A large cohort study in Japan has revealed significant associations between changes in alcohol consumption and lipid profiles among adults undergoing annual health checkups.
In the analysis, published in JAMA Network Open, investigators included 328,676 visits from 57,691 patients between October 2012 and October 2022. Participants on lipid-lowering medications were excluded. The investigators assessed changes in alcohol consumption—specifically initiation and cessation—between consecutive visits and evaluated subsequent changes in low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels.
The cohort evaluating alcohol cessation comprised 49,898 visits from 25,144 patients (mean age = 49 years). Alcohol cessation was associated with statistically significant increases in LDL-C and decreases in HDL-C. Specifically, LDL-C increased by 1.10 mg/dL among those who ceased drinking fewer than 1.5 standard drinks per day, 3.71 mg/dL among those ceasing 1.5 to 3 drinks per day, and 6.53 mg/dL among those ceasing 3 or more drinks per day. HDL-C decreased by 1.25 mg/dL, 3.35 mg/dL, and 5.65 mg/dL across the same categories, respectively.
The cohort assessing alcohol initiation included 107,880 visits from 29,042 patients. Alcohol initiation was associated with inverse dose-response patterns in lipid levels. Initiating alcohol at 3.0 or more drinks per day was associated with a 7.44 mg/dL decrease in LDL-C and a 6.12 mg/dL increase in HDL-C compared with those who remained abstinent.
“After alcohol reduction, lipid profile changes should be carefully monitored to optimize cardiovascular disease risk management at both individual and population levels,” said lead study author Takahiro Suzuki, MD, MPH, of the Department of Cardiovascular Medicine at St Luke’s International Hospital in Tokyo, and colleagues.
Although previous research has linked moderate alcohol intake with improved lipid levels, the current study offered real-world observational evidence that cessation may be associated with adverse changes in cholesterol. The investigators noted that even modest absolute increases in LDL-C could have public health implications, given that a 5 mg/dL increase is associated with a 2% to 3% increased risk of major cardiovascular events.
Further studies are needed to clarify mechanisms and to guide clinical and public health decision-making.
Full disclosures are available in the study.