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The J-shape association of ethanol intake with total homocysteine concentrations: the ATTICA study

Christos Pitsavos1, Demosthenes B Panagiotakos2*, Meropi D Kontogianni2, Christina Chrysohoou1, Yannis Chloptsios3, Antonis Zampelas2, Antonia Trichopoulou3 and Christodoulos Stefanadis1

Author Affiliations

1 First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

2 Department of Dietetics and Nutrition, Harokopio University, Athens, Greece

3 Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Athens, Greece

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Nutrition & Metabolism 2004, 1:9  doi:10.1186/1743-7075-1-9

Published: 14 October 2004



Epidemiological studies suggest a non-monotonic effect of alcohol consumption on cardiovascular risk, while there is strong evidence concerning the involvement of homocysteine levels on thrombosis. The aim of this work was to evaluate the association between usual ethanol consumption and homocysteine levels, in cardiovascular disease free adults.


From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 women, without any evidence of cardiovascular disease, stratified by age – gender (census 2001), from the greater area of Athens, Greece. Among the variables ascertained we measured the daily ethanol consumption and plasma homocysteine concentrations.


Data analysis revealed a J-shape association between ethanol intake (none, <12 gr, 12 – 24 gr, 25 – 48 gr, >48 gr per day) and total homocysteine levels (mean ± standard deviation) among males (13 ± 3 vs. 11 ± 3 vs. 14 ± 4 vs. 18 ± 5 vs. 19 ± 3 μmol/L, respectively, p < 0.01) and females (10 ± 4 vs. 9 ± 3 vs. 11 ± 3 vs. 15 ± 4 vs. 17 ± 3 μmol/L, respectively, p < 0.01), after controlling for several potential confounders. The lowest homocysteine concentrations were observed with ethanol intake of < 12 gr/day (Bonferroni α* < 0.05). No differences were observed when we stratified our analysis by type of alcoholic beverage consumed.


We observed a J-shape relationship between homocysteine concentrations and the amount of ethanol usually consumed.

ethanol; homocysteine; inflammation