A new index confirms cardio-metabolic risk reduction for light to moderate consumption of alcoholic beverages
This study is the first study showing the relationship between the consumption of alcoholic beverages and the Cardio-Metabolic Index (CMI = an index indicating the risk of diabetes) and confirming the J-shaped association.
Central obesity is an eminent risk factor for cardio-metabolic diseases. The widely applied Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults, but fails to distinguish weight from adiposity. It is central obesity, i.e. the visceral abdominal adipose tissue, that is implicated in cardio-metabolic risk. Accordingly, anthropometric measures for central obesity, as opposed to total obesity assessed by BMI, are better predictors of increased levels of health risk factors in populations of all ages. In most studies, waist circumference (WC) and waist-to-hip ratio (WHR) have been used as proxies for central obesity. But recently, the waist-to-height ratio (WHtR) as a proxy for central (visceral) adipose tissue was found to identify more people at ‘early health risk’ than traditional boundary values for BMI and WC (1).
Also with regards to blood lipids as cardio-metabolic risk factors, it was shown that the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) is a simple method to establish insulin resistance, diabetes risk and increased cardio-metabolic risk in the general population.
Japanese researchers combined both the WHtR and the TG/HDL-C, as a new lipid- and adiposity-related index and named it Cardio-Metabolic Index (CMI). It is the product of waist-to-height ratio and triglycerides-to-HDL cholesterol ratio. The scientists were able to show that it is strongly associated with prevalence of diabetes and atherosclerotic progression (1, 2).
In a recent study, the same research team wanted to determine whether the CMI is affected by the consumption of alcoholic beverages (4). They analysed the data of 21.572 men (35-60 years) receiving annual health checkups and divided them according to the average daily ethanol consumption into non-, light (<22 g), moderate (≥ 22 and < 44 g), heavy (≥ 44 and < 66 g) and very heavy (≥ 66 g) drinkers. The relationship between the alcohol intake and CMI was investigated (confounding factors such as age and histories of smoking and regular exercise were adjusted).
A J-shaped association between the consumption of alcoholic beverages and CMI was observed. The CMI was significantly lower in light, moderate and heavy drinkers than in nondrinkers. While CMI was lowest in light drinkers, there was no significant difference between nondrinkers and very heavy drinkers. These relationships were independent of smoking and regular exercise. Thus, this new finding of a lower CMI in light and moderate drinkers compared to nondrinkers confirms previous results where moderate alcohol intake was associated with a lower risk of cardiovascular disease; it also points to a causal mechanism provided by moderate consumption of alcoholic beverages.
References:
1. Ashwell M, Gibson S. Waist-to-height ratio as an indicator of ‘early health risk’: Simpler and more predictive than using a ‘matrix’ based on BMI and waist circumference. BMJ Open 2016;6:e010159
For more information about this article, read the scientific abstract here
2. Wakabayashi I, Sotoda Y, Hirooka S, et al. Association between cardiometabolic index and atherosclerotic progression in patients with peripheral arterial disease. Clin Chim Acta 2015;446:231-6.
For more information about this article, read the scientific abstract here
3. Wakabayashi I, Daimon T. The “cardiometabolic index” as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta 2015;438:274-8.
For more information about this article, read the scientific abstract here
4. Wakabayashi I. A U-shaped relationship between alcohol consumption and cardiometabolic index in middle-aged men. Lipids Health Dis 2016;15(1):50.
For more information about this article, read the scientific abstract here