Alcohol Intake and Incident Myocardial Infarction: The Role of High-density Lipoprotein Cholesterol (P18-020-19)
Abstract Objectives The aim of this study is to test the hypothesis that the lower risk of myocardial infarction (MI) associated with alcohol intake is through its effect on raising high-density lipoprotein (HDL) cholesterol. Methods This study included 81,827 Chinese men and women (mean age: 51 ± 12 yr.) from the Kailuan Study who were free of cardiovascular disease in 2006 (at baseline) and were followed up to Dec. 2016. At baseline, alcohol consumption was assessed via a questionnaire and the concentration of HDL cholesterol was measured. Incident MI at follow up was a first MI event, confirmed by medical record review. Multivariable Cox regression was used to model the association between habitual alcohol intake and risks of MI, adjusting for potential covariates including age, sex, education, monthly income, occupation, smoking status, physical activity, body mass index, waist circumferences, hypertension, diabetes and total cholesterol. Mediated effect through HDL cholesterol was assessed using a causal mediating analysis (SAS macro). Results During an average of 9.6 years of follow-up, we documented 1095 incident cases. The adjusted hazard ratio (HR) for MI was 0.64 (95% confidence interval (CI), 0.54–0.76) for current alcohol drinkers compared with never or former. The ratio changed very slightly, to 0.65 (95% CI, 0.55–0.76) after further adjustment of HDL cholesterol concentration. Mediation analysis showed that HDL cholesterol concentrations mediated a small, non-significant proportion (1.8%) of the effect of alcohol on MI. Conclusions Alcohol consumption was associated with a lower risk for MI incidence in a large Chinese cohort. Our results suggest that the benefits associated with moderate alcohol consumption is not related to the effects of alcohol on HDL cholesterol. Funding Sources Start-up grant from Penn State College of Health and Human Development, and Penn State CyberScience Seed Grant Program.