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Context and objective. Lipoproteins are involved in the pathophysiology of several metabolic diseases. Here we focus on the interplay between lipoprotein metabolism and adiponectin with the extension of alcohol intake. Design and subjects. Eighty-three low-to-moderate and 80 heavy alcohol drinkers were studied. Plasma adiponectin, other biochemical and extensive lipoprotein data were measured. Self-organizing maps were applied to characterize lipoprotein phenotypes and their interrelationships with biochemical measures and alcohol consumption. Results. Alcohol consumption and plasma adiponectin had a strong positive association. Heavy alcohol consumption was associated with decreased low-density lipoprotein cholesterol (LDL-C). Nevertheless, two distinct lipoprotein phenotypes were identified, one with elevated high-density lipoprotein cholesterol (HDL-C) and decreased very-low-density lipoprotein triglycerides (VLDL-TG) together with low prevalence of metabolic syndrome, and the other vice versa. The HDL particles were enlarged in both phenotypes related to the heavy drinkers. The low-to-moderate alcohol drinkers were characterized with high LDL-C and C-enriched LDL particles. Conclusions. The analyses per se illustrated the multi-faceted and non-linear nature of lipoprotein metabolism. The heavy alcohol drinkers were characterized either by an anti-atherogenic lipoprotein phenotype (with also the highest adiponectin concentrations) or by a phenotype with pro-atherogenic and metabolic syndrome-like features. Clinically this underlines the need to distinguish the differing individual risk for lipid-related metabolic disturbances also in heavy alcohol drinkers. [ABSTRACT FROM AUTHOR]