Associations Between Alcohol Consumption Patterns and Dyslipidemia Among Chinese Adults Aged 18 and Above: China Nutrition and Health Surveillance (2015–2017)

<b>Background/Objectives:</b> Alcohol consumption can increase the risk of dyslipidemia, thereby elevating the risk of cardiovascular diseases. However, the relationship between alcohol consumption patterns and dyslipidemia remains controversial. Based on large-scale cross-sectional data from the Chinese population, this study aims to investigate the correlations between various alcohol consumption behaviors and dyslipidemia among adult residents in China. <b>Methods</b>: Our analysis utilized data from the 2015-2017 China Nutrition and Health Surveillance project, which provides a large, nationally representative sample (<i>N</i> = 52,471). We employed a binary logistic regression model specifically designed for complex sampling frameworks. This model was utilized to assess the relationship between various alcohol consumption behaviors (including daily alcohol intake levels and drinking frequency) and the incidence of hypercholesterolemia, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol (low HDL-C), and elevated levels of low-density lipoprotein cholesterol (high LDL-C). Drinking behaviors were classified into three distinct categories for analysis: China classification (never, moderate, excessive), WHO classification (never, low-risk, medium-risk, high-risk), and drinking frequency (never, <1, 1-3, 4-6, ≥7 times/week). <b>Results</b>: Compared with never drinkers, the risk of hypercholesterolemia was significantly higher in men who were excessive drinkers (aOR = 1.39, 95%CI: 1.24-1.57), medium-risk drinkers (aOR = 1.24, 95%CI 1.01-1.53), high-risk drinkers (aOR = 1.67, 95%CI: 1.4-1.95), and those who drank more than once a week (aOR range: 1.27-1.65), and there was no such association in women (<i>p</i> > 0.05). Compared with never drinkers, the risk of hypertriglyceridemia was higher in male drinkers with excessive drinking (aOR = 1.35, 95%CI: 1.24-1.47), medium-risk drinking (aOR = 1.29, 95%: 1.11-1.50), high-risk drinking (aOR = 1.52, 95%CI: 1.3-1.71), and a drinking frequency more than 1 time/week (aOR range: 1.22-1.38), while in women, it was moderate drinking (aOR = 0.85, 95%CI 0.77-0.94), low-risk drinking (aOR = 0.86, 95%CI 0.78-0.94), and a drinking frequency of more than once a week (aOR = 0.74, 95%CI 0.63-0.87) that reduced the occurrence of hypertriglyceridemia. Compared with non-drinkers, men with any drinking status had a lower risk of low HDL-C (aOR range: 0.38-0.90) and a similar association was also observed in women (aOR range: 0.26-0.84). Compared with never drinkers, male excessive drinkers (aOR = 0.86, 95%CI: 0.77-0.97), medium-risk drinkers (aOR = 0.80, 95%CI:0.65-0.99), high-risk drinkers (aOR = 0.83, 95%CI: 0.70-0.97), and those with a drinking frequency of 1-3 times/week (aOR = 0.89, 95%: 0.79-0.99) had a lower risk of high LDL-C, and there was no such association in women (<i>p</i> > 0.05). <b>Conclusions</b>: Significant gender differences were observed in the effects of alcohol consumption on lipid profiles. Men who were excessive drinkers, medium-risk drinkers, high-risk drinkers, and those who drank more than once a week had a higher risk of hypercholesterolemia and hypertriglyceridemia, but a lower risk of low HDL-C and high LDL-C. In women, moderate drinking was associated with a reduced risk of hypertriglyceridemia. Any alcohol consumption and drinking frequency more than 1 time/week were associated with a lower risk of low HDL-C in women. No significant association was found between alcohol consumption and hypercholesterolemia or high LDL-C in women.