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咖啡消费对乙型肝炎病毒流行地区肝细胞癌发展的影响。

The effect of coffee consumption on the development of hepatocellular carcinoma in hepatitis B virus endemic area.

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seongnam-si, Korea.

出版信息

Liver Int. 2013 Aug;33(7):1092-9. doi: 10.1111/liv.12186. Epub 2013 May 8.

Abstract

BACKGROUND & AIMS: Coffee consumption is inversely related to the risk of cirrhosis or hepatocellular carcinoma (HCC). However, the protective effect of coffee drinking against the risk of HCC was not established in HBV-prevalent region. To elucidate the relationship between lifetime coffee consumption and the risk of HCC development under the consideration of replication status of HBV.

METHODS

A hospital-based case-control study was performed in 1364 subjects. A total of 258 HCC patients, 480 health-check examinees (control 1, HCE) and 626 patients with chronic liver disease other than HCC (control 2, CLD) were interviewed on smoking, alcohol and coffee drinking using a standardized questionnaire. HBV e-antigen (HBeAg) status and serum HBV DNA levels were measured in patients infected with HBV.

RESULTS

After adjustment for age, gender, obesity, DM, presence of hepatitis virus (except for HCE) and lifetime alcohol drinking/smoking, a high lifetime coffee consumption (≥20 000 cups) was an independent protective factor against HCC, in each analyses using healthy and risky control groups respectively (HCE group, OR 0.56, 95% CI 0.33-0.95; CLD group, OR 0.55, 95% CI 0.36-0.85). However, the high coffee consumption did not affect the HCC risk in patients with HBV (OR 0.64, 95% CI 0.36-1.14) after adjustment for HBeAg status, serum HBV DNA level and antiviral therapy.

CONCLUSIONS

A high lifetime coffee consumption was negatively associated with a HCC development. However, this difference of coffee exposure with the HCC group was reduced in chronic hepatitis B patients by the dominant role of viral replication.

摘要

背景与目的

咖啡的摄入与肝硬化或肝细胞癌(HCC)的风险呈负相关。然而,在乙型肝炎病毒(HBV)流行地区,咖啡饮用对 HCC 风险的保护作用尚未得到证实。为了阐明在考虑 HBV 复制状态的情况下,终生咖啡摄入量与 HCC 发展风险之间的关系。

方法

在 1364 名受试者中进行了一项基于医院的病例对照研究。通过使用标准化问卷,对 258 名 HCC 患者、480 名健康体检者(对照组 1,HCE)和 626 名非 HCC 慢性肝病患者(对照组 2,CLD)进行了吸烟、饮酒和咖啡饮用情况的访谈。在感染 HBV 的患者中测量了 HBV e 抗原(HBeAg)状态和血清 HBV DNA 水平。

结果

在校正年龄、性别、肥胖、糖尿病、是否存在肝炎病毒(除 HCE 外)和终生饮酒/吸烟后,高终生咖啡摄入量(≥20000 杯)是 HCC 的独立保护因素,分别在使用健康和高危对照组的分析中(HCE 组,OR 0.56,95%CI 0.33-0.95;CLD 组,OR 0.55,95%CI 0.36-0.85)。然而,在调整 HBeAg 状态、血清 HBV DNA 水平和抗病毒治疗后,高咖啡摄入量对 HBV 患者的 HCC 风险没有影响(OR 0.64,95%CI 0.36-1.14)。

结论

高终生咖啡摄入量与 HCC 发展呈负相关。然而,在慢性乙型肝炎患者中,由于病毒复制的主导作用,这种咖啡暴露与 HCC 组之间的差异减小。

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