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Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes

A meta-analysis of prospective observational studies

  1. Lando L.J. Koppes, PHD12,
  2. Jacqueline M. Dekker, PHD1,
  3. Henk F.J. Hendriks, PHD3,
  4. Lex M. Bouter, PHD1 and
  5. Robert J. Heine, MD, PHD14
  1. 1Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, the Netherlands
  2. 2Department of Public and Occupational Health, VU University Medical Center, Amsterdam, the Netherlands
  3. 3Department of Nutritional Physiology, TNO Nutrition and Food Research, Zeist, the Netherlands
  4. 4Department of Endocrinology, VU University Medical Center, Amsterdam, the Netherlands
  1. Address correspondence and reprint requests to Lando L.J. Koppes, PhD, VU University Medical Center, EMGO Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands. E-mail: l.koppes{at}vumc.nl
Diabetes Care 2005 Mar; 28(3): 719-725. https://doi.org/10.2337/diacare.28.3.719
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    Figure 1—

    Scatterplot of the RR estimates of type 2 diabetes reported in the 15 included studies, and the pooled RR estimates with corresponding 95% CIs for five alcohol consumption categories with the nonconsumers as reference category. Each study provides more than one RR estimate. The area of each circle is proportional to the precision of the RR estimate (inverse of its variance).

Tables

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  • Table 1—

    Characteristics of the included studies

    ReferenceStudy name, countryPopulationAge range at baseline (years)SexNo. at risk with follow-upNo. of incident cases of diabetesFollow-up (years)Diabetes definitionConfounders adjusted for
    Lee et al. (34)Iowa Women’s Health Study, U.S.Population based55–69Women35,6981,9219.3Baseline and four follow-up self reportsNone
    Sawada et al. (33)Tokyo Gas Company Study, JapanEmployees of one company20–40Men4,74528013.6Annual testing1–6
    Carlsson et al. (32)Finnish Twin Cohort, FinlandPopulation based≥18Men and women10,856 and 11,664277 and 29720.0Record linkage with national hospital and drug registers1 and 3
    Lee et al. (27)GGT-study, KoreaEmployees of one company25–55Men4,055834.0Annual testingNone
    Nakanishi, Suzuki, and Tatara (28)Building Company Study, JapanOffice workers of one company35–59Men2,9533707.0Annual testing*1–4 and 7
    Wannamethee et al. (8)Nurses’ Health Study 2, U.S.Nurses25–42Women109,70593510.0Biennial self-report1–4 and 7–11
    de Vegt et al. (25)Hoorn Study, the NetherlandsPopulation based50–75Men and women1,3221317.6Baseline and follow-up testing1 and 12
    Meisinger et al. (28)MONICA, GermanyPopulation based35–74Men and women3,052 and 3,114128 and 857.6Baseline and follow-up self-report1, 4, and 13
    Wannamethee et al. (31)British Regional Heart Study, U.K.General practitioners’ register40–59Men5,22119816.8Baseline and follow-up self-report1, 2, 4, 7, 14, and 15
    Conigrave et al. (24)Health Professionals Follow-up Study, U.S.Health professionals40–75Men46,8921,57112.0Biennial self-report1–4, 7, 9, 10, and 15–22
    Hu et al. (26)Nurses’ Health Study, U.S.Nurses30–55Women82,3933,29616.0Biennial self-report1, 3, and 23–25
    Kao et al. (7)ARIC Study, U.S.Population based45–64Men and women5,423 and 6,838547 and 5696.0Baseline and follow-up testing1–4, 7, 9, 20, and 26–28
    Ajani et al. (22)Physicians’ Health Study, U.S.Physicians40–85Men20,95166612.1Baseline and follow-up self-report1–3, 7, 9, and 10
    Wei et al. (23)Cooper Clinic Study, U.S.Population based30–79Men8,6331496.0Baseline and follow-up testing1, 3, and 29
    Tsumura et al. (30)Osaka Health Survey, JapanEmployees of one company35–61Men6,3624569.7Biennial testing1–4, 7, and 30
    • *

      ↵* Impaired fasting glucose also included in diabetes definition. 1, age; 2, smoking; 3, family history of diabetes; 4, BMI; 5, blood pressure; 6, fitness; 7, physical activity; 8, oral contraceptive use; 9, hypertension; 10, hypercholesterolemia; 11, infertility; 12, sex; 13, survey; 14, social class; 15, preexisting coronary heart disease; 16, dietary glycemic load; 17, fiber; 18, trans fat; 19, polyunsaturated fat; 20, energy intake; 21, profession; 22, cancer; 23, time; 24, menopausal status; 25, hormone therapy; 26, waist-to-hip ratio; 27, race; 28, education; 29, years of follow-up; 30, fasting plasma glucose.

  • Table 2—

    RR (95% CI) of type 2 diabetes for alcohol consumption categories for all data, crude and adjusted data, diabetes definition tested and self-reported, men and women, and low and high BMI, with two-sided P values for differences between subgroups

    Number of studiesAlcohol consumption categories (g/day)
    0 (ref.)<66–1212–2424–48>48
    All data1510.87 (0.79–0.95)0.70 (0.61–0.79)0.69 (0.58–0.81)0.72 (0.62–0.84)1.04 (0.84–1.29)
    Crude10 (w)10.70 (0.59–0.83)0.59 (0.40–0.89)0.50 (0.36–0.69)0.71 (0.59–0.85)0.98 (0.78–1.23)
    Adjusted10 (w)10.88 (0.80–0.95)0.73 (0.62–0.86)0.66 (0.59–0.75)0.74 (0.63–0.88)0.93 (0.74–1.18)
        P0.040.360.120.750.77
    Type 2 diabetes tested7 (b)10.91 (0.79–1.05)0.89 (0.72–1.10)0.86 (0.64–1.15)0.76 (0.63–0.93)1.14 (0.89–1.45)
    Type 2 diabetes self-reported7 (b)10.85 (0.75–0.97)0.65 (0.57–0.73)0.57 (0.50–0.65)0.59 (0.49–0.71)0.88 (0.55–1.39)
        P0.510.040.030.100.36
    Men11 (w and b)10.93 (0.82–1.04)0.80 (0.71–0.90)0.75 (0.60–0.95)0.71 (0.60–0.83)1.06 (0.86–1.32)
    Women6 (w and b)10.81 (0.75–0.88)0.59 (0.54–0.64)0.55 (0.47–0.65)0.78 (0.49–1.23)*
        P0.140.010.21
    BMI lowest strata6 (w)10.76 (0.65–0.88)0.64 (0.44–0.92)0.73 (0.53–1.01)0.85 (0.49–1.46)1.28 (0.37–4.40)
    BMI highest strata6 (w)10.85 (0.79–0.92)0.75 (0.63–0.90)0.67 (0.57–0.78)0.71 (0.55–0.91)0.92 (0.73–1.16)
        P0.530.450.530.790.65
    • *

      ↵* The single observation in women in the >48-g/day category is pooled with the observations in the 24- to 48-g/day category. w, within-study comparison; b, between-study comparison.

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Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes
Lando L.J. Koppes, Jacqueline M. Dekker, Henk F.J. Hendriks, Lex M. Bouter, Robert J. Heine
Diabetes Care Mar 2005, 28 (3) 719-725; DOI: 10.2337/diacare.28.3.719

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Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes
Lando L.J. Koppes, Jacqueline M. Dekker, Henk F.J. Hendriks, Lex M. Bouter, Robert J. Heine
Diabetes Care Mar 2005, 28 (3) 719-725; DOI: 10.2337/diacare.28.3.719
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