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. 2020 Mar 27;12(4):912. doi: 10.3390/nu12040912

Table 1.

Characteristics of studies evaluating anti-inflammatory, antioxidant, and antithrombotic effects of alcohol.

Reference Design, Subjects (No), Follow-up Population Primary Outcome Main Results
Anti-inflammatory and antioxidant effects
OBSERVATIONAL STUDIES
Nova et al. [33] Observational, cross-sectional study, 143 participants. Participants were classified as abstainers and occasional consumers; predominantly beer consumers, and mixed beverage consumers (including wine, beer, and liquor). Healthy adults 55 years of age and older. Spain. Glucose, lipid profile, iron, transferrin, ferritin, and hs-CRP, VCAM-1, ICAM-1, P-selectin, E-selectin, IL-1β, IL-6, IL-8, IL-10, leptin, and adiponectin. Consumption of alcohol: <25 g/d women and <40 g/d men.
Mixed group: HDL-c and P-selectin compared with the abstainers’ group. Adiponectin compared with the beer group.
Howard et al. [34] Cross-sectional, 48,023 participants. NHANES laboratory and questionnaire data from the nine surveys between 1999 and 2016. All participants aged 18 years or older. USA. Demographic, socioeconomic, and lifestyle factors associated with the magnitude of NLR. NLR:
Non-drinkers (zero drinking d/y): 2.06
Frequent drinkers (>100 drinking d/y): 2.01
Less frequent drinkers (<100 drinking d/y): 1.95–1.96
Hamed et al. [36] Prospective, nonrandomized, and observational study, 14 participants consumed 250 mL red wine daily for 21 consecutive days. Healthy volunteers. Israel. Vascular endothelial function, plasma SDF1a concentrations, circulating EPCs and FC. Moderate intake of RW (1–2 glasses/d) increased EPC migration and proliferation, NO production and decreased extent of apoptosis.
Barbaresko et al. [37] Cohort study, 112 participants, mean follow-up of 1.7 years. Northern German study population aged between 18 and 80 years. CRP and IL-6 as response variables were used to derive dietary patterns. Consumption of alcohol was associated with increase of CRP (OR 2.20; 95% CI 1.12, 4.35) and IL-6 (OR 3.14; 95% CI 1.26, 7.87).
Da Luz et al. [38] Cohort study, 354 participants, follow-up of 5.5 years. All males (200 healthy RW drinkers and 154 abstainers) aged 50–70 years. Brazil. The composite endpoint of total death, AMI, or MACE was assessed. RW drinkers (28.9 ± 15g/d) showed higher HDL and LDL but lower CRP than abstainers.
INTERVENTIONAL STUDIES
Chiva-Blanch et al. [39] Randomized, crossover consumption trial, 67 volunteers. After a washout period, the subjects received 30 g alcohol/d of RW, DRW, or gin for 4 wk. High-risk, male volunteers between 55 and 75 y old recruited at Hospital Clinic of Barcelona. Seven cellular and 18 serum inflammatory biomarkers were evaluated. Moderate consumption of RW (30 g alcohol/d):
Phenolic compounds modulate leukocyte adhesion molecules.
Ethanol and polyphenols of RW modulate ICAM-1, IL-6, E-selectin
Estruch et al. [40] Randomized cross-over trial. Forty participants received 30 g/ethanol/d as either wine or gin for 28 days. Healthy men. Mean age, 38 years. Barcelona, Spain. Serum vitamins, MDA, SOD, and glutathione peroxidase activities, lipid profile, oxidized LDL and LDL resistance to ex vivo oxidative stress. RW (30 g/ethanol/d) intake:
SOD activity (–8.1 U/gHb (95% confidence interval, CI, –138 to –25; p = 0.009)) and MDA levels (–11.9 nmol/L (CI, –21.4 to–2.5; p = 0.020)).
Stote et al. [41] Randomized crossover design, 53 volunteers consumed a weight-maintaining diet plus 0, 15, and 30 g/day of alcohol for 8 weeks. Women older than 50 years of age; postmenopausal (last menses ≥12 months before the beginning of the study). s-ICAM, hs-CPR, IL-6 fibrinogen, PAI-1, D-dimer, Factor VII c, CRP, IL-6 After intake of 15 g and 30 g of alcohol, women showed decreased s-ICAM (5% and 5%), fibrinogen (4% and 6%), D-dimer (24% only for 30 g), and increased PAI-1 (27% and 54%). No difference for Factor VIIc, CRP, and IL-6.
Roth et al. [42] Randomized, controlled, crossover study, 38 volunteers were randomized to receive 30 g of ethanol/day as AWW or gin for 3 weeks. High-risk male volunteers between 55 and 80 y old recruited at primary care centers associated with Hospital Clinic of Barcelona. Classical cardiovascular risk factors, cellular expression of circulating adhesion molecules, EPCs, and plasma biomarkers. AWW (30 g ethanol/day) shows a greater ability to repair and maintain endothelial integrity compared with gin (39.6% increase in EPCs).
Anti-thrombotic effects
OBSERVATIONAL STUDIES
Lawlor et al. [43] Causal associations in a cross-sectional study, 54,604 participants, Copenhagen General Population Study. Danish General Population, mean age 56 years BMI, BP, lipids, fibrinogen, and glucose Non-drinkers were weakly associated with higher levels of fibrinogen.
Wakabayashi, [44] Cross-sectional, 6508 participants. Men aged 30–69 years. Japan. BMI, Platelet count, leukocyte count, GGT Mean platelet counts in drinkers, at any level of intake, were not significantly different from that in non-drinkers
Smith et al. [45] Prospective, nonrandomized observational study, 54 volunteers. Healthy volunteers, older than 21 years. TEG-PM, maximal platelet activation, full platelet inhibition, ADP receptor agonist, or AA receptor agonist activation. Acute alcohol consumption (maximum 2 g/kg) is associated with ADP receptor-mediated platelet inhibition in men, but not in women.
INTERVENTIONAL STUDIES
Chiva-Blanch et al. [46] Randomized, crossover consumption trial, 67 volunteers. After a washout period, the subjects received 30 g alcohol/d of RW, DRW, or gin for 4 weeks. High-risk, male volunteers between 55 and 75 y old recruited at Hospital Clinic of Barcelona. Fasting plasma glucose and insulin, HOMA-IR, plasma lipoproteins, apolipoproteins, and adipokines. Beneficial effect of the polyphenols on insulin resistance (insulin and HOMA-IR for RW and DRW) with consumption of 30 g alcohol/d.

ADP: adenosin diphosphate; AWW, aged white wine; AMI, acute myocardial infarction; Apo-AI, apolipoprotein; BMI, body mass index; CHD, coronary heart disease; CI: confidence interval; CPR, C-reactive protein; CV, cardiovascular; DRW, dealcoholized red wine; EPC, endothelial progenitor cell; FC, flow cytometry; GGT, gamma glutamyl transpeptidase; HDL-C, high-density lipoprotein cholesterol; HOMA-IR, homeostasis model assessment of insulin resistance; HTG, hypertriglyceridemia; ICAM-1, intercellular adhesion molecule 1; IL, interleukin; LDL-C, low-density lipoprotein cholesterol; MACE, major adverse cardiovascular events; MDA, malondialdehyde; NLR, neutrophil-to-lymphocyte ratio; PAI-1, Plasminogen activator inhibitor-1; RW, red wine; SOD, superoxide dismutase; TC, total cholesterol; TEG-PM, Thromboelastography with platelet mapping; TG, triglycerides; VCAM-1, vascular cell adhesion molecule 1. SDF1a, stromal cell-derived factor-1.