Obesity and alcohol drinking are associated with metabolic syndrome. However, few studies show the relationship between alcohol drinking and metabolic syndrome according to varying degrees of obesity. This study aimed to determine the association between alcohol drinking and metabolic syndrome in obese and non-obese Korean male adults.

This cross-sectional study included 5,867 males aged ≥ 20 years who were examined at the Soonchunhyang University health promotion center during June 2008–December 2010. The subjects were divided into non-obese (body mass index [BMI] < 25 kg/m²) and obese (BMI ≥ 25 kg/m²) groups and further divided according to weekly alcohol consumption into nondrinking (0 drinks/week), moderate drinking (≤ 14 drinks/week), and heavy drinking (> 14 drinks/week) groups. The subjects were also categorized into binge drinking and non-binge drinking groups. To obtain odds ratios (ORs) for metabolic syndrome, binary logistic regression analysis was performed.

The overall metabolic syndrome prevalence was 27.3% (12.8%, non-obese group; 50.4%, obese group). After adjusting for age, physical activity, and smoking, in the non-obese group, the OR for heavy drinking with binge drinking (reference: nondrinking) was 1.56 (95% confidence interval [CI] = 1.12–2.18), with a significant increase in metabolic syndrome prevalence. In the obese group, the OR for heavy drinking with binge drinking was 1.42 (95% CI = 1.07–1.88), showing a significant increase in metabolic syndrome prevalence ( P < 0.05).

In both non-obese and obese Korean males, heavy drinking with binge drinking was associated with increased risk of metabolic syndrome. Thus, both non-obese and obese males should restrict their alcohol intake and not indulge in binge drinking.