My colleagues and I thank Mascitelli and Pezzetta for their comments regarding our article and drawing our attention to the possible role of anti-inflammatory action in the alcohol-diabetes relationship. It is true that we did not mention anti-inflammatory properties as a possible mechanism. We had focused on the more well-established factors related to alcohol and diabetes. It is only in recent years that CRP has emerged as a predictor of type 2 diabetes mellitus. The authors quote references that have observed an independent relationship between CRP and diabetes. However, several studies have not shown CRP to be significantly predictive of diabetes after allowing for obesity or body fat or have only shown CRP to be predictive in women but not men.1- 3 Thus, the role inflammation may play in diabetes is still unclear. Furthermore, some studies have not observed significant relationships between total alcohol consumption and CRP.4,5 We have recently examined total alcohol intake and CRP in a large cohort of men and did not find light to moderate drinking overall to be associated with lower CRP level. However, wine drinking specifically was associated with lower CRP level.5 It remains possible that an anti-inflammatory action of alcohol may be one of the mechanisms by which light to moderate drinking is associated with lower risk of diabetes. But from the current evidence it would seem unlikely that the anti-inflammatory action of alcohol will be a major factor explaining the link between light to moderate drinking and type 2 diabetes mellitus, which is seen in both wine and beer drinkers.
Wannamethee SG. Anti-Inflammatory Action of Alcohol and Risk of Type 2 Diabetes Mellitus—Reply. Arch Intern Med. 2004;164(5):570-571. doi:10.1001/archinte.164.5.572-b