The progression of carotid-plaque volume in patients with type 2 diabetes is common. Previous observational studies showed an association between moderate alcohol and reduced risk of coronary disease. A group of researchers examined whether consuming moderate wine affects the progression of carotid atherosclerosis.
In the CASCADE (CArdiovaSCulAr Diabetes and Ethanol) 2-year randomised controlled trial, abstainers with type 2 diabetes were randomised to drink 150 ml of either red wine, white wine, or water, provided for 2 years. In addition, groups were guided to maintain a Mediterranean diet. 2-year changes in carotid total plaque volume (carotid-TPV) and carotid vessel wall volume (carotid-VWV were followed using three-dimensional ultrasound.
Carotid images were available from 174 of the 224 CASCADE participants (67% men; mean age = 59 yr; and mean hemoglobin A1c level = 6.8%). 45% had detectable plaque at baseline. After 2 years, no significant progression in carotid-TPV was observed (water, -1.4 (17.0) mm3, white-wine, -1.2 (16.9) mm3, red wine, -1.3 (17.6) mm3). In post hoc analysis, the 78 participants with detectable baseline carotid plaque were divided into tertiles. Those with the higher baseline plaque burden, whom were assigned to drink wine, reduced their plaque volume significantly after 2 years, compared to baseline. Two-year reductions in Apo(B)/Apo(A) ratio(s) were independently associated with regression in carotid- TPV (beta = 0.4; p < 0.001). Two-year decreases in systolic blood pressure were independently associated with regression in carotid-VWV (beta = 0.2; p = 0.005).
The researchers conclude that although overall no progression in carotid-TPV was observed. In subgroup analyses, those with the greatest plaque burden assigned to drink wine had a significant regression of plaque burden.
Source: Effect of wine on carotid atherosclerosis in type 2 diabetes: a 2-year randomized controlled trial. Golan R, Shai I, Gepner Y, Harman Boehm I, Schwarzfuchs D, Spence JD, Parraga G, et al. European Journal of Clinical Nutrition, published early online 29 January 2018. doi:10.1038/ s41430-018-0091-4