Browsing by Subject "High-density-Lipoproteine"

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Einfluss der Ernährung und von Genussmitteln auf Risikofaktoren für das Auftreten von ischämischem Herzinfarkt und Schlaganfall
(2005) Eckoldt, Joachim; Bode, Christiane
Background and aims of the study: Arteriosclerotic changes of blood vessels which contribute to coronary heart disease (CHD) and ischemic stroke are influenced by risk factors like cigarette smoking, overweight, hypertension, diabetes mellitus, missing physical exercise and nutritional factors, such as alcohol consumption. Beyond this, the concentrations of serum lipids, antioxidants, coagulation factors or other risk factors, such as C-reactive protein, and homocysteine are considered to be additional factors that indicate an enhanced or lowered risk of atherosclerosis. In this study we examined the effect of nutritional factors, in particular alcohol consumption, on various plasma components that are believed to play a role in the pathogenesis of atherosclerosis. Multiple epidemiologic studies suggest that moderate alcohol consumption reduces the mortality from cardiovascular diseases and that this effect is chiefly mediated by elevation of high-density lipoprotein (HDL). This cross-sectional study assessed the effect of moderate alcohol consumption and other life-style factors on the composition of HDL in healthy working males. An additional goal of the present study was to find out whether there is an association between alcohol consumption and the concentration of vitamins and cardio-protective substances. Methods: We included a collective of healthy men (n = 284, age 23-66 years), investigated with respect to cardiovascular risk factors. The average daily alcohol consumption, nutrient intake, smoking and other life-style factors was assessed by a computer based questionnaire. Group 1 (n = 62) comprised subjects with an average daily alcohol consumption of 0-5g, group 2 (n = 175): 5-30g, and group 3 (n = 47): 30-70g. In addition, the study design made it possible to subdivide groups 2 and 3 in a so called ?beer drinker group 2+3? (> 80 % beer), a ?wine drinker group 2+3? (> 80 % wine) and persons without preference of a certain alcoholic beverage. Results: The alcohol groups showed no significant differences in the nutritional profile (nutrients, energy intake, and metabolic rate). The markers for regular, higher alcohol consumption (g-GT and MCV) were positive correlated to the amount of alcohol consumption. There was no correlation between the great number of clinical laboratory parameters and the amount or kind of alcohol consumption. Thereby the groups are comparable in view of these laboratory parameters. Besides, there were no indications for the existence of diseases, which might influence blood lipid and vitamin concentrations. Antioxidative substances in the blood: Dietary assessment: The intake of vitamin B2, B6, B12, folic acid, retinol, ß-carotene and other carotenoids, as assessed by the computer interview was comparable in groups 1-3. The subjects in group 1 had a higher supply of the vitamins C, B1 and a-tocopherol, ?beer drinker Gr. 2+3? had a higher intake of vitamin B2, B6 and folic acid. Blood measurements: Antioxidative vitamins: The vitamin B2 status in erythrocytes (EGRAC) was lower in group 3 (vs. group 1 and 2). The plasma level of ß-carotene and ß-cryptoxanthin was lower in group 3 than in group 1. Vitamins that influence homocysteine metabolism (including homocysteine): Influence of beer and wine: The status of vitamin B6 and the concentration of free plasma pydridoxal phosphate in group 3 was significantly higher than in group 1. These results cannot explain the postulated positive influence of moderate or higher alcohol consumption through improvements of the vitamin status and the concentration of vitamins in the blood. The vitamins in beer improved the vitamin status only in case of vitamin B6, no effect was calculated in case of vitamin B2 and folic acid. Higher alcohol consumption (group 3) made the vitamin status respectively the plasma concentration of vitamin B2, ß-carotene and ß-cryptoxanthin lower compared with group 1 ? in spite of comparable supply. Coagulation factors, markers of inflammation: The coagulation factors prothrombin time and fibrinogen as well as the ?newer? risk factors C-reactive protein and homocysteine were not correlated to the amount or the kind of alcohol. Lipoproteins: The serum concentration of total cholesterol, cholesterol ester, phospholipids, apolipoprotein A-1 and A-2 was higher in group 3. Moderate and higher alcohol consumption raises the concentration of cholesterol in the high-density lipoproteins (HDL) (including subfractions) ? independent of the sort of alcoholic beverage. The concentration of cholesterol in the low- (LDL) (including subfractions), very-low (VLDL) and intermediate-density lipoproteins (IDL) in the blood was not influenced by alcohol consumption. Composition of HDL: The induced increase of HDL cholesterol was lower in the subfraction HDL3 as in the subfractions HDL2b und HDL2a. Besides we found qualitative changes of the HDL-components: the phospholipid component increased more than the other HDL-components. This phenomenon might play a beneficial role in the mechanism of atherosclerosis. Conclusions: Vitamins: The changes of antioxidative vitamins and vitamins influencing homocysteine metabolism observed in persons with moderate and increased alcohol consumption do not explain the antiatherogenic effect of alcohol. On the other hand, our study confirmed a positive association of moderate alcohol consumption with HDL plasma levels ? independent of other nutritional factors. In addition, alcohol might induce qualitative alterations of HDL composition (more pronounced increased of HDL2 relative increase of the phospholipid component). The pathophysiological significance of this phenomenon remains unclear.