Association between alcohol consumption and ectopic fat among adults of the Multi-Ethnic Study of Atherosclerosis

Authors: KAZIBWE, RICHARD - Wake Forest School Of Medicine; CHEVLI, PARAG - Wake Forest School Of Medicine; EVANS, JONI - Wake Forest School Of Medicine; ALLISON, MATTHEW - University Of California, San Diego; MICHOS, ERIN - Johns Hopkins University School Of Medicine; WOOD, ALEXIS - Children'S Nutrition Research Center (CNRC); DING, JINGZHONG - Wake Forest School Of Medicine; SHAPIRO, MICHAEL - Wake Forest School Of Medicine; MONGRAW-CHAFFIN, MORGANA - Wake Forest School Of Medicine

Submitted to: Journal of the American Heart Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/11/2023
Publication Date: 9/8/2023
Citation: Kazibwe, R., Chevli, P.A., Evans, J.K., Allison, M.A., Michos, E.D., Wood, A.C., Ding, J., Shapiro, M.D., Mongraw-Chaffin, M. 2023. Association between alcohol consumption and ectopic fat among adults of the Multi-Ethnic Study of Atherosclerosis. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.123.030470.
DOI: https://doi.org/10.1161/JAHA.123.030470

Interpretive Summary: Ectopic fat is when fats such as triglycerides are stored outside of our fat cells, for example, the liver and heart. High amounts of ectopic fat have been associated with an increased risk for cardiovascular disease. High alcohol intake is known to contribute to overall fat levels, and the goal of this study was to examine whether alcohol intake also contributes to ectopic fat. In our analyses, low to moderate amounts of daily alcohol intake (1-2 drinks per day) was not associated with ectopic fat, but heavy daily drinking (more than 2 drinks a day, on average) was associated with 15% higher amounts of ectopic fat compared to lifetime abstainers. Future studies will investigate the role that ectopic fat plays in cardiovascular disease.

Technical Abstract: The relationship between alcohol consumption and ectopic fat distribution, both known factors for cardiovascular disease, remains understudied. Therefore, we aimed to examine the association between alcohol consumption and ectopic adiposity in adults at risk for cardiovascular disease. In this cross-sectional analysis, we categorized alcohol intake among participants in MESA (Multi-Ethnic Study of Atherosclerosis) as follows (drinks/day): <1 (light drinking), 1 to 2 (moderate drinking), >2 (heavy drinking), former drinking, and lifetime abstention. Binge drinking was defined as consuming >=5 drinks on 1 occasion in the past month. Visceral, subcutaneous, and intermuscular fat area, pericardial fat volume, and hepatic fat attenuation were measured using noncontrast computed tomography. Using multivariable linear regression, we examined the associations between categories of alcohol consumption and natural log-transformed fat in ectopic depots. We included 6756 MESA participants (62.1+/-10.2 years; 47.2% women), of whom 6734 and 1934 had chest computed tomography (pericardial and hepatic fat) and abdominal computed tomography (subcutaneous, intermuscular, and visceral fat), respectively. In adjusted analysis, heavy drinking, relative to lifetime abstention, was associated with a higher (relative percent difference) pericardial 15.1 [95% CI, 7.1–27.7], hepatic 3.4 [95% CI, 0.1–6.8], visceral 2.5 [95% CI, -10.4 to 17.2], and intermuscular 5.2 [95% CI, -6.6 to 18.4] fat but lower subcutaneous fat -3.5 [95% CI, -15.5 to 10.2]). The associations between alcohol consumption and ectopic adiposity exhibited a J-shaped pattern. Binge drinking, relative to light-to-moderate drinking, was also associated with higher ectopic fat. Alcohol consumption had a J-shaped association with ectopic adiposity. Both heavy alcohol intake and binge alcohol drinking were associated with higher ectopic fat.