To examine gender-specific relationships between alcohol drinking patterns (average drinking frequency, typical drinking quantity and frequency of binge drinking) and the prevalence of metabolic syndrome (MetS) and its components in the Korean population.

Cross-sectional study using complex sampling design analyses.

The Korea National Health and Nutrition Examination Survey IV, which was conducted in 2008.

Current drinkers (n 3793, 1963 men and 1830 women).

After adjusting for confounders (age, educational level, income, physical activity, smoking, energy intake and drinking frequency in the analysis for drinking quantity), the associations of drinking quantity and frequency of binge drinking with the prevalence of MetS were gender-specific. Seven or more drinks for men and ≥3 drinks for women per typical occasion and binge drinking ≥1 time/week for both sexes resulted in significantly higher odds for the prevalence of MetS compared with men and women who had 1 or 2 drinks and no instances of binge drinking. The association of drinking quantity and the criteria of MetS was stronger for men with high blood pressure and abdominal obesity, whereas it was stronger for women with high glucose. Binge drinking frequency was dose-dependently associated with high TAG, high glucose, high blood pressure and abdominal obesity in men, and with high glucose and high blood pressure in women. Interestingly, average drinking frequency was not associated with the prevalence of MetS in either sex.

Higher drinking quantity and frequent binge drinking are indicators of a higher prevalence of MetS, and the association strength is thought to be gender-specific.