Compared to non-drinkers, individuals who drink alcohol have a more favorable multisystem physiologic risk score as measured by allostatic load

Autoři: Deena Goldwater aff001;  Arun Karlamangla aff001;  Sharon Stein Merkin aff001;  Teresa Seeman aff001
Působiště autorů: Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America aff001
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223168



Alcohol use is associated with both positive and negative effects on individual cardiovascular risk factors, depending upon which risk factor is assessed. The present analysis uses a summative multisystem index of biologic risk, known as allostatic load (AL), to evaluate whether the overall balance of alcohol-associated positive and negative cardiovascular risk factors may be favorable or unfavorable.


This analysis included 1255 adults from the Midlife in the United States (MIDUS) biomarker substudy. Participants, average age 54.5 (±11) years, were divided into 6 alcohol-use categories based on self-reported drinking habits. Current non-drinkers were classified as lifelong abstainers and former light drinkers, former moderate drinkers, or former heavy drinkers. Current alcohol users were classified as light, moderate, or heavy drinkers. A total AL score was calculated using 24 biomarkers grouped into 7 physiologic systems including cardiovascular, inflammation, glucose metabolism, lipid metabolism, sympathetic and parasympathetic nervous systems, and the hypothalamic-pituitary-adrenal axis. Mixed-effects regression models were fit to determine the relationship between alcohol use categories and AL with controls for covariates that may influence the relationship between alcohol use and AL.


468 (37.6%) individuals were current non-drinkers while 776 (62.4%) were current drinkers. In adjusted mixed-effects regression models, all 3 groups of current drinkers had significantly lower average AL scores than the lifelong abstainer/former light drinker group (light: -0.23, 95% CI -0.40, -0.07, p < 0.01; moderate: -0.20, 95% CI -0.38, -0.02, p < 0.05; heavy: -0.30, 95% CI -0.57, -0.04, p < 0.05), while the average AL scores of former moderate and former heavy drinkers did not differ from the lifelong abstainer/former light drinker group.


Current alcohol use is associated cross-sectionally with a favorable multisystem physiologic score known to be associated with better long-term health outcomes, providing evidence in support of long-term health benefits related to alcohol consumption.

Klíčová slova:

Alcohol consumption – Biomarkers – Cardiovascular diseases – Cirrhosis – Glucose metabolism – Inflammation – Socioeconomic aspects of health – Urine


1. Mukamal KJ, Chen CM, Rao SR, Breslow RA (2010) Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002. J Am Coll Cardiol 55: 1328–1335. doi: 10.1016/j.jacc.2009.10.056 20338493

2. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA (2011) Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 342: d671. doi: 10.1136/bmj.d671 21343207

3. Song RJ, Nguyen XT, Quaden R, Ho YL, Justice AC, Gagnon DR, et al. (2018) Alcohol Consumption and Risk of Coronary Artery Disease (from the Million Veteran Program). Am J Cardiol 121: 1162–1168. doi: 10.1016/j.amjcard.2018.01.042 29580627

4. Thun MJ, Peto R, Lopez AD, Monaco JH, Henley SJ, Heath CW Jr., et al. (1997) Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med 337: 1705–1714. doi: 10.1056/NEJM199712113372401 9392695

5. Hvidtfeldt UA, Tolstrup JS, Jakobsen MU, Heitmann BL, Gronbaek M, O'Reilly E, et al. (2010) Alcohol intake and risk of coronary heart disease in younger, middle-aged, and older adults. Circulation 121: 1589–1597. doi: 10.1161/CIRCULATIONAHA.109.887513 20351238

6. Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G (2010) Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. J Am Coll Cardiol 55: 1339–1347. doi: 10.1016/j.jacc.2010.01.006 20338495

7. Kerr WC, Fillmore KM, Bostrom A (2002) Stability of alcohol consumption over time: evidence from three longitudinal surveys from the United States. Journal of Studies on Alcohol 63: 325–333. doi: 10.15288/jsa.2002.63.325 12086133

8. Shaper AG, Wannamethee G, Walker M (1988) Alcohol and mortality in British men: explaining the U-shaped curve. Lancet 2: 1267–1273. doi: 10.1016/s0140-6736(88)92890-5 2904004

9. Stockwell T, Zhao J, Panwar S, Roemer A, Naimi T, Chikritzhs T (2016) Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality. J Stud Alcohol Drugs 77: 185–198. doi: 10.15288/jsad.2016.77.185 26997174

10. Linn S, Carroll M, Johnson C, Fulwood R, Kalsbeek W, Briefel R (1993) High-density lipoprotein cholesterol and alcohol consumption in US white and black adults: data from NHANES II. American Journal of Public Health 83: 811–816. doi: 10.2105/ajph.83.6.811 8498617

11. Sierksma A, van der Gaag MS, Kluft C, Hendriks HF (2002) Moderate alcohol consumption reduces plasma C-reactive protein and fibrinogen levels; a randomized, diet-controlled intervention study. Eur J Clin Nutr 56: 1130–1136. doi: 10.1038/sj.ejcn.1601459 12428180

12. Sierksma A, Patel H, Ouchi N, Kihara S, Funahashi T, Heine RJ, et al. (2004) Effect of Moderate Alcohol Consumption on Adiponectin, Tumor Necrosis Factor-α, and Insulin Sensitivity. Diabetes Care 27: 184–189. doi: 10.2337/diacare.27.1.184 14693987

13. Greenfield JR, Samaras K, Hayward CS, Chisholm DJ, Campbell LV (2005) Beneficial postprandial effect of a small amount of alcohol on diabetes and cardiovascular risk factors: modification by insulin resistance. J Clin Endocrinol Metab 90: 661–672. doi: 10.1210/jc.2004-1511 15522927

14. Briasoulis A, Agarwal V, Messerli FH (2012) Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. J Clin Hypertens (Greenwich) 14: 792–798.

15. Badrick E, Bobak M, Britton A, Kirschbaum C, Marmot M, Kumari M (2008) The relationship between alcohol consumption and cortisol secretion in an aging cohort. J Clin Endocrinol Metab 93: 750–757. doi: 10.1210/jc.2007-0737 18073316

16. Ireland MA, Vandongen R, Davidson L, Beilin LJ, Rouse IL (1984) Acute effects of moderate alcohol consumption on blood pressure and plasma catecholamines. Clinical Science 66: 643–647. doi: 10.1042/cs0660643 6723203

17. Thayer JF, Hall M, Sollers JJ 3rd, Fischer JE (2006) Alcohol use, urinary cortisol, and heart rate variability in apparently healthy men: Evidence for impaired inhibitory control of the HPA axis in heavy drinkers. Int J Psychophysiol 59: 244–250. doi: 10.1016/j.ijpsycho.2005.10.013 16325293

18. Adinoff B, Iranmanesh A, Veldhuis J, Fisher L (1998) Disturbances of the stress response: the role of the HPA axis during alcohol withdrawal and abstinence. Alcohol Health Res World 22: 67–72. 15706736

19. McEwen BS (1998) Protective and damaging effects of stress mediators. N Engl J Med 338: 171–179. doi: 10.1056/NEJM199801153380307 9428819

20. Seeman TE, Singer BH, Rowe JW, Horwitz RI, McEwen BS (1997) Price of adaptation—allostatic load and its health consequences. MacArthur studies of successful aging. Arch Intern Med 157: 2259–2268. 9343003

21. Seeman TE, McEwen BS, Rowe JW, Singer BH (2001) Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proc Natl Acad Sci U S A 98: 4770–4775. doi: 10.1073/pnas.081072698 11287659

22. Karlamangla AS, Singer BH, Seeman TE (2006) Reduction in allostatic load in older adults is associated with lower all-cause mortality risk: MacArthur studies of successful aging. Psychosom Med 68: 500–507. doi: 10.1097/01.psy.0000221270.93985.82 16738085

23. Merkin SS, Karlamangla A, Elashoff D, Grogan T, Seeman T (2015) Change in cardiometabolic score and incidence of cardiovascular disease: the multi-ethnic study of atherosclerosis. Ann Epidemiol 25: 912–917 e911. doi: 10.1016/j.annepidem.2015.09.006 26603128

24. Forrester SN, Leoutsakos JM, Gallo JJ, Thorpe RJ Jr., Seeman TE (2019) Association between allostatic load and health behaviours: a latent class approach. J Epidemiol Community Health 73: 340–345. doi: 10.1136/jech-2018-211289 30700494

25. Tan M, Mamun A, Kitzman H, Mandapati SR, Dodgen L (2017) Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases. Prev Chronic Dis 14: E119. doi: 10.5888/pcd14.170143 29166248

26. Hawkley LC, Lavelle LA, Berntson GG, Cacioppo JT (2011) Mediators of the relationship between socioeconomic status and allostatic load in the Chicago Health, Aging, and Social Relations Study (CHASRS). Psychophysiology 48: 1134–1145. doi: 10.1111/j.1469-8986.2011.01185.x 21342206

27. Brim OG, Ryff CD, Kessler RC (2004) How healthy are we?: a national study of well-being at midlife. Chicago: University of Chicago Press.

28. Dienberg Love G, Seeman TE, Weinstein M, Ryff CD (2010) Bioindicators in the MIDUS national study: protocol, measures, sample, and comparative context. J Aging Health 22: 1059–1080. doi: 10.1177/0898264310374355 20876364

29. NIAAA (2019) National Institue on Alcohol Abuse and Alcoholism: Understanding the impact of alcohol on human health and well-being. Accessed April 2, 2019

30. Gruenewald TL, Karlamangla AS, Hu P, Stein-Merkin S, Crandall C, Koretz B, et al. (2012) History of socioeconomic disadvantage and allostatic load in later life. Soc Sci Med 74: 75–83. doi: 10.1016/j.socscimed.2011.09.037 22115943

31. Seeman M, Stein Merkin S, Karlamangla A, Koretz B, Seeman T (2014) Social status and biological dysregulation: the "status syndrome" and allostatic load. Soc Sci Med 118: 143–151. doi: 10.1016/j.socscimed.2014.08.002 25112569

32. Karlamangla AS, Miller-Martinez D, Lachman ME, Tun PA, Koretz BK, Seeman TE (2014) Biological correlates of adult cognition: midlife in the United States (MIDUS). Neurobiol Aging 35: 387–394. doi: 10.1016/j.neurobiolaging.2013.07.028 24011541

33. Murray RP, Connett JE, Tyas SL, Bond R, Ekuma O, Silversides CK, et al. (2002) Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: is there a U-shaped function? Am J Epidemiol 155: 242–248. doi: 10.1093/aje/155.3.242 11821249

34. Xi B, Veeranki SP, Zhao M, Ma C, Yan Y, Mi J (2017) Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults. J Am Coll Cardiol 70: 913–922. doi: 10.1016/j.jacc.2017.06.054 28818200

35. Yu SS, Castillo DC, Courville AB, Sumner AE (2012) The triglyceride paradox in people of African descent. Metab Syndr Relat Disord 10: 77–82. doi: 10.1089/met.2011.0108 22224930

36. Ransome Y, Slopen N, Karlsson O, Williams DR (2017) The association between alcohol abuse and neuroendocrine system dysregulation: Race differences in a National sample. Brain Behav Immun 66: 313–321. doi: 10.1016/j.bbi.2017.07.154 28751021

37. Ransome Y, Slopen N, Karlsson O, Williams DR (2018) Elevated inflammation in association with alcohol abuse among Blacks but not Whites: results from the MIDUS biomarker study. J Behav Med 41: 374–384. doi: 10.1007/s10865-017-9905-4 29230616

38. Hajat A, Diez-Roux AV, Sanchez BN, Holvoet P, Lima JA, Merkin SS, et al. (2013) Examining the association between salivary cortisol levels and subclinical measures of atherosclerosis: the Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology 38: 1036–1046. doi: 10.1016/j.psyneuen.2012.10.007 23146655

Článek vyšel v časopise


2019 Číslo 9