Aims: To assess the association of alcohol intake with high-sensitivity C-reactive protein (hs-CRP), uric acid and leukocyte count in blood, and whether sex and body mass index (BMI) modify these associations.

Methods: Individuals aged ≥18 years were randomly selected from the population of Porto, Portugal (70% of participation). A total of 840 women and 490 men with reliable information on inflammatory markers and alcohol intake, obtained from a validated food frequency questionnaire, were studied. Associations and their respective trends were estimated from generalized linear models, with adjustment for potential confounders. Analyses were stratified by sex and BMI.

Results: In women, adjusted hs-CRP levels (mg/l) were 2.69 in non-drinkers, 2.25 in drinkers of >0–15 g alcohol/day, 2.32 in drinkers of >15–30 g alcohol/day and 3.18 in drinkers of >30 g alcohol/day (P-value for the quadratic trend <0.001). In men, the association between alcohol intake and hs-CRP was positive and linear (P-value for the linear trend = 0.014). Alcohol intake was also positively and linearly associated with uric acid in each sex. Body weight modified these associations, which remained statistically significant only in normal-weight (BMI <25 kg/m²) women and overweight (BMI ≥25 kg/m²) men for hs-CRP, and in normal-weight individuals for uric acid. No significant association between alcohol intake and leukocyte count was found.

Conclusions: The association of alcohol intake with hs-CRP was J-shaped in women but positive and linear-shaped in men. Alcohol intake was directly associated with uric acid in men and women. BMI modifies the effect of alcohol on hs-CRP and uric acid levels in each sex.