 ± 0.9 |