on March 7, 2002
Published online before print March 7, 2002, doi: 10.1161/01.ATV.0000014589.22121.6C
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Submitted on January 23, 2002
Accepted on February 22, 2002
Impact of Alcohol Intake on Measures of Lipid Metabolism Depends on Context Defined by Gender, Body Mass Index, Cigarette Smoking, and Apolipoprotein E Genotype
Suzanne Lussier-Cacan *;
From the Hyperlipidemia and Atherosclerosis Research Group (S.L.-C., A.B., M.X.), Clinical Research Institute of Montreal, Montreal, Quebec, Canada; Département de médecine familiale (M.X.), Faculté de médecine, Université de Sherbrooke and Centre de recherche clinique (M.X., T.N.), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada; Department of Human Genetics (C.F.S.), University of Michigan, Ann Arbor, Mich.
* To whom correspondence should be addressed. E-mail: cacans{at}ircm.qc.ca.
Abstract—Hyperlipidemia,
smoking, and obesity are well-known risk factors for
cardiovascular disease. Conversely, moderate alcohol
intake is associated with lower atherosclerosis risk.
However, the influence of taking alcohol on the interrelationships of
these factors in a particular context has not been thoroughly
investigated. In this study, we asked whether the association between
plasma measures of lipid metabolism and alcohol intake is
dependent on context defined by gender, age, body mass index (BMI),
smoking, and apolipoprotein E
(APOE) genotype. Data
were obtained in a sample of 869 women and 824 men who participated in
the Quebec Heart Health Survey. There was no evidence that variation
among APOE genotypes
influenced the association between LDL cholesterol (LDL-C)
or HDL cholesterol (HDL)-C and alcohol, after adjustment
for age and BMI. Further, the positive (LDL-C and BMI) and the negative
(HDL-C and BMI) associations that were observed in men and women with
the 
3/2
and 3/3
genotypes were not modified by alcohol intake. However, in
women with the 4/3
genotype only, we found a significant influence of an alcohol
by BMI interaction on the prediction of total cholesterol,
LDL-C, HDL-C, apoA-I, and apoB, and this interaction was influenced by
the status of smoking. Whereas the influence of an alcohol by BMI
interaction on total cholesterol and LDL-C was significant
in smokers, its influence on HDL-C was significant only in non-smokers.
This study emphasizes the context dependency of the influence of
alcohol on lipid metabolism and demonstrates how
biological, environmental, and genetic factors interact to determine
cardiovascular disease risk.
Key words: alcohol intake • smoking • lipids • lipoproteins • gender • apolipoprotein E polymorphism • APOE genotype • context dependency