Relationship between heavy drinking, binge drinking, and metabolic syndrome in obese and non-obese Korean male adults

  • Oh, Jung Eun (Department of Family Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine)
  • Received : 2017.12.29
  • Accepted : 2018.03.02
  • Published : 2018.04.01


BACKGROUND/OBJECTIVES: Obesity and alcohol drinking are associated with metabolic syndrome. However, few studies show the relationship between alcohol drinking and metabolic syndrome according to varying degrees of obesity. This study aimed to determine the association between alcohol drinking and metabolic syndrome in obese and non-obese Korean male adults. SUBJECTS/METHODS: This cross-sectional study included 5,867 males aged ${\geq}20$ years who were examined at the Soonchunhyang University health promotion center during June 2008-December 2010. The subjects were divided into non-obese (body mass index [BMI] < $25kg/m^2$) and obese (BMI ${\geq}25kg/m^2$) groups and further divided according to weekly alcohol consumption into nondrinking (0 drinks/week), moderate drinking (${\leq}14$ drinks/week), and heavy drinking (> 14 drinks/week) groups. The subjects were also categorized into binge drinking and non-binge drinking groups. To obtain odds ratios (ORs) for metabolic syndrome, binary logistic regression analysis was performed. RESULTS: The overall metabolic syndrome prevalence was 27.3% (12.8%, non-obese group; 50.4%, obese group). After adjusting for age, physical activity, and smoking, in the non-obese group, the OR for heavy drinking with binge drinking (reference: nondrinking) was 1.56 (95% confidence interval [CI] = 1.12-2.18), with a significant increase in metabolic syndrome prevalence. In the obese group, the OR for heavy drinking with binge drinking was 1.42 (95% CI = 1.07-1.88), showing a significant increase in metabolic syndrome prevalence (P < 0.05). CONCLUSIONS: In both non-obese and obese Korean males, heavy drinking with binge drinking was associated with increased risk of metabolic syndrome. Thus, both non-obese and obese males should restrict their alcohol intake and not indulge in binge drinking.


Supported by : Soonchunhyang University


  1. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis 2014;11:E109.
  2. World Health Organization. Global status report on alcohol and health 2014 [Internet]. Geneva: World Health Organization; 2014 [cited 2017 August 15]. Available from:
  3. Sun K, Ren M, Liu D, Wang C, Yang C, Yan L. Alcohol consumption and risk of metabolic syndrome: a meta-analysis of prospective studies. Clin Nutr 2014;33:596-602.
  4. Yoon YS, Oh SW, Baik HW, Park HS, Kim WY. Alcohol consumption and the metabolic syndrome in Korean adults: the 1998 Korean National Health and Nutrition Examination Survey. Am J Clin Nutr 2004;80:217-24.
  5. Ford ES. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care 2005;28:1769-78.
  6. Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005;112:3066-72.
  7. Cameron AJ, Boyko EJ, Sicree RA, Zimmet PZ, Soderberg S, Alberti KG, Tuomilehto J, Chitson P, Shaw JE. Central obesity as a precursor to the metabolic syndrome in the AusDiab study and Mauritius. Obesity (Silver Spring) 2008;16:2707-16.
  8. Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, Shofer JB, Fish BE, Knopp RH, Kahn SE. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53:2087-94.
  9. Ferrannini E, Haffner SM, Mitchell BD, Stern MP. Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia 1991;34:416-22.
  10. Junyent M, Arnett DK, Tsai MY, Kabagambe EK, Straka RJ, Province M, An P, Lai CQ, Parnell LD, Shen J, Lee YC, Borecki I, Ordovas JM. Genetic variants at the PDZ-interacting domain of the scavenger receptor class B type I interact with diet to influence the risk of metabolic syndrome in obese men and women. J Nutr 2009;139:842-8.
  11. Razzouk L, Muntner P. Ethnic, gender, and age-related differences in patients with the metabolic syndrome. Curr Hypertens Rep 2009;11:127-32.
  12. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003;163:427-36.
  13. Korean Statistical Information Service. Statistical database for metabolic syndrome [Internet]. Daejeon: Statistics Korea; year [cited 2018 January 11]. Available from:
  14. Posey D, Mozayani A. The estimation of blood alcohol concentration: Widmark revisited. Forensic Sci Med Pathol 2007;3:33-9.
  15. Fan AZ, Russell M, Naimi T, Li Y, Liao Y, Jiles R, Mokdad AH. Patterns of alcohol consumption and the metabolic syndrome. J Clin Endocrinol Metab 2008;93:3833-8.
  16. Santos AC, Ebrahim S, Barros H. Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome. Prev Med 2007;44:328-34.
  17. U.S. Department of Health and Human Services; U.S. Department of Agriculture. 2015-2020 Dietary guidelines for Americans. 8th ed [Internet]. Washington, D.C.: U.S. Department of Agriculture; 2015 [cited 2016 February 3]. Available from:
  18. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.
  19. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007;75:72-80.
  20. Freiberg MS, Cabral HJ, Heeren TC, Vasan RS, Ellison RC. Alcohol consumption and the prevalence of the metabolic syndrome in the U.S.: a cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27:2954-9.
  21. Kim BJ, Kim BS, Kang JH. Alcohol consumption and incidence of metabolic syndrome in Korean men. A 3-year follow-up study. Circ J 2012;76:2363-71.
  22. Wakabayashi I. Relationship between alcohol consumption and metabolic syndrome in Japanese men with overweight or obesity. Obes Res Clin Pract 2011;5:e79-156.
  23. Lee K. Gender-specific relationships between alcohol drinking patterns and metabolic syndrome: the Korea National Health and Nutrition Examination Survey 2008. Public Health Nutr 2012;15:1917-24.
  24. Im HJ, Park SM, Choi JH, Choi EJ. Binge drinking and its relation to metabolic syndrome in Korean adult men. Korean J Fam Med 2014;35:173-81.
  25. Suter PM, Tremblay A. Is alcohol consumption a risk factor for weight gain and obesity? Crit Rev Clin Lab Sci 2005;42:197-227.
  26. Stokes PE. Adrenocortical activation in alcoholics during chronic drinking. Ann N Y Acad Sci 1973;215:77-83.
  27. Bjorntorp P. Obesity. Lancet 1997;350:423-6.
  28. Klatsky AL. Alcohol and hypertension. Clin Chim Acta 1996;246:91-105.
  29. Lindtner C, Scherer T, Zielinski E, Filatova N, Fasshauer M, Tonks NK, Puchowicz M, Buettner C. Binge drinking induces whole-body insulin resistance by impairing hypothalamic insulin action. Sci Transl Med 2013;5:170ra14.
  30. Shelmet JJ, Reichard GA, Skutches CL, Hoeldtke RD, Owen OE, Boden G. Ethanol causes acute inhibition of carbohydrate, fat, and protein oxidation and insulin resistance. J Clin Invest 1988;81:1137-45.
  31. Castelli WP, Doyle JT, Gordon T, Hames CG, Hjortland MC, Hulley SB, Kagan A, Zukel WJ. Alcohol and blood lipids. The cooperative lipoprotein phenotyping study. Lancet 1977;2:153-5.
  32. Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: metaanalysis of effects on lipids and haemostatic factors. BMJ 1999;319:1523-8.
  33. Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829-34.
  34. Savolainen MJ, Kesaniemi YA. Effects of alcohol on lipoproteins in relation to coronary heart disease. Curr Opin Lipidol 1995;6:24350.
  35. Hannuksela M, Marcel YL, Kesaniemi YA, Savolainen MJ. Reduction in the concentration and activity of plasma cholesteryl ester transfer protein by alcohol. J Lipid Res 1992;33:737-44.