AP-HP, Service d'Hépatologie et de Gastroentérologie, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil 94000, France.
J Hepatol. 2011 Jun;54(6):1123-9. doi: 10.1016/j.jhep.2010.08.027. Epub 2011 Feb 24.
BACKGROUND & AIMS: The severity of chronic hepatitis C (CHC) is modulated by host and environmental factors. Several reports suggest that caffeine intake exerts hepatoprotective effects in patients with chronic liver disease. The aim of this study was to evaluate the impact of caffeine consumption on activity grade and fibrosis stage in patients with CHC.
A total of 238 treatment-naïve patients with histologically-proven CHC were included in the study. Demographic, epidemiological, environmental, virological, and metabolic data were collected, including daily consumption of alcohol, cannabis, tobacco, and caffeine during the six months preceding liver biopsy. Daily caffeine consumption was estimated as the sum of mean intakes of caffeinated coffee, tea, and caffeine-containing sodas. Histological activity grade and fibrosis stage were scored according to Metavir. Patients (154 men, 84 women, mean age: 45±11 years) were categorized according to caffeine consumption quartiles: group 1 (<225 mg/day, n=59), group 2 (225-407 mg/day, n=57), group 3 (408-678 mg/day, n=62), and group 4 (>678 mg/day, n=60).
There was a significant inverse relationship between activity grade and daily caffeine consumption: activity grade>A2 was present in 78%, 61%, 52%, and 48% of patients in group 1, 2, 3, and 4, respectively (p<0.001). By multivariate analysis, daily caffeine consumption greater than 408 mg/day was associated with a lesser risk of activity grade>A2 (OR=0.32 (0.12-0.85). Caffeine intake showed no relation with fibrosis stage.
Caffeine consumption greater than 408 mg/day (3 cups or more) is associated with reduced histological activity in patients with CHC. These findings support potential hepatoprotective properties of caffeine in chronic liver diseases.
慢性丙型肝炎（CHC）的严重程度受宿主和环境因素的调节。有几项报告表明，咖啡因摄入对慢性肝病患者具有肝保护作用。本研究旨在评估咖啡因摄入对 CHC 患者活动度分级和纤维化分期的影响。
共纳入 238 例经组织学证实的 CHC 初治患者。收集了人口统计学、流行病学、环境、病毒学和代谢数据，包括肝活检前 6 个月内每天摄入的酒精、大麻、烟草和咖啡因。每日咖啡因摄入量估计为含咖啡因咖啡、茶和含咖啡因苏打水的平均摄入量之和。根据 Metavir 评分对组织学活动度分级和纤维化分期进行评分。根据咖啡因摄入量四分位数将患者（154 名男性，84 名女性，平均年龄：45±11 岁）分为 4 组：第 1 组（<225mg/天，n=59）、第 2 组（225-407mg/天，n=57）、第 3 组（408-678mg/天，n=62）和第 4 组（>678mg/天，n=60）。
活动度分级与每日咖啡因摄入量呈显著负相关：第 1、2、3 和 4 组中分别有 78%、61%、52%和 48%的患者活动度分级为 A2（p<0.001）。多变量分析显示，每日咖啡因摄入量大于 408mg/天与活动度分级>A2的风险降低相关（OR=0.32（0.12-0.85））。咖啡因摄入与纤维化分期无关。
每日咖啡因摄入量大于 408mg/天（3 杯或更多）与 CHC 患者的组织学活动度降低相关。这些发现支持咖啡因在慢性肝病中具有潜在的肝保护作用。
