Alcohol use behaviors, fat intake and the function of pancreatic β-cells in non-obese, healthy Korean males: findings from 2010 Korea National Health and Nutrition Examination Survey

Alcohol and coronary artery calcification: an investigation using alcohol flushing as an instrumental variable

Background

We examined whether alcohol flushing could be used as an instrumental variable (IV) and investigated the effect of alcohol consumption on coronary calcification using alcohol flushing status as an IV.

Methods

We analysed cross-sectional data from 24 681 Korean adults (20 696 men and 3985 women) who had been administered a questionnaire assessing alcohol consumption and alcohol flushing, as well as a coronary artery calcium (CAC) measurement. The associations of alcohol flushing status with potential confounders and alcohol consumption were examined. We employed two-stage predictor substitution methodology for the IV analysis.

Results

The prevalence of alcohol flushing did not differ depending on gender, education, household income, cigarette smoking or physical activity. Balanced levels of confounders were observed between alcohol flushers and non-flushers. Alcohol flushing was closely related to alcohol consumption and levels of liver enzymes. In men, a doubling in alcohol consumption was associated with increased odds of coronary calcification in both the IV analysis [odds ratio (OR) of CAC scores of 1 or over = 1.11; 95% confidence interval (CI) = 1.03-1.20) and the multivariable regression analysis (OR = 1.04; 95% CI = 1.01-1.07). For cardiovascular risk factors, the IV analysis showed a positive association between alcohol consumption and blood pressure and high-density lipoprotein-cholesterol.

Conclusions

Alcohol flushing can be used as an IV in studies evaluating the health impact of alcohol consumption, especially in East Asian countries. Through such an analysis, we found that increased alcohol consumption was associated with an increased risk of subclinical coronary atherosclerosis.

Chronic alcohol consumption potentiates the development of diabetes through pancreatic β-cell dysfunction

Chronic ethanol consumption is well established as a major risk factor for type-2 diabetes (T2D), which is evidenced by impaired glucose metabolism and insulin resistance. However, the relationships between alcohol consumption and the development of T2D remain controversial. In particular, the direct effects of ethanol consumption on proliferation of pancreatic β-cell and the exact mechanisms associated with ethanol-mediated β-cell dysfunction and apoptosis remain elusive. Although alcoholism and alcohol consumption are prevalent and represent crucial public health problems worldwide, many people believe that low-to-moderate ethanol consumption may protect against T2D and cardiovascular diseases. However, the J- or U-shaped curves obtained from cross-sectional and large prospective studies have not fully explained the relationship between alcohol consumption and T2D. This review provides evidence for the harmful effects of chronic ethanol consumption on the progressive development of T2D, particularly with respect to pancreatic β-cell mass and function in association with insulin synthesis and secretion. This review also discusses a conceptual framework for how ethanol-produced peroxynitrite contributes to pancreatic β-cell dysfunction and metabolic syndrome.

Pharmacological attenuation of chronic alcoholic pancreatitis induced hypersensitivity in rats

AIM

To characterize an alcohol and high fat diet induced chronic pancreatitis rat model that mimics poor human dietary choices.

METHODS

Experimental rats were fed a modified Lieber-DeCarli alcohol (6%) and high-fat (65%) diet (AHF) for 10 wk while control animals received a regular rodent chow diet. Weekly behavioral tests determined mechanical and heat sensitivity. In week 10 a fasting glucose tolerance test was performed, measuring blood glucose levels before and after a 2 g/kg bodyweight intraperitoneal (i.p.) injection of glucose. Post mortem histological analysis was performed by staining pancreas and liver tissue sections with hematoxylin and eosin. Pancreas sections were also stained with Sirius red and fast green to quantify collagen content. Insulin-expressing cells were identified immunohistochemically in separate sections. Tissue staining density was quantified using Image J software. After mechanical and heat sensitivity became stable (weeks 6-10) in the AHF-fed animals, three different drugs were tested for their efficacy in attenuating pancreatitis associated hypersensitivity: a Group II metabotropic glutamate receptor specific agonist (2R,4R)-4-Aminopyrrolidine-2,4-dicarboxylate (APDC, 3 mg/kg, ip; Tocris, Bristol, United Kingdom), nociceptin (20, 60, 200 nmol/kg, ip; Tocris), and morphine sulfate (3 mg/kg, μ-opioid receptor agonist; Baxter Healthcare, Deerfield, IL, United States).

RESULTS

Histological analysis of pancreas and liver determined that unlike control rats, AHF fed animals had pancreatic fibrosis, acinar and beta cell atrophy, with steatosis in both organs. Fat vacuolization was significantly increased in AHF fed rats (6.4% ± 1.1% in controls vs 23.8% ± 4.2%, P < 0.05). Rats fed the AHF diet had reduced fasting glucose tolerance in week 10 when peak blood glucose levels reached significantly higher concentrations than controls (127.4 ± 9.2 mg/dL in controls vs 161.0 ± 8.6 mg/dL, P < 0.05). This concurred with a 3.5 fold higher incidence of single and small 2-10 cell insulin-positive cell clusters (P < 0.05). Insulin expressing islet of Langerhans cells appeared hypertrophied while islet number and area measurements were not different from controls. Weekly behavioral tests determined that mechanical and heat sensitivities were significantly increased by 4 wk on AHF diet compared to controls. Hypersensitivity was attenuated with efficacy similar to morphine with single dose treatment of either metabotropic glutamate receptor 2/3 agonist APDC, or nociceptin, the endogenous ligand for opioid-receptor-like 1 receptor.

CONCLUSION

The AHF diet induces a chronic alcoholic pancreatitis in rats with measurable features resembling clinical patients with chronic pancreatitis and type 3c diabetes mellitus.

The association between serum 25-hydroxyvitamin D concentrations and depressive symptoms in Korean adults: findings from the fifth Korea National Health and Nutrition Examination Survey 2010

The aims of this study were to examine the association between circulating vitamin D (25(OH)D) levels and depressive symptoms and to evaluate the associations between depressive symptoms and various sociodemographic factors. Data on serum 25(OH)D levels, sociodemographic factors, and information on depressive symptoms were obtained from the Korea National Health and Nutrition Examination Survey V-1 2010. A total of 3,570 Koreans aged ≥20 years were included in the statistical analysis. Subjects with depressive symptoms had lower serum levels of 25(OH)D (41.6±16.2 nmol/L) than those without (44.3±16.2 nmol/L; P-value<0.05; effect size = 0.17). In a logistic regression analysis, the 25(OH)D sufficiency group (≥50 nmol/L) revealed fewer depressive symptoms (OR, 0.72; 95% CI, 0.53-0.97; P-value = 0.032) after adjusting for multiple factors. In addition, females (OR, 3.61; 95% CI, 2.55-5.11; P-value<0.001), problematic alcohol users (OR, 2.33; 95% CI, 1.63-3.34; P-value<0.001), current smokers (OR, 1.43; 95% CI, 1.02-1.99; P-value = 0.036), and subjects who experienced weight loss (OR, 1.78; 95% CI, 1.30-2.44; P-value<0.001) were more likely to answer "yes" on question for depressive symptoms. In conclusion, low serum levels of 25(OH)D were associated with an increased risk for depression symptoms in Korean adults. In addition, several sociodemographic factors were related to the depressive symptoms. Our results provide insight into the relationships among vitamin D status, sociodemographic factors, and depression in the Korean population.

Factors in relation to bone mineral density in Korean middle-aged and older men: 2008-2010 Korea National Health and Nutrition Examination Survey

BACKGROUND/AIMS

Studies on determinants of bone mineral density (BMD) among Asian middle-aged and older men are very limited. The aim of this study was to investigate general determinants and dietary factors influencing BMD in Korean middle-aged and older men.

METHODS

This study was conducted using data from the 2008-2010 Korea National Health and Nutrition Examination Survey. A total of 2,305 male subjects aged 50-79 years were included. Whole-body, total femur, femoral neck, and lumbar spine BMDs were measured by dual-energy X-ray absorptiometry. Dietary intake was estimated by 24-hour dietary recall. A food frequency questionnaire for 63 food items was also administered.

RESULTS

Proportions of osteoporosis at the total femur, femoral neck, and lumbar spine were 0.7, 3.3 and 7.0%, respectively. Age, height, weight, body mass index, fat mass, lean body mass, waist circumference, serum vitamin D, parathyroid hormone, and exercise were related to BMD, but the relationships were site specific. Diet quality and intake of vegetables, fruits, and calcium were associated with BMD.

CONCLUSIONS

These results suggest that a high-quality diet, an adequate intake of fruits, vegetables, and calcium, as well as exercise, high serum vitamin D and weight maintenance might be determinants of BMD among middle-aged and older Asian men.