Abstract
BACKGROUND: Type 2 diabetes mellitus is a well-known risk factor for atherosclerosis. Intima media thickness (IMT) of the carotid arteries has been widely used for assessing atherosclerotic changes representing cerebro-cardiovascular disease risk. Previous studies have associated the presence of inactive aldehyde dehydrogenase with progression of atherosclerosis and alcohol flushing. However, reports conflict on whether alcohol flushing could potentially modify the degree of atherosclerosis in type 2 diabetic patients. METHODS: We retrospectively assessed the relationships among alcohol flushing, IMT, and clinical characteristics in 123 consecutive Japanese type 2 diabetic patients. Alcohol flushing was assessed by standardized questionnaires. RESULTS: Patients with alcohol flushing had lower mean IMT [0.7 (0.65-0.80) vs. 0.8 (0.73-0.90) mm, p < 0.05], despite having higher triglycerides [132 (94-169) vs. 98 (70-139) mg/dL, p < 0.01] and lower high-density lipoprotein cholesterol [52 (44-60) vs. 59 (49-67) mg/dL, p < 0.05] concentration. Patients with alcohol flushing had lower frequency of alcohol intake (45 vs. 76%, p < 0.0001). Mean IMT was positively associated with age and low-density lipoprotein cholesterol concentration, and negatively with alcohol flushing according to stepwise multiple regression analysis. Alcohol flushing was also independently associated with mean IMT by multivariate analysis. CONCLUSIONS: These findings suggest that alcohol flushing is independently associated with lesser degree of carotid atherosclerosis in Japanese type 2 diabetic patients.