Effect of alcohol consumption on systemic markers of inflammation
Abstract
Background Epidemiological studies suggest that light to moderate alcohol intake is associated with lower all-cause mortality than abstention or heavy alcohol intake, primarily through reduced risk of coronary heart disease. The underlying mechanisms are incompletely understood.Methods We investigated the association between alcohol consumption (assessed by a 7-day food record) and concentrations of C-reactive protein (CRP), alpha1-globulins, alpha2-globulins, albumin, and transferrin, and leucocyte count in a sample of 2006 men and women aged 18-88 years participating in a national health survey carried out in former West Germany in 1987-88. Analyses were based on 781 men and 995 women with complete data.Findings Among men, alcohol consumption showed a U-shaped association with mean values of CRP (p for linear term 0.65, for quadratic term 0.048), alpha1-globulins (p=0.20, 0.0006), alpha2-globulins (p=0.82, 0.31), and leucocyte count (p=0.51, 0.26) even after adjustment for age, smoking, body-mass index, HDL and LDL cholesterol, history of hypertension, education, and income. There were inverted U-shaped associations between the negative acute-phase reactants albumin (p=0.41, 0.006) and transferrin (p=0.14, 0.28) and alcohol intake. In women, the associations were less strong for CRP (p=0.35, 0.31), leucocyte count (p=0.28, 0.15), and transferrin (p=0.86, 0.83). Concentrations of alpha1-globulins and alpha2-globulins were inversely related to alcohol consumption, and albumin showed a positive association with increasing alcohol intake in women.Interpretation Non-drinkers and heavy drinkers had higher CRP concentrations than moderate drinkers. In view of the robust association between markers of inflammation, especially CRP, and risk of coronary heart disease, an anti-inflammatory action of alcohol could contribute to the link between moderate consumption and lower cardiovascular mortality.
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Quercetin at 50, 100 or 150 mg per day for two weeks did not affect serum TNF-α concentrations in healthy adults.
“Quercetin (50, 100 or 150 mg/d for 2 weeks) did not affect serum concentrations of TNF-a in healthy adults (805) .”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [805]
Cites
Atherosclerosis--an inflammatory disease
Ross, R. (1999) · New England Journal of Medicine · doi:10.1056/nejm199901143400207 · Cited by 21,725 · see citing works
Baumann, H., & Gauldie, J. (1994) · Immunology Today · doi:10.1016/0167-5699(94)90137-6 · Cited by 2,907 · see citing works
Yudkin, J. S., Stehouwer, C. D. A., Emeis, J. J., & Coppack, S. W. (1999) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/01.atv.19.4.972 · Cited by 2,465 · see citing works
The Prognostic Value of C-Reactive Protein and Serum Amyloid A Protein in Severe Unstable Angina
Liuzzo, G., Biasucci, L. M., Gallimore, J. R., Grillo, R. L., Rebuzzi, A. G., Pepys, M. B., & Maseri, A. (1994) · New England Journal of Medicine · doi:10.1056/nejm199408183310701 · Cited by 2,354 · see citing works
Self-citationDanesh, J., Collins, R., Appleby, P. N., & Peto, R. (1998) · JAMA · doi:10.1001/jama.279.18.1477 · Cited by 2,027 · see citing works
Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses
Danesh, J. (2000) · BMJ · doi:10.1136/bmj.321.7255.199 · Cited by 1,692 · see citing works
Rimm, E. B., Williams, P., Fosher, K., Criqui, M., & Stampfer, M. J. (1999) · BMJ · doi:10.1136/bmj.319.7224.1523 · Cited by 1,360 · see citing works
Lindahl, B., Toss, H., Siegbahn, A., Venge, P., & Wallentin, L. C. (2000) · New England Journal of Medicine · doi:10.1056/nejm200010193431602 · Cited by 1,221 · see citing works
Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors
Doll, R., Peto, R., Hall, E., Wheatley, K., & Gray, R. G. (1994) · BMJ · doi:10.1136/bmj.309.6959.911 · Cited by 1,179 · see citing works
ALCOHOL AND MORTALITY IN BRITISH MEN: EXPLAINING THE U-SHAPED CURVE
Shaper, A. G., Wannamethee, G., & Walker, M. (1988) · The Lancet · doi:10.1016/s0140-6736(88)92890-5 · Cited by 780 · see citing works
Castell, J. V., Gómez-Lechón, M. J., David, M., Fabra, R., Trullenque, R., & Heinrich, P. C. (1990) · Hepatology · doi:10.1002/hep.1840120517 · Cited by 759 · see citing works
Alcohol Consumption and Mortality among Women
Fuchs, C. S., Stampfer, M. J., Colditz, G. A., Giovannucci, E. L., Manson, J. E., Kawachi, I. I., Hunter, D. J., Hankinson, S. E., Hennekens, C. H., ROSNER, B. A., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199505113321901 · Cited by 704 · see citing works
Cytokines in Alcoholic Liver Disease
McClain, C. J., Barve, S. S., Deaciuc, I. V., Kugelmas, M., & Hill, D. B. (1999) · Seminars in Liver Disease · doi:10.1055/s-2007-1007110 · Cited by 399 · see citing works
Demonstration of deductive meta-analysis: ethanol intake and risk of myocardial infarction
Maclure, M. (1993) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a036124 · Cited by 397 · see citing works
CROSS-CULTURAL AND ANTHROPOBIOLOGICAL REFLECTIONS ON AFRICAN UVULECTOMY
Wind, J. (1984) · The Lancet · doi:10.1016/s0140-6736(84)92809-5 · Cited by 317 · see citing works
Gaziano, J. M., Gaziano, T. A., Glynn, R. J., Sesso, H. D., Ajani, U. A., Stampfer, M. J., Manson, J. E., Buring, J. E., & Hennekens, C. H. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00531-8 · Cited by 301 · see citing works
McElduff, P., & Dobson, A. J. (1997) · BMJ · doi:10.1136/bmj.314.7088.1159 · Cited by 270 · see citing works
Alcohol consumption and risk of coronary heart disease.
Jackson, R., Scragg, R. K. R., & Beaglehole, R. (1991) · BMJ · doi:10.1136/bmj.303.6796.211 · Cited by 258 · see citing works
Hutchinson, W. L., Köenig, W., Fröhlich, M., Sund, M., Lowe, G. D. O., & Pepys, M. B. (2000) · Clinical Chemistry · doi:10.1093/clinchem/46.7.934 · Cited by 250 · see citing works
Self-citationMcCarty, M. F. (1999) · Medical Hypotheses · doi:10.1054/mehy.1997.0684 · Cited by 234 · see citing works
Keil, U., Chambless, L. E., Döring, A., Filipiak, B., & Stieber, J. (1997) · Epidemiology · doi:10.1097/00001648-199703000-00005 · Cited by 208 · see citing works
Mortality and light to moderate alcohol consumption after myocardial infarction
Muntwyler, J., Hennekens, C. H., Buring, J. E., & Gaziano, J. M. (1998) · The Lancet · doi:10.1016/s0140-6736(98)06351-x · Cited by 176 · see citing works
Pilotti, S., Torre, G. D., Lavarino, C. E., Palma, S. D., Sozzi, G., Minoletti, F., Rao, S., PASQUINI, G., Azzarelli, A., Rilke, F. O., et al. (1997) · The Journal of Pathology · doi:10.1002/(sici)1096-9896(199701)181:1 · Cited by 149 · see citing works
Alcohol intake and mortality in middle aged men with diagnosed coronary heart disease
Shaper, A. G., & Wannamethee, S. G. (2000) · Heart · doi:10.1136/heart.83.4.394 · Cited by 113 · see citing works
The Level of Alcohol Consumption at Which All-Cause Mortality Is Least
White, I. R. (1999) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(99)00076-1 · Cited by 88 · see citing works
Mennen, L. I., Balkau, B., Vol, S., Cacès, E., & Eschwège, E. (1999) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.19.4.887 · Cited by 75 · see citing works
Romelsjö, A., & Leifman, A. (1999) · BMJ · doi:10.1136/bmj.319.7213.821 · Cited by 72 · see citing works
Requirement and supply of vitamin C, E and beta-carotene for elderly men and women.
Heseker, H., & Schneider, R. (1994) · PubMed · Cited by 48 · see citing works
Brenner, H., Arndt, V., Rothenbacher, D., Schuberth, S., Fraisse, E., & Fliedner, T. M. (1997) · International Journal of Epidemiology · doi:10.1093/ije/26.1.85 · Cited by 43 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
C-reactive protein: a critical update
Pepys, M. B., & Hirschfield, G. M. (2003) · Journal of Clinical Investigation · doi:10.1172/jci200318921 · Cited by 3,436 · see citing works
Self-citationThe relation between different dimensions of alcohol consumption and burden of disease: an overview
Rehm, J., Baliunas, D., Borges, G. L. G., Graham, K., Irving, H., Kehoe, T., Parry, C. D., Patra, J., Popova, S., Poznyak, V., et al. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.02899.x · Cited by 1,174 · see citing works
Dietary factors and low-grade inflammation in relation to overweight and obesity
Calder, P. C., Ahluwalia, N., Brouns, F., Buetler, T., Clement, K., Cunningham, K., Esposito, K., Jönsson, L. S., Kolb, H., Lansink, M., et al. (2011) · British Journal of Nutrition · doi:10.1017/s0007114511005460 · Cited by 1,098 · see citing works
The Effects of Diet on Inflammation
Giugliano, D., Ceriello, A., & Esposito, K. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.03.052 · Cited by 842 · see citing works
Alcohol as a Risk Factor for Type 2 Diabetes
Baliunas, D. O., Taylor, B. J., Irving, H., Roerecke, M., Patra, J., Mohapatra, S., & Rehm, J. (2009) · Diabetes Care · doi:10.2337/dc09-0227 · Cited by 703 · see citing works
Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes
Koppes, L. L. J., Dekker, J. M., Hendriks, H. F. J., Bouter, L. M., & Heine, R. J. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.719 · Cited by 671 · see citing works
Cytokine Alterations in Bipolar Disorder: A Meta-Analysis of 30 Studies
Modabbernia, A., Taslimi, S., Brietzke, E., & Ashrafi, M. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.01.007 · Cited by 596 · see citing works
Nettleton, J. A., Steffen, L. M., Mayer-Davis, E. J., Jenny, N. S., Jiang, R., Herrington, D. M., & Jacobs, D. R. (2006) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/83.6.1369 · Cited by 484 · see citing works
Chronic diseases and conditions related to alcohol use
Shield, K. (2013) · Alcohol Research: Current Reviews · doi:10.35946/arcr.v35.2.06 · Cited by 488 · see citing works
“…effect of moderate alcohol consumption involve an increase in the levels of alcohol metabolites, such as acetaldehyde and acetate (Sarkola et al. 2002); an increase in high-density lipoprotein (HDL)4 (Rimm et al. 1999); and the anti-inflammatory effects of alcohol consumption (Imhof et al. 2001).”
BackgroundCytokines in bipolar disorder vs. healthy control subjects: A systematic review and meta-analysis
Munkholm, K., Braüner, J. V., Kessing, L. V., & Vinberg, M. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.05.018 · Cited by 402 · see citing works
Dietary pattern, inflammation, and incidence of type 2 diabetes in women
Schulze, M. B., Hoffmann, K., Manson, J. E., Willett, W. C., Meigs, J. B., Weikert, C., Heidemann, C., Colditz, G. A., & Hu, F. B. (2005) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.3.675 · Cited by 457 · see citing works
Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis.
Chisholm, D., Rehm, J., Van Ommeren, M., & Monteiro, M. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.782 · Cited by 326 · see citing works
Ajani, U. A., Ford, E. S., & Mokdad, A. H. (2004) · The Journal of Nutrition · doi:10.1093/jn/134.5.1181 · Cited by 301 · see citing works
Cytokines in bipolar disorder: A systematic review and meta-analysis
Munkholm, K., Vinberg, M., & Vedel Kessing, L. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.06.010 · Cited by 256 · see citing works
Sierksma, A., van der Gaag, M., Kluft, C., & Hendriks, H. (2002) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601459 · Cited by 231 · see citing works
IMHOF, A., WOODWARD, M., DOERING, A., HELBECQUE, N., LOEWEL, H., AMOUYEL, P., LOWE, G., & KOENIG, W. (2004) · European Heart Journal · doi:10.1016/j.ehj.2004.09.032 · Cited by 204 · see citing works
Avan, A., Tavakoly Sany, S. B., Ghayour‐Mobarhan, M., Rahimi, H. R., Tajfard, M., & Ferns, G. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26791 · Cited by 182 · see citing works
Volpato, S., Pahor, M., Ferrucci, L., Simonsick, E. M., Guralnik, J. M., Kritchevsky, S. B., Fellin, R., & Harris, T. B. (2004) · Circulation · doi:10.1161/01.cir.0000109503.13955.00 · Cited by 176 · see citing works
Corpechot, C., Carrat, F., Poupon, R., & Poupon, R. (2002) · Gastroenterology · doi:10.1053/gast.2002.31880 · Cited by 169 · see citing works
Rehm, J., Sempos, C. T., & Trevisan, M. (2003) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/174182670301000104 · Cited by 164 · see citing works
Exposure-dependent effects of ethanol on the innate immune system
Goral, J., Karavitis, J., & Kovacs, E. J. (2008) · Alcohol · doi:10.1016/j.alcohol.2008.02.003 · Cited by 152 · see citing works
Moderate alcohol consumption and lower levels of inflammatory markers in US men and women
Pai, J. K., Hankinson, S. E., Thadhani, R., Rifai, N., Pischon, T., & Rimm, E. B. (2006) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2005.06.037 · Cited by 149 · see citing works
Ciubotaru, I., Lee, Y.-S., & Wander, R. C. (2003) · The Journal of Nutritional Biochemistry · doi:10.1016/s0955-2863(03)00101-3 · Cited by 127 · see citing works
Short-term exposure to air pollution and inflammation-sensitive biomarkers
Steinvil, A., Kordova-Biezuner, L., Shapira, I., Berliner, S., & Rogowski, O. (2008) · Environmental Research · doi:10.1016/j.envres.2007.08.006 · Cited by 120 · see citing works
Alcohol consumption: Risks and benefits
Mukamal, K. J., & Rimm, E. B. (2008) · Current Atherosclerosis Reports · doi:10.1007/s11883-008-0083-2 · Cited by 109 · see citing works
Greenfield, J. R., Samaras, K., Hayward, C. S., Chisholm, D. J., & Campbell, L. V. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1511 · Cited by 101 · see citing works
Vázquez-Agell, M., Sacanella, E., Tobias, E., Monagas, M., Antúnez, E., Zamora-Ros, R., Andrés-Lacueva, C., Lamuela-Raventós, R. M., Fernández-Solá, J., Nicolás, J. M., et al. (2007) · The Journal of Nutrition · doi:10.1093/jn/137.10.2279 · Cited by 86 · see citing works
Moderate alcohol intake and markers of inflammation and endothelial dysfunction among diabetic men
Shai, I., Rimm, E. B., Schulze, M. B., Rifai, N., Stampfer, M. J., & Hu, F. B. (2004) · Diabetologia · doi:10.1007/s00125-004-1526-0 · Cited by 83 · see citing works
Hamer, M., Molloy, G. J., de Oliveira, C., & Demakakos, P. (2009) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2009.01.005 · Cited by 82 · see citing works
Alcohol consumption and inflammatory markers in older adults: the Cardiovascular Health Study
Mukamal, K. J., Cushman, M., Mittleman, M. A., Tracy, R. P., & Siscovick, D. S. (2004) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2003.10.011 · Cited by 65 · see citing works
Silverwood, R. J., Holmes, M. V., Dale, C. E., Lawlor, D. A., Whittaker, J. C., Smith, G. D., Leon, D. A., Palmer, T., Keating, B. J., Zuccolo, L., et al. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyu187 · Cited by 66 · see citing works
Metabolic Syndrome and Bipolar Disorder: What Should Psychiatrists Know?
de Almeida, K. M., Moreira, C. L. R. L., & Lafer, B. (2012) · CNS Neuroscience & Therapeutics · doi:10.1111/j.1755-5949.2011.00240.x · Cited by 64 · see citing works
Alcohol Intake Revisited: Risks and Benefits
Roerecke, M., & Rehm, J. (2012) · Current Atherosclerosis Reports · doi:10.1007/s11883-012-0277-5 · Cited by 58 · see citing works
Bergmans, R. S., Kelly, K. M., & Mezuk, B. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.046 · Cited by 50 · see citing works
Mori, T. A., Burke, V., Zilkens, R. R., Hodgson, J. M., Beilin, L. J., & Puddey, I. B. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000000816 · Cited by 47 · see citing works
Are the associations between diet and C-reactive protein independent of obesity?
Hickling, S., Hung, J., Knuiman, M., Divitini, M., & Beilby, J. (2008) · Preventive Medicine · doi:10.1016/j.ypmed.2008.02.007 · Cited by 45 · see citing works
Janszky, I., Mukamal, K. J., Orth-Gomér, K., Romelsjö, A., Schenck-Gustafsson, K., Svane, B., Kirkeeide, R. L., & Mittleman, M. A. (2004) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2004.05.012 · Cited by 36 · see citing works
Grodin, E. N., Nieto, S. J., Meredith, L. R., Burnette, E., O'Neill, J., Alger, J., London, E. D., Miotto, K., Evans, C. J., Irwin, M. R., et al. (2022) · Addiction Biology · doi:10.1111/adb.13182 · Cited by 25 · see citing works
Averina, M., Nilssen, O., Arkhipovsky, V. L., Kalinin, A. G., & Brox, J. (2006) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2005.11.007 · Cited by 24 · see citing works
Weekday variation in triglyceride concentrations in 1.8 million blood samples
Jaskolowski, J., Ritz, C., Sjödin, A., Astrup, A., Szecsi, P. B., Stender, S., & Hjorth, M. F. (2017) · Journal of Lipid Research · doi:10.1194/jlr.m074062 · Cited by 20 · see citing works
Effect of 15% Alcohol Dependence on Alveolar Bone Loss and TNF-α Secretion in Wistar Rats
Wagner, M. C., Rocha, J. M. D., Gaio, E. J., Cavagni, J., Carrard, V. C., & Rösing, C. K. (2016) · Brazilian Dental Journal · doi:10.1590/0103-6440201600545 · Cited by 6 · see citing works
- Authors
- Imhof, A., Froehlich, M., Brenner, H., Boeing, H., Pepys, M. B., & Koenig, W.
- Affiliations
- Universität Ulm (DE)
- University Medical Center Utrecht (NL)
- Heidelberg University (DE)
- German Institute of Human Nutrition (DE)
- The Royal Free Hospital (GB)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2001-03
- Volume
- 357
- Issue
- 9258
- Pages
- 763-767
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2061511405
- Cited by
- 559
- References
- 29
- Citations by year
- 2026: 13 · 2025: 9 · 2024: 14 · 2023: 11 · 2022: 16 · 2021: 20 · 2020: 10 · 2019: 19 · 2018: 17 · 2017: 18 · 2016: 20 · 2015: 21 · 2014: 22 · 2013: 21 · 2012: 29
- FWCI
- 24.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- alcohol consumption, inflammation, C-reactive protein, acute phase proteins, albumin, transferrin, alpha-1 globulin, alpha2-globulin, white blood cell count, coronary artery disease, cardiovascular mortality, sex differences, U-shaped relationship, heavy drinking
- MeSH terms
- Acute-Phase Proteins, Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking, alpha-Macroglobulins, C-Reactive Protein, Female, Humans, Inflammation, Leukocyte Count, Male, Middle Aged, Serum Albumin, Smoking, Transferrin
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