Alcohol Consumption Patterns and Growth Differentiation Factor 15 Among Life-Time Drinkers Aged 65+ Years in Spain: A Cross-Sectional Study
Abstract
Aims
To examine the association of alcohol consumption patterns with growth differentiation factor 15 (GDF-15) in older alcohol users, separately among individuals with cardiovascular disease (CVD)/diabetes and those without them, as GDF-15 is a strong biomarker of chronic disease burden.
Design
Cross-sectional study.
Setting
Population-based study in Madrid (Spain).
Participants
A total of 2051 lifetime alcohol users aged 65+ years were included in the Seniors-ENRICA-2 study in 2015–17. Participants’ mean age was 71.4 years and 55.4% were men.
Measurements
According to their average lifetime alcohol intake, participants were classified as occasional (≤ 1.43 g/day), low-risk (men: > 1.43–20 g/day; women: > 1.43–10 g/day), moderate-risk (men: > 20–40 g/day; women: > 10–20 g/day) and high-risk alcohol users (men: > 40 g/day; women: > 20 g/day; or binge alcohol users). The study also ascertained wine preference (> 80% of alcohol derived from wine), alcohol use with meals, and adherence to a Mediterranean alcohol use pattern (MDP) defined as low-risk alcohol use, wine preference, and one of the following: alcohol use only with meals; higher adherence to the Mediterranean diet; or any of these.
Findings
In participants without CVD/diabetes, GDF-15 increased by 0.27% [95% confidence interval (CI) = 0.06%, 0.48%] per 1 g/day increment in alcohol among high-risk alcohol users, but there was no clear evidence of association in those with lower intakes or in the overall group, or across categories of alcohol consumption status. Conversely, among those with CVD/diabetes, GDF-15 rose by 0.19% (95% CI = 0.05%, 0.33%) per 1 g/day increment in the overall group and GDF-15 was 26.89% (95% CI = 12.93%, 42.58%) higher in high-risk versus low-risk alcohol users. Alcohol use with meals did not appear to be related to GDF-15, but among those without CVD/diabetes, wine preference and adherence to the MDP were associated with lower GDF-15, especially when combined with high adherence to the Mediterranean diet.
Conclusions
Among older lifetime alcohol users in Madrid, Spain, high-risk alcohol use was positively associated with growth differentiation factor 15 (a biomarker of chronic disease burden). There was inconclusive evidence of a beneficial association for low-risk consumption.