Influence of the Flushing Response in the Relationship between Alcohol Consumption and Cardiovascular Disease Risk

Hae Sun Suh,김종성,Sung Soo Kim,Jin Gyu Jung,Seok Jun Yoon,Jae Bum Ahn 대한가정의학회 2014 Korean Journal of Family Medicine Vol.35 No.6

Background: The purpose of this study was to examine the relationship between cardiovascular disease risk and alcohol consumption according to facial flushing after drinking among Korean men. Methods: The subjects were 1,817 Korean men (non-drinker group, 283 men; drinking-related facial flushing group, 662 men; non-flushing group, 872 men) >30 years who had undergone comprehensive health examinations at the health promotion center of a Chungnam National University Hospital between 2007 and 2009. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. Cardiovascular disease risk was investigated based on the 2008 Framingham Heart Study. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and cardiovascular disease risk within 10 years for the flushing and non-flushing groups, with adjustment for confounding factors such as body mass index, diastolic blood pressure, low density lipoprotein cholesterol, triglycerides, and exercise patterns. Results: Individuals in the non-flushing group with alcohol consumption of ≤4 standard drinks (1 standard drink = 14 g of alcohol) per week had significantly lower moderate or high cardiovascular disease risk than individuals in the nondrinker group (adjusted odds ratio, 0.51; 95% confidence interval, 0.37 to 0.71). However, no significant relationship between the drinking amount and cardiovascular disease risk was observed in the flushing group. Conclusion: Cardiovascular disease risk is likely lowered by alcohol consumption among non-flushers, and the relationship between the drinking amount and cardiovascular disease risk may differ according to facial flushing after drinking, representing an individual’s vulnerability.

Relationship Between Alcohol Consumption and Prostatic Hyperplasia According to Facial Flushing After Drinking in Korean Men

장학선,김종성,김성수,정진규,윤석준,양현주,정현철 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.2

Background: The purpose of this study was to examine whether facial flushing after drinking influences the rela-tionship between alcohol consumption and prostatic hyperplasia among Korean men.Methods: The subjects were 957 Korean men (180 non-drinkers, 389 with drinking-related facial flushing, 388 without facial flushing) in the 40–69 age group, who underwent prostate ultrasound at the health promotion center of Chungnam National University Hospital between 2008 and 2014. Alcohol consumption and alcohol-related fa-cial flushing were assessed through a questionnaire. In terms of the amount consumed, 14 g of alcohol was consid-ered a standard drink. With the non-drinker group as reference, logistic regression was used to analyze the relation-ship between weekly alcohol intake and prostatic hyperplasia in the flushing and non-flushing groups, with adjust-ment for confounding factors such as age, body mass index, smoking, and exercise patterns.Results: Individuals aged 50–59 years who experienced drinking-related facial flushing had a significantly lower risk of prostatic hyperplasia than the non-drinker group, depending on alcohol consumption: ≤4 standard drinks (adjusted odds ratio [OR], 0.38; 95% confidence interval [CI], 0.16 to 0.86); >4 ≤8 standard drinks (OR, 0.35; 95% CI, 0.13 to 0.95); >8 standard drinks (OR, 0.33; 95% CI, 0.13 to 0.84). However, no significant relationship was observed between the number of drinks consumed and the risk of prostate hyperplasia in the non-flushing group.Conclusion: The risk of prostatic hyperplasia appears to be reduced by alcohol consumption among Korean men aged 50–59 years who exhibit drinking-related facial flushing.

Relationships between the Level of Alcohol Consumption and Abnormality in Biomarkers According to Facial Flushing in Korean Male Drinkers

김성구,김종성,김성수,정진규,윤석준,김어진 대한가정의학회 2013 Korean Journal of Family Medicine Vol.34 No.2

Background: This research investigated the association between facial flushing after drinking and alcohol-induced biomarker abnormalities. Methods: This retrospective study included 374 male drinkers who visited the department of Family Medicine of Chungnam National University Hospital between January and December of 2010. The participants were classified into two groups: the flushing group (n = 107) and the non-flushing group (n = 267). The biomarkers assessed were %carbohydrate-deficient transferrin (CDT) and gamma glutamyl transferase (rGTP). The upper limits of %CDT and rGTP were set as 2.47 and 50, respectively. The receiver operating characteristic (ROC) curve was used to obtain the cut-off value for the amount of drinking that caused abnormal %CDT and rGTP levels in the two groups. The sensitivity and specificity of the cut-off drinking amount for %CDT and rGTP abnormalities were analyzed in each group. Results: In the flushing group, the cut-off value for alcohol-induced %CDT abnormality was 3.38 drinks (1 drink: 14 g of alcohol) per week, with sensitivity of 77.8% and specificity of 70.4%. In the non-flushing group, the cut-off value was 11.25 drinks per week, with sensitivity of 62.2% and specificity of 69.6%. The cut-off value for the amount of alcohol that induced rGTP abnormality was 3.38 drinks per week in the flushing group, with sensitivity of 68.0% and specificity of 76.8%, whereas it was 8.75 drinks in the non-flushing group, with sensitivity of 71.1% and specificity of 66.7%. The area under the ROC of the drinking level was 0.726 in the flushing group and 0.684 in the non-flushing group for %CDT. For rGTP, the value was 0.738 in the flushing group and 0.718 in the non-flushing group. Conclusion: The weekly drinking amount required to induce biomarker abnormalities was lower in the flushers than in the non-flushers.

Relationship between Alcohol Consumption and Metabolic Syndrome according to Facial Flushing in Korean Males

김민영,김성수,김종성,정진규,권보라,유영일,김기석 대한가정의학회 2012 Korean Journal of Family Medicine Vol.33 No.4

Background: The aim of the present study is to evaluate the risk of metabolic syndrome (MS) according to alcohol consumption for those subjects showing facial flushing, as well as the absence of facial flushing. Methods: One thousand two hundred and one males were recruited in the health promotion center of a university hospital. Evaluation of alcohol consumption and facial flushing was assessed via questionnaires and interviews. The criteria for MS were defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria with a modified waist circumference cutoff value (men ≥ 90 cm) for Korean subjects. Subjects were divided into three groups according to the amount of alcohol they consume: nondrinkers, moderate drinkers (≤14 standard drinks per week), and heavy drinkers (>14 standard drinks per week). They were also separated into two groups according to facial flushing:non-flushers (no occurrence) and flushers (steady occurrence). Factors related to MS were assessed by logistic regression analysis. Results: In non-flushing moderate drinkers, the risk of MS did not significantly increase compared to non-drinkers. However in flushing moderate drinkers, there was significant increase (odds ratio [OR], 1.81; confidence interval [CI], 1.08to 3.06) compared to non-drinkers. In non-flushing and flushing heavy drinkers, significant increase (OR, 2.23; CI, 1.23 to 4.04; OR, 2.90; CI, 1.25 to 6.73, respectively) was evident compared to non-drinkers. Conclusion: Non-flushing moderate drinkers did not show an increased risk of metabolic syndrome compared to the nondrinkers,but flushing moderate drinkers showed an increased risk of metabolic syndrome compared to non-drinkers.

Effect of Alcohol Consumption on Risk of Hyperhomocysteinemia Based on Alcohol-Related Facial Flushing Response

김어진,김종성,정진규,김성수,윤석준,유정선 대한가정의학회 2013 Korean Journal of Family Medicine Vol.34 No.4

Background: This study examined the relationship between alcohol consumption and hyperhomocysteinemia based on facial flushing caused by drinking. Methods: Among male patients aged ≥ 18 years who visited Health Promotion Center of Chungnam National University Hospital in Daejeon from January 2008 to December 2010, 948 males (182 nondrinkers, 348 subjects with drinking-related facial flushing, and 418 subjects without drinking-related facial flushing) were selected. After adjusting for confounding factors such as age, body mass index, hypertension, diabetes, smoking, triglycerides, high density lipoprotein cholesterol,and gamma-glutamyl transpeptidase, a multiple logistic regression analysis was performed to assess the risk of hyperhomocysteinemia in the nonfacial flushing and facial flushing groups compared with the nondrinkers. Results: After adjusting for confounding factors, risk of hyperhomocysteinemia was significantly lower in the group with a weekly alcohol consumption of < 8 standard drinks (1 drink = 14 g alcohol) in the nonfacial flushing group (<4 drinks:odds ratio [OR], 0.27; 95% confidence interval [CI], 0.10 to 0.74; 4≤, <8 drinks: OR, 0.21; 95% CI, 0.06 to 0.73). Risk of hyperhomocysteinemia was significantly lower in the group with a weekly alcohol consumption < 4 drinks in the facial flushing group (OR, 0.30; 95% CI, 0.13 to 0.68). Conclusion: Our results suggest that the risk of hyperhomocysteinemia is likely lowered by alcohol consumption based on drinking quantity, as lowering the risk of hyperhomocysteinemia differs depending on vulnerability associated with facial flushing.

대학생들의 홍조반응과 알코올 사용의 관계에 관한 연구

장승옥 한국 정신보건 사회사업학회 1998 정신보건과 사회사업 Vol.5 No.-

The association of flushing with the alcohol use of Korean college students is examined. The physiological explanation has attributed the light alcohol use among Asians to their high propensity to flush, which protects them from heavy drinking. Facial flushing after drinking was used as the primary indicator of the flushing responses. The subjects were 329 college students in Taegu area. Female students drank less than male students and the effect of the flushing response had less impact on alcohol intake among men than among women. Although typical flushers drank less than nonflushers, the majority of drinkers were able to continue drinking despite having flushing. More female drinkers reported embarrassment than male students because of flushing. This study of female drinkers showed that flushing response may protect them from heavy drinking but the relationship among male drinkers was less pronounced. The results of this study indicated that the socio-cultural factors appeared to have a moderating effect on the relationship between the flushing response and alcohol use.

Association between Alcohol Consumption and Metabolic Syndrome Determined by Facial Flushing in Korean Women

Yu Ri Seo,Jong Sung Kim,Sung Soo Kim,Jin Gyu Jung,Seok-Jun Yoon 대한가정의학회 2021 Korean Journal of Family Medicine Vol.42 No.1

Background: This study aimed to examine the relationship between alcohol consumption and metabolic syndrome in Korean women as determined by facial flushing. Methods: Of the female patients aged <65 years who visited the health promotion center at Chungnam National University Hospital from January 2016 to March 2017, 1,344 women were included. After adjusting for confounding factors such as age, body mass index, smoking, exercise, and menopausal status, multiple logistic regression analysis was performed to assess the association between alcohol consumption and the risk of metabolic syndrome in the facial flushing and non-facial flushing groups compared with the non-drinkers. Results: Even after adjusting for confounding factors, the risk of metabolic syndrome was significantly high in all drinking subgroups (≤2 standard drinks: odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10–2.68; 2<, ≤4 standard drinks: OR, 2.48; 95% CI, 1.29–4.74; and >4 standard drinks: OR, 4.16; 95% CI, 2.03–8.30) of the facial flushing group. The risk of metabolic syndrome was significantly high only in the subgroup of weekly alcohol consumption >4 standard drinks (OR, 2.20; 95% CI, 1.07–4.52) in the non-facial flushing group. Conclusion: This study suggests that Korean women experiencing facial flushing when drinking have a higher risk of developing metabolic syndrome even with a low weekly drinking amount than those who do not experience face flushing.

Influence of Facial Flushing on Pre- or Type 2 Diabetes Risk according to Alcohol Consumption in Korean Male

Ji-Han Kim,Jong-Sung Kim,Sung-Soo Kim,정진규,윤석준,서유리,Sa-Mi Lee,Yoon-Kyung Bae,Won-Jin Lee 대한가정의학회 2020 Korean Journal of Family Medicine Vol.41 No.3

Background: This study aims to examine the association between alcohol consumption and the risk of pre- or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI). Methods: This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre- or T2DM. Results: In both the normal-weight group (BMI <23 kg/m2) and the overweight group (BMI ≥23 kg/m2 and <25 kg/ m2), the flushers had a higher risk of pre- or T2DM (odds ratio, 95% confidence interval) when consuming more than 8 drinks of alcohol per week than the non-drinkers (normal-weight group: 3.43, 1.06–11.07; overweight group: 4.94, 1.56–15.67). But in the non-flushers among the normal-weight group and the overweight group, there was no significant difference compared to non-drinkers regarding the risk of pre- or T2DM. Obese flushers had a significantly higher risk of pre- or T2DM when consuming more than 4 drinks of alcohol per week than the non-drinkers (>4 and ≤8 drinks: 2.64, 1.10–6.36; >8 drinks: 2.42, 1.11–5.27). However, obese non-flushers had only a significant higher risk of pre- or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39–5.30) Conclusion: These results suggest that obese flushers have an increased risk of developing pre- or T2DM even with less alcohol consumption.

Current Status of Korean Alcohol Drinking in Accordance with the Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing

Sami Lee,Jihan Kim,Jong Sung Kim 대한가정의학회 2023 Korean Journal of Family Medicine Vol.44 No.3

Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans’ alcohol metabolism capabilities that can be predicted by presence of facial flush-ing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups ac-cording to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.

음주연관 안면홍조에 따른 혈중 요산과 호모시스테인 농도 관계의 변화

김어진,김종성,어원철,최수영,이선경,정복선 대한임상건강증진학회 2015 Korean Journal of Health Promotion Vol.15 No.3

Background: This study aimed to determine the correlation between blood uric acid and homocysteine levels, based on alcohol-related facial flushing. Methods: Among male adults who visited a health examination center of a university hospital located in Daejeon, Korea, for a personal health examination from March 2013 to February 2014, 702 subjects were analyzed including 401 subjects without alcohol-related facial flushing and 301 with facial flushing. Pearson’s correlation and stepwise multivariate linear regression analyses were performed between the log homocysteine levels and other variables including uric acid. Results: Uric acid showed a significant positive correlation with log homocysteine (γ=0.166, P=0.001) (ß=0.176; P=0.001) in the non-flushing group. In contrast, none of the variables showed any significant correlations with log homocysteine in the flushing group. Conclusions: Alcohol users not exhibiting alcohol-related facial flushing showed a positive correlation between uric acid and homocysteine levels, whereas those without facial flushing showed no such correlation. 연구배경: 본 연구는 음주연관 안면 홍조 여부에 따라 혈중 요산과 호모시스테인 농도의 연관 관계가 다른지를 분석하였다. 방법: 2013년 3월부터 2014년 2월까지 대전의 한 대학병원에 건강검진을 목적으로 내원한 성인 남성 중 702명(비안면홍조자 401명, 홍조자 301명)을 대상으로 하였다. 비안면홍조자 그룹과 안면 홍조자 그룹에서 로그 호모시스테인과 요산을 포함한 다른 변수들과의 관계를 Pearson’s correlation과 stepwise multivariate linear regression analyses로분석하였다. 결과: 비안면홍조군에서 혈중 요산 농도와 로그 호모시스테인은 유의한 양의 연관관계를 보였다(γ=0.166, P=0.001) (ß=0.176; P=0.001). 하지만 홍조군에서는 어느 변수도 로그호모시스테인과 유의한 연관관계를 보이지 않았다. 결론: 음주관련 안면홍조가 없는 음주자의 경우 혈중 요산과 호모시스테인 농도의 연관관계는 양의 연관관계를보이지만, 음주관련 안면홍조가 있는 경우에는 연관관계를 보이지 않는다고 판단된다.