Ethanol induces a paradoxical simultaneous increase in circulating concentrations of insulin-like growth factor binding protein-1 and insulin.

The aim of this study was to examine the effect of acute alcohol intake on circulating concentrations of insulin, C-peptide, insulin-like growth factor (IGF) binding protein-1 (IGFBP-1), and plasma glucose levels. We measured these parameters for 12 hours after administration of 0, 0.5, or 1.0 g ethanol/kg body weight to nine healthy volunteers between 7:00 and 7:45 PM according to a randomized, double-blind, crossover design. Following a snack at 9:00 PM, plasma insulin (P < .05) and C-peptide (P < .01) concentrations were significantly increased at 10:00 PM in the 1.0-g group as compared with the control group. C-peptide to insulin molar ratios were significantly higher (P < .05) in both ethanol groups at 10:00 PM and 2:00 AM than in the control group. No differences were observed in plasma glucose levels between the three groups. Plasma IGFBP-1 levels showed a dose-dependent increase in the ethanol groups, and remained increased from 10:00 PM for 3 hours (P < .05 or less) at the lower dose and for 6 hours (P < .05 or less) at the higher dose. These observations indicate that ethanol-induced postprandial hyperinsulinemia is due to increased insulin secretion and that alcohol may increase hepatic insulin extraction. The lack of any effect on plasma glucose levels suggests that alcohol intake must be associated with decreased insulin sensitivity. Alcohol intake results in a paradoxical increase in peripheral concentrations of IGFBP-1 despite simultaneous hyperinsulinemia. This implies that ethanol has a direct stimulatory effect on hepatic IGFBP-1 synthesis.