Study suggests a complex metabolic basis between alcohol consumption and CVD

A new study identified 60 alcohol-associated circulating metabolites, which appear to produce counteractive effects on the risk of heart disease.

While past research has indicated that moderate alcohol consumption can lower one's risk of cardiovascular disease (CVD), more recent studies suggest that moderate levels of drinking may be hazardous to heart health. A new analysis led by Boston University School of Public Health (BUSPH) and the Friedman School of Nutrition Science and Policy at Tufts University now sheds new insight on this complex relationship between alcohol consumption and the progression of CVD.

Published in the journal BMC Medicine, the study found that alcohol consumption may have counteractive effects on CVD risk, depending on the biological presence of certain circulating metabolites—molecules that are produced during or after a substance is metabolized and studied as biomarkers of many diseases.

The researchers observed a total of 60 alcohol consumption-related metabolites, identifying seven circulating metabolites that link long-term moderate alcohol consumption with an increased risk of CVD, and three circulating metabolites that link this same drinking pattern with a lower risk of CVD.

The findings provide a better understanding of the molecular pathway of long-term alcohol consumption and highlight the need for and direction of further research on these metabolites to inform targeted prevention and treatment of alcohol-related CVD.

The study findings demonstrate that alcohol consumption may trigger changes of our metabolomic profiles, potentially yielding both beneficial and harmful outcomes. Because the majority of our study participants are moderate alcohol consumers, our findings contribute to the ongoing discussion about the relationship between moderate alcohol drinking and heart health."

Chunyu Liu, assistant professor of biostatistics at BUSPH

Liu is the co-corresponding/co-senior author of the study along with Jiantao Ma, assistant professor in the Division of Nutrition Epidemiology and Data Science at the Friedman School

"However, rather than definitively settling that debate, this study underscores the intricate effects of alcohol consumption on cardiovascular health and generates a useful hypothesis for future investigations," Liu says.

For the study, the researchers examined blood samples to measure the association between the cumulative average consumption over 20 years of beer, wine, and liquor and 211 metabolites among 2,428 Framingham Heart Study Offspring Study participants, who are the children of participants in the long-running Boston University-based Framingham Heart Study. Among the participants, 636 developed CVD over the study period.

Among the 60 drinking-related metabolites, 13 metabolites had a stronger association with alcohol consumption in women than in men, perhaps due to women's generally smaller body size and likely higher blood alcohol concentration after consuming the same amount of alcohol as men.

The results also showed that consumption of different types of alcohol was linked to different metabolomic responses, with beer consumption generating a slightly weaker association overall than wine and liquor. In roughly two-thirds of the 60 metabolites, higher plasma levels were detected in participants who consumed greater amounts of alcohol.

Branched-chain amino acids (BCAAs) were among the metabolites that were not associated with alcohol consumption.

The researchers then calculated two alcohol consumption-associated metabolite scores, which had opposite associations with the development of CVD.

"While our study presents intriguing findings, validation through state-of-the-art methods and large and diverse study populations is crucial," Ma says. "To enhance reliability, we aim to conduct larger-scale research involving a more diverse racial and ethnic background, as the current study participants are all white. In addition, we will expand our study to integrate with other molecular markers such as genetic information to illustrate the complex relationships between alcohol consumption, metabolite features, and cardiovascular risk."

The study was funded by the National Institutes of Health's National Institute on Alcohol Abuse and Alcoholism under award R01AA028263. Data collection in the Framingham Heart Study was supported by the National Heart, Lung, and Blood Institute. Complete information on authors, funders, methodology, limitations, and conflicts of interest is available in the published paper.