Effect of moderate alcohol intake on blood apolipoproteins concentrations: A meta-analysis of human intervention studies

Aims: This study assessed the effect of alcohol intake (up to 40 g/d) on blood apolipoproteins (APOs) concentration in human intervention studies. Additionally, it evaluates whether the effect of alcohol intake on APOs differs depending on sex. Data synthesis: The literature search was performed in PubMed, Cochrane, Embase, and Web of Science databases. The Cochrane risk of bias tool was applied. A total of 5559 articles were identified, yielding 80 articles for full-text screening. Twenty-five articles were included for data extraction. Compared to no alcohol intake, alcohol intake up to a dose of 40 g/d showed an increase in Apolipoprotein A-I levels (ApoA-I) [mean difference (MD): 7.77 mg/dl, 95 % confidence interval (CI): 4.95 mg/dl, 10.59 mg/dl] and Apolipoprotein A-II levels (ApoA-II) [MD: 1.61 mg/dl, 95 % CI: 0.33 mg/dl, 2.90 mg/dl], but no significant change in Apolipoprotein B levels (ApoB) [MD: −0.06 mg/dl, 95 % CI: −3.38 mg/dl, 3.27 mg/dl]. Males showed a significant increase, while females showed a non-significant increase in ApoA-I levels [MD: 9.70 mg/dl, 95 % CI: 6.16 mg/dl, 13.28 mg/dl vs MD: 7.31 mg/dl, 95 % CI: −0.67 mg/dl, 15.30 mg/dl]. The results had less certainty as most studies were at high risk of bias. Conclusion: Alcohol consumption up to 40 g/d increases ApoA-I and ApoA-II levels. Further research is required for ApoB. Considerations should be given when applying this research to practice. High-quality clinical trials with large sample sizes and longer intervention periods are required, focusing on including female participants. PROSPERO IDCRD42021283256.