EFFECT OF A MODERATE ALCOHOL INTAKE ON THE LIPOPROTEINS OF NORMOTRIGLYCERIDEMIC OBESE SUBJECTS COMPARED WITH NORMOPONDERAL CONTROLS

Moderate alcohol intake is frequently associated with an elevated concentration of high-density lipoprotein (HDL), which is one of the potential causes for the relative decrease in cardiovascular risk reported in moderate drinkers. Conversely, low HDL concentrations, particularly HDL2, in obese subjects may be a risk factor. The effect of 30 g alcohol daily (wine) during 14 days following a period of abstinence was studied in seven normolipidemic obese subjects (body mass index [BMI], 30 ± 1.7 kg/m2) compared with seven normoponderal controls (BMI, 22 ± 1.2 kg/m2). Alcohol caused apolipoprotein (apo) AI and apo AII concentrations to increase in all controls by 12% and 16% (P < .05), but not in obese subjects. Lipoprotein (Lp) AI HDL particles (without AII) were initially in the same proportions in the two groups. Their increase in controls only (P < .03) was not matched by an increase in HDL2 in all subjects. In obese subjects, neither Lp AI nor HDL2 were increased by alcohol, but their HDL-triglyceride (TG) contents, initially elevated, were normalized. Cholesterol ester (CE) transfer activity was not different in controls and obese subjects during abstinence (105.7 ± 40.8 v 104.8 ± 34.5 mmol/mg protein/h). It was notably depressed by alcohol in controls (74.2 ± 27.4, P < .002), but not in obese subjects. It is concluded that (1) The reduced pool of HDL2 in obese subjects is not due to insufficient Lp AI nor to excess CE transfer; (2) Alcohol acts on HDL both by an increase of the HDL apoprotein pool and by a decrease of cholesterol ester transfer protein (CETP); (3) Obesity inhibits both effects. © 1992.