The Effect of Cessation and Resumption of Moderate Alcohol Intake on Serum High-Density-Lipoprotein Subfractions

Abstract

High-density lipoproteins (HDL) in plasma may be divided into two subfractions: less dense HDL₂, the concentration of which appears to be negatively associated with coronary heart disease, and more dense HDL₃, which is reportedly unrelated to coronary disease. Alcohol consumption correlates with both reduced coronary heart disease and increased plasma HDL cholesterol concentrations; however, the relation of moderate alcohol intake to HDL₂ and HDL₃ is obscure. To study the effect of alcohol on these HDL subfractions, we randomly assigned 24 men who were moderate drinkers to an abstention group (n = 12) or a control drinking group (n = 12). After six weeks, concentrations of HDL cholesterol and HDL₃ mass were decreased in abstainers but not in drinkers (P≤0.05), whereas HDL₂ mass was unchanged. Resumption of drinking increased the levels of HDL cholesterol and HDL₃ mass (P≤0.05) without affecting HDL₂ mass. These data suggest that the association of alcohol with coronary disease is not mediated by increases in plasma HDL₂ levels. Furthermore, the HDL₃ fraction may not be "inert" with respect to coronary heart disease, or the association of alcohol with coronary disease may operate through mechanisms unrelated to HDL. (N Engl J Med 1984;310:805–10.)