The Role of Obesity in the Association Between Alcohol Consumption and HDL‐c Levels: Baependi Heart Study

Cardiovascular diseases (CVD) are a leading cause of global mortality, with dyslipidemia playing a central role in their pathogenesis. The influence of alcohol consumption on lipid profiles, particularly high-density lipoprotein cholesterol (HDL-c), in relation to obesity status remains insufficiently explored. We evaluated the association between alcohol consumption and HDL-c levels in individuals with and without obesity in a Brazilian population. This cross-sectional analysis used data from the Baependi Heart Study, comprising 2345 participants aged 18-100 years. Alcohol intake was categorized according to weekly ethanol consumption, and HDL-c levels were measured through standard biochemical methods. No significant differences were observed across alcohol consumption groups for total cholesterol, LDL-c, triacylglycerols, and fasting glucose; however, the HDL-c/LDL-c ratio was significantly higher among male moderate consumers. A significant interaction was found between obesity and moderate alcohol consumption (β = 0.90, p = 0.015), indicating that the relationship between alcohol intake and low HDL-c varies according to obesity status. Moderate alcohol consumers exhibited significantly higher HDL-c levels compared to abstainers, an association observed exclusively among nonobese participants. In this group, moderate alcohol intake was linked to a 65% reduction in the odds of low HDL-c in women and a 66% reduction in men. No significant association was observed among individuals with obesity. Moderate alcohol consumption was associated with higher HDL-c levels and lower odds of low HDL-c, particularly among individuals without obesity. These findings contribute to the understanding of the complex interplay between alcohol intake, lipid metabolism, and adiposity.