Objective: In observational studies, mainly from western Caucasian populations, moderate alcohol use has been shown to be associated with a lower risk of diabetes. However, whether the protection is due to the attributes of alcohol or of moderate alcohol users is difficult to disentangle. We studied a population with a different distribution of alcohol consumption and diabetes prevalence from western populations as a counterfactual comparison.
Method: We used baseline data from the Guangzhou Biobank Cohort Study phases 1& 2 (2003-6) to examine the adjusted associations, using multivariable censored linear regression, of alcohol use with fasting blood glucose in older (≥50 years) men (n=5,740) and women (n=14,274) from southern China. Moderate alcohol use was defined as weekly drinking of <210g alcohol in men and <140g in women. We also checked that alcohol had the expected associations with HDL-cholesterol and blood pressure.
Results: Moderate alcohol users had very similar fasting glucose to never-users, adjusted for age, sex, socio-economic status, smoking and physical activity. In contrast, moderate alcohol users had higher HDL-cholesterol by 0.05 mmol/L (95% confidence interval 0.02 to 0.07). Excessive (more than moderate) alcohol users had higher fasting glucose.
Conclusions: In an under-studied population with a different pattern of alcohol use from populations usually studied, the biologically expected effects of moderate alcohol use were seen, but little effect on fasting glucose. Although cross-sectional studies cannot be conclusive this pattern of findings, if confirmed, suggests that moderate alcohol use may not affect fasting glucose, although excessive use may be a risk factor.
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