Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Clin Gastroenterol Hepatol. 2015 Jun;13(6):1096-1102.e1. doi: 10.1016/j.cgh.2014.09.029. Epub 2014 Sep 19.
BACKGROUND & AIMS: There is conflicting epidemiologic evidence on whether coffee consumption reduces the risk of gallstone disease. We examined the association between coffee consumption and risk of cholecystectomy (as a proxy for symptomatic gallstone disease) in a prospective cohort study.
We collected data from 30,989 women (born 1914-1948) and 40,936 men (born 1918-1952) from the Swedish Mammography Cohort and the Cohort of Swedish Men. Baseline information on coffee consumption was collected by using a food-frequency questionnaire; subjects were followed up for procedures of cholecystectomy from 1998 through 2011 by linkage to the Swedish Patient Register. Hazard ratios (HRs) were estimated by using Cox proportional hazard models.
During a total follow-up period of 905,933 person-years, we identified 1057 women and 962 men who had undergone a cholecystectomy. After adjustment for potential confounders, the HR of cholecystectomy was 0.58 (95% confidence interval [CI], 0.44-0.78) for women who drank ≥6 cups of coffee/day compared with women who drank <2 cups/day. In contrast, there was no association in men (HR, 0.96; 95% CI, 0.75-1.24). Because of this sex difference, we examined and found evidence of effect modification by menopausal status and use of hormone replacement therapy (HRT) (Pinteraction = .026). An inverse association was observed only in women who were premenopausal (HR, 0.17; 95% CI, 0.05-0.55) or used HRT (HR, 0.44; 95% CI, 0.28-0.70).
We observed an inverse association between coffee consumption and risk of cholecystectomy in women who were premenopausal or used HRT but not in other women or in men.
关于咖啡摄入是否降低胆石病风险,目前存在相互矛盾的流行病学证据。我们在一项前瞻性队列研究中,调查了咖啡摄入与胆囊切除术风险(作为胆石病症状的替代指标)之间的关联。
我们从瑞典乳腺队列和瑞典男性队列中收集了 30989 名女性(出生于 1914-1948 年)和 40936 名男性(出生于 1918-1952 年)的数据。通过使用食物频率问卷收集基线咖啡摄入信息;通过与瑞典患者登记处的链接,从 1998 年到 2011 年对胆囊切除术进行了随访。使用 Cox 比例风险模型估计危险比(HRs)。
在总计 905933 人年的随访期间,我们确定了 1057 名女性和 962 名男性接受了胆囊切除术。在校正潜在混杂因素后,与每天饮用<2 杯咖啡相比,每天饮用≥6 杯咖啡的女性胆囊切除术的 HR 为 0.58(95%置信区间[CI],0.44-0.78)。相比之下,男性没有关联(HR,0.96;95%CI,0.75-1.24)。由于这种性别差异,我们进行了检验并发现了绝经状态和激素替代疗法(HRT)使用的效应修饰的证据(P 交互=.026)。仅在绝经前女性(HR,0.17;95%CI,0.05-0.55)或使用 HRT 的女性(HR,0.44;95%CI,0.28-0.70)中观察到负相关。
我们观察到,在绝经前或使用 HRT 的女性中,咖啡摄入与胆囊切除术风险呈负相关,但在其他女性或男性中则没有。