Drinking, Atherosclerotic Risk, and Flushing in Asians With Diabetes

The relationship between alcohol use and atherosclerotic risk may differ between Asians with and without a high sensitivity to alcohol. In this cross-sectional study, researchers assessed alcohol use, atherosclerotic risk factors, and flushing (a marker for alcohol sensitivity) in 225 Asian adults with type 2 diabetes. Analyses were adjusted for potential confounders (e.g., age, treatment for hypertension).

  • Forty-four percent of subjects did not drink alcohol; 19% drank moderately, and 37% drank heavier amounts.*
  • Thirty percent of subjects were nonflushers, and 56% were “always” flushers (occasional flushers were excluded from analyses). Nonflushers reported a higher mean alcohol intake than “always” flushers (approximately 25 versus 8 drinks per week).
  • Among nonflushers, drinking did not affect blood pressure, total cholesterol, or high-density lipoprotein (HDL) cholesterol.
  • Among “always” flushers, those who drank heavier amounts had higher diastolic blood pressure and HDL cholesterol than did nondrinkers, and higher systolic blood pressure than did both nondrinkers and moderate drinkers. Total cholesterol did not differ across drinking categories.
  • Drinking did not affect other risk factors (e.g., fibrinogen, uric acid, HBA1c) in nonflushers and “always” flushers.


In this study, Asians with diabetes who flush in response to alcohol but who still averaged >1 drinks per day had higher blood pressure and HDL cholesterol than did flushers who abstained. The significance of these findings is uncertain because the study’s design was cross-sectional. Further, the main outcomes associated with heavier drinking have opposite effects on atherosclerotic risk (i.e., higher blood pressure confers a greater risk and higher HDL cholesterol confers less risk).

Kevin L. Kraemer, MD, MSc

*Moderate amounts: approximately <11 drinks per week; heavier amounts: approximately >11 drinks per week


Wakabayashi I, Masuda H. Influence of drinking alcohol on atherosclerotic risk in alcohol flushers and non-flushers of oriental patients with type 2 diabetes mellitus. Alcohol Alcohol. 2006;41(6):672–677.

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