The J-shape association of ethanol intake with total homocysteine concentrations: the ATTICA study

From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 women, without any evidence of cardiovascular disease, stratified by age – gender (census 2001), from the greater area of Athens, Greece. Among the variables ascertained we measured the daily ethanol consumption and plasma homocysteine concentrations.Data analysis revealed a J-shape association between ethanol intake (none, <12 gr, 12 – 24 gr, 25 – 48 gr, >48 gr per day) and total homocysteine levels (mean ± standard deviation) among males (13 ± 3 vs. 11 ± 3 vs. 14 ± 4 vs. 18 ± 5 vs. 19 ± 3 μmol/L, respectively, p < 0.01) and females (10 ± 4 vs. 9 ± 3 vs. 11 ± 3 vs. 15 ± 4 vs. 17 ± 3 μmol/L, respectively, p < 0.01), after controlling for several potential confounders. The lowest homocysteine concentrations were observed with ethanol intake of < 12 gr/day (Bonferroni α* < 0.05). No differences were observed when we stratified our analysis by type of alcoholic beverage consumed.We observed a J-shape relationship between homocysteine concentrations and the amount of ethanol usually consumed.Alcoholic beverages are widely consumed throughout the world and it has long been known that heavy alcohol consumption is hazardous to various body organs. In several countries alcohol is considered as one of the leading causes of preventable deaths, after smoking [1]. However, there is now also substantial evidence that the intake of light to moderate amounts of ethanol is associated with reduced morbidity and mortality from several cardiovascular conditions, particularly coronary heart disease (CHD) [2]. The interpretation of these beneficial effects has been extensively discussed and it has been suggested that the effects on cardiovascular disorders might not be due to ethanol per se but to other confounding factors [3]. Low to moderate ethanol consumption has been associated with reduced mortality, primarily due to a reduction in coronary heart disease (CHD). Conversely, heavy drinking increases mortalit