Citation

Seyedsadjadi N, Ramchandani VA, Plawecki MH, Kosobud AEK, O'Connor S, Rowitz B, Pepino MY. Alcohol Clin. Exp. Res. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, John Wiley and Sons)

DOI

10.1111/acer.15047

PMID

36871954

Abstract

BACKGROUND: Understanding blood alcohol concentrations (BAC) achieved after drinking is critical to predicting alcohol exposure to the brain and other organs and alcohol effects. However, predicting such end-organ exposures is challenging, as there is a wide variation in BAC achieved after drinking a similar amount of alcohol. This variation is partly due to differences in body composition and alcohol elimination rates (AER), but there is limited data on how obesity affects AER. Here we assess associations between obesity, fat-free mass (FFM), and AER in women and determine whether bariatric surgeries, which are linked to increased risk for alcohol misuse, affect these associations.

METHODS: We conducted an analysis of data from three studies that used similar intravenous alcohol clamping procedures to estimate AER in 143 women (21-64 years old) with a wide range of body mass index (BMI; 18.5-48.4 kg/m(2) ). Body composition was measured in a subgroup using dual-energy X-ray absorptiometry (n=42) or Bioimpedance (n=60), and 19 of them underwent bariatric surgery 2.1 ± 0.3 years before participation. We analyzed data using multiple linear regression analyses.

RESULTS: Obesity and older age were associated with a faster AER (BMI: r(s) = 0.70 and age: r(s) = 0.61, both P< 0.001). Compared to women with normal weight, AER was 52% faster (95% Confidence Interval: 42-61%) in women with obesity. However, BMI lost predictive value when adding fat-free mass (FFM) to the regression model. Age, FFM, and its interaction explained 72% of individual variance in AER (F ((4, 97)) = 64.3, P < 0.001). AER was faster in women with higher FFM, particularly for women in the top tertile of age. After controlling for FFM and age, bariatric surgery was not associated with differences in AER (P= 0.74).

CONCLUSIONS: Obesity is associated with a faster AER, but this association is mediated by an obesity-related increase in FFM, particularly in older women. Previous findings of a reduced alcohol clearance post-bariatric surgery compared to pre-surgery are likely explained by a reduction in FFM post-surgery.

Language: en

Keywords

Alcohol Elimination Rate; Bariatric surgery; BMI; Fat-free mass; Obesity