Alcohol and the risk for latent autoimmune diabetes in adults: results based on Swedish ESTRID study

Bahareh Rasouli; Tomas Andersson; Per-Ola Carlsson; Mozhgan Dorkhan; Valdemar Grill; Leif Groop; Mats Martinell; Tiinamaja Tuomi; Sofia Carlsson

doi:10.1530/EJE-14-0403

Alcohol and the risk for latent autoimmune diabetes in adults: results based on Swedish ESTRID study

Eur J Endocrinol. 2014 Nov;171(5):535-43. doi: 10.1530/EJE-14-0403. Epub 2014 Aug 12.

Authors

Bahareh Rasouli¹, Tomas Andersson², Per-Ola Carlsson³, Mozhgan Dorkhan³, Valdemar Grill³, Leif Groop³, Mats Martinell³, Tiinamaja Tuomi³, Sofia Carlsson³

Affiliations

¹ Epidemiology UnitInstitute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77 Stockholm, SwedenCenter for Occupational and Environmental MedicineStockholm County Council, Stockholm, SwedenDepartment of Medical SciencesUppsala University, SE-751 85 Uppsala, SwedenDepartment of Clinical Sciences in MalmöClinical Research Centre, Lund University, SE-205 02 Malmö, SwedenNTNU Institute of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, Trondheim University Hospital, Trondheim, NorwayDepartment of Public Health and Caring SciencesUppsala University, SE-751 22 Uppsala, SwedenDivision of EndocrinologyDepartment of Medicine, Helsinki University Central Hospital, Research Program for Diabetes and Obesity and Folkhalsan Research Center, University of Helsinki, F-00014 Helsinki, Finland bahareh.rasouli@ki.se.
² Epidemiology UnitInstitute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77 Stockholm, SwedenCenter for Occupational and Environmental MedicineStockholm County Council, Stockholm, SwedenDepartment of Medical SciencesUppsala University, SE-751 85 Uppsala, SwedenDepartment of Clinical Sciences in MalmöClinical Research Centre, Lund University, SE-205 02 Malmö, SwedenNTNU Institute of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, Trondheim University Hospital, Trondheim, NorwayDepartment of Public Health and Caring SciencesUppsala University, SE-751 22 Uppsala, SwedenDivision of EndocrinologyDepartment of Medicine, Helsinki University Central Hospital, Research Program for Diabetes and Obesity and Folkhalsan Research Center, University of Helsinki, F-00014 Helsinki, Finland Epidemiology UnitInstitute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77 Stockholm, SwedenCenter for Occupational and Environmental MedicineStockholm County Council, Stockholm, SwedenDepartment of Medical SciencesUppsala University, SE-751 85 Uppsala, SwedenDepartment of Clinical Sciences in MalmöClinical Research Centre, Lund University, SE-205 02 Malmö, SwedenNTNU Institute of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, Trondheim University Hospital, Trondheim, NorwayDepartment of Public Health and Caring SciencesUppsala University, SE-751 22 Uppsala, SwedenDivision of EndocrinologyDepartment of Medicine, Helsinki University Central Hospital, Research Program for Diabetes and Obesity and Folkhalsan Research Center, University of Helsinki, F-00014 Helsinki, Finland.
³ Epidemiology UnitInstitute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77 Stockholm, SwedenCenter for Occupational and Environmental MedicineStockholm County Council, Stockholm, SwedenDepartment of Medical SciencesUppsala University, SE-751 85 Uppsala, SwedenDepartment of Clinical Sciences in MalmöClinical Research Centre, Lund University, SE-205 02 Malmö, SwedenNTNU Institute of Cancer Research and Molecular MedicineNorwegian University of Science and Technology, Trondheim University Hospital, Trondheim, NorwayDepartment of Public Health and Caring SciencesUppsala University, SE-751 22 Uppsala, SwedenDivision of EndocrinologyDepartment of Medicine, Helsinki University Central Hospital, Research Program for Diabetes and Obesity and Folkhalsan Research Center, University of Helsinki, F-00014 Helsinki, Finland.

Abstract

Objective: Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes. Our aim was to investigate whether alcohol consumption is associated with the risk of latent autoimmune diabetes in adults (LADA), an autoimmune form of diabetes with features of type 2 diabetes.

Design: A population-based case-control study was carried out to investigate the association of alcohol consumption and the risk of LADA.

Methods: We used data from the ESTRID case-control study carried out between 2010 and 2013, including 250 incident cases of LADA (glutamic acid decarboxylase antibodies (GADAs) positive) and 764 cases of type 2 diabetes (GADA negative), and 1012 randomly selected controls aged ≥35. Logistic regression was used to estimate the odds ratios (ORs) of diabetes in relation to alcohol intake, adjusted for age, sex, BMI, family history of diabetes, smoking, and education.

Results: Alcohol consumption was inversely associated with the risk of type 2 diabetes (OR 0.95, 95% CI 0.92-0.99 for every 5-g increment in daily intake). Similar results were observed for LADA, but stratification by median GADA levels revealed that the results only pertained to LADA with low GADA levels (OR 0.85, 95% CI 0.76-0.94/5 g alcohol per day), whereas no association was observed with LADA having high GADA levels (OR 1.00, 95% CI 0.94-1.06/5 g per day). Every 5-g increment of daily alcohol intake was associated with a 10% increase in GADA levels (P=0.0312), and a 10% reduction in homeostasis model assessment of insulin resistance (P=0.0418).

Conclusions: Our findings indicate that alcohol intake may reduce the risk of type 2 diabetes and type 2-like LADA, but has no beneficial effects on diabetes-related autoimmunity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Alcohol Drinking / epidemiology*
Case-Control Studies
Diabetes Mellitus, Type 1 / epidemiology*
Diabetes Mellitus, Type 2 / epidemiology
Female
Humans
Male
Middle Aged
Risk Factors
Surveys and Questionnaires
Sweden / epidemiology