Abstract
The prevalence of high-intensity binge drinking (HIBD), defined as consuming 2 or more times the binge threshold defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is rapidly increasing in the United States. While the relationship between alcohol consumption and lipid and liver function enzyme (LFT) biomarkers has been previously examined, the associations of HIBD with those biomarkers remain unknown. To examine associations of HIBD with lipid and LFT levels in a cross-sectional sample enriched with participants who engage in HIBD. Cross-sectional study using data from the NIAAA clinical sample collected from March 3, 2005, to August 21, 2017, with participants recruited for either the NIAAA screening protocols or inpatient alcohol treatment program. For this study, participants were stratified by self-reported alcohol consumption into 4 sex-specific binge levels: nonbinge and 1, 2, and 3 or more times the binge threshold (levels I, II, and III). Multivariable analyses examined the odds of clinically high levels of lipids and LFTs across binge levels. Analyses were performed from December 3, 2018, to January 30, 2019. Serum levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyltransferase. A total of 2065 participants underwent protocol screening; 1519 with data available on alcohol consumption, body mass index, lipid levels, and LFT levels were included in the final analyses. Mean (SD) age was 39.7 (12.1) years; mean (SD) body mass index was 26.6 (5.1); 978 (64.4%) were male; 718 (47.3%) were white; and 578 (31.1%) consumed alcohol at the nonbinge level, 321 (21.2%) at level I, 239 (15.7%) at level II, and 318 (25.1%) at level III. High-intensity binge drinking was associated with 2- to 8-fold increased odds for clinically high levels of HDL-C, total cholesterol, triglycerides, and all LFTs (eg, for HDL-C: level III odds ratio [OR], 8.65; 95% CI, 4.75-15.77 and for γ-glutamyltransferase: level III OR, 8.21; 95% CI, 5.90-11.43). Increased HIBD frequency (days consuming at levels II and III) was associated with increased odds for clinically high levels of HDL-C, total cholesterol, and all LFTs (per unit increase in days consuming at the respective binge level) (eg, for HDL-C: level II OR, 1.025; 95% CI, 1.014-1.036 and level III OR, 1.033; 95% CI, 1.019-1.047 and for γ-glutamyltransferase: level II OR, 1.028; 95% CI, 1.019-1.037 and level III OR, 1.033; 95% CI, 1.019-1.047). High-impact binge drinking was significantly associated with increased odds for clinically high levels of lipids and LFTs. Given that HIBD is increasingly common among US adults, targeted interventions aimed at reducing HIBD may have important health benefits.
Highlights
The percentage of US adults reporting binge drinking, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as 4 or more drinks for women and 5 or more drinks for men in a given day,[1] has escalated in the last 2 decades, with recent studies[2,3] finding that approximately 32 million adults engage in high-intensity binge drinking (HIBD), defined as consuming 2 or more times the NIAAA binge drinking cutoff.[4]
High-intensity binge drinking was associated with 2- to 8-fold increased odds for clinically high levels of high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides, and all liver function enzyme (LFT)
Increased HIBD frequency was associated with increased odds for clinically high levels of HDL-C, total cholesterol, and all LFTs
Summary
The percentage of US adults reporting binge drinking, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as 4 or more drinks for women and 5 or more drinks for men in a given day,[1] has escalated in the last 2 decades, with recent studies[2,3] finding that approximately 32 million adults engage in high-intensity binge drinking (HIBD), defined as consuming 2 or more times the NIAAA binge drinking cutoff.[4] This trend suggests that negative health outcomes associated with HIBD represent an emerging public health threat and that research examining the health effects of HIBD is needed.[3] The impact of alcohol on cardiovascular disease (CVD) and liver disease risk is partly predicted by changes in lipid profiles and liver function enzyme levels (LFTs),[5,6] but previous studies either grouped individuals reporting HIBD using dichotomous binge thresholds or excluded them as outliers. The associations between HIBD and levels of both lipids and LFTs remain unknown
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