Mohamed Ali (University of Illinois at Chicago)| Imaduddin Mirza (University of Illinois at Chicago)| Chandra Hassan (University of Illinois at Chicago)| Mario Masrur (University of Illinois at Chicago)| Francesco Bianco (University of Illinois at Chicago)| Eduardo Fernandes (University of Illinois at Chicago)| Giulianotti Cristoforo (University of Illinois at Chicago)| Antonio Gangemi (University of Illinois at Chicago)| Shane Phillips (University of Illinois at Chicago)| Abeer Mahmoud (University of Illinois at Chicago)
More than 30% of obese patients in the U.S. suffer from eating disorders; nearly 20% of them have a comorbid substance use disorder, usually alcohol drinking. On the other hand, alcohol is a source of energy intake and based on the fact that 1 gram of alcohol provides 7.1 kcal, alcohol consumption could contribute to weight gain if not compensated for. Indeed, obesity and excessive alcohol intake are two public health problems that showed direct association by epidemiological studies. In the current study, we investigate the association between alcohol consumption and cardiometabolic risk factors in obese bariatric patients and non-obese controls. We obtained blood, subcutaneous adipose tissue (SAT) and visceral AT (VAT) biopsies from obese patients having bariatric surgery and non-obese adults having elective surgeries (such as hernia repair). Dual energy X-ray absorptiometry (DEXA) scanning was used for body composition analyses. Flow induced dilation (FID) in AT-isolated arterioles were tested for vasoreactivity in response to increasing pressure gradients. Brachial artery flow-mediated dilation (FMD) was measured via doppler ultrasound. Protein expression of the hypoxic marker, hypoxia-inducible factor (HIF1α) and inflammation-related cytokines was measured in the AT biopsy. Other cardiometabolic risk factors that are related to glucose and lipid metabolism, systemic inflammation, and micronutrients affected by alcohol consumption (folate and vitamin B12) were measured in blood. Finally, information about alcohol administration and were obtained via questionnaires. Using drinking level categories modified from those of Cahalan et al., participants were classified as abstainers, light, moderate, or heavy drinkers. Alcohol consumption was found to be higher in the obese (68%) compared to the non-obese group (37%), most of this difference was in the moderate (obese: 29%, control: 16%) and heavy (obese: 16%, control: 0%) drinker categories. Alcohol consumption correlated positively with weight, waist circumference (WC), body surface area (BSA), body mass index (BMI), DEXA-measured total and visceral fat percentage, fasting plasma insulin (FPI), insulin resistance measurement (HOMA-IR), systolic BP, AT protein levels of HIF1α and plasma levels of C-reactive protein (CRP), interleukin 1(IL6), and tumor necrosis factor alpha (TNF α). Alcohol consumption correlated negatively with DEXA-measured lean percentage, plasma folate and vitamin B12, brachial artery FMD. and SAT and VAT arteriolar FID. All correlations lost significance after accounting for weight except the arteriolar FID and plasma levels of folate and vitamin B12 indicating that body weight had huge influence in controlling the relationship between alcohol consumption and several cardiometabolic risk factors. On the other hand, the relationship between the body weight and other cardiometabolic risk factors was minimally affected after adjusting for alcohol consumption.
Conclusion: The current study demonstrates that alcohol intake is higher in obese individuals and associated with cardiometabolic risk.