Hedström A K, Mowry E M, Gianfrancesco M A, Shao X, Schaefer C A, Shen L, Olsson T, Barcellos L F, Alfredsson L
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
J Neurol Neurosurg Psychiatry. 2016 May;87(5):454-60. doi: 10.1136/jnnp-2015-312176. Epub 2016 Mar 3.
Previous studies on consumption of caffeine and risk of multiple sclerosis (MS) have yielded inconclusive results. We aimed to investigate whether consumption of coffee is associated with risk of MS.
Using two population-representative case-control studies (a Swedish study comprising 1620 cases and 2788 controls, and a US study comprising 1159 cases and 1172 controls), participants with different habits of coffee consumption based on retrospective data collection were compared regarding risk of MS, by calculating ORs with 95% CIs. Logistic regression models were adjusted for a broad range of potential confounding factors.
Compared with those who reported no coffee consumption, the risk of MS was substantially reduced among those who reported a high consumption of coffee exceeding 900 mL daily (OR 0.70 (95% CI 0.49 to 0.99) in the Swedish study, and OR 0.69 (95% CI 0.50 to 0.96) in the US study). Lower odds of MS with increasing consumption of coffee were observed, regardless of whether coffee consumption at disease onset or 5 or 10 years prior to disease onset was considered.
In accordance with studies in animal models of MS, high consumption of coffee may decrease the risk of developing MS. Caffeine, one component of coffee, has neuroprotective properties, and has been shown to suppress the production of proinflammatory cytokines, which may be mechanisms underlying the observed association. However, further investigations are needed to determine whether exposure to caffeine underlies the observed association and, if so, to evaluate its mechanisms of action.
先前关于咖啡因摄入与多发性硬化症(MS)风险的研究结果尚无定论。我们旨在调查咖啡饮用是否与MS风险相关。
采用两项具有人群代表性的病例对照研究(一项瑞典研究包括1620例病例和2788例对照,以及一项美国研究包括1159例病例和1172例对照),通过回顾性数据收集,根据咖啡饮用习惯的不同将参与者分组,计算比值比(OR)及95%置信区间(CI),比较MS风险。逻辑回归模型针对一系列潜在混杂因素进行了调整。
与报告不喝咖啡的人相比,报告每日咖啡摄入量超过900毫升的人群中,MS风险显著降低(瑞典研究中OR为0.70(95%CI为0.49至0.99),美国研究中OR为0.69(95%CI为0.50至0.96))。无论考虑疾病发作时还是疾病发作前5年或10年的咖啡摄入量,均观察到随着咖啡摄入量增加MS的几率降低。
与MS动物模型研究一致,大量饮用咖啡可能会降低患MS的风险。咖啡因作为咖啡的一种成分,具有神经保护特性,已被证明可抑制促炎细胞因子的产生,这可能是观察到的关联背后的机制。然而,需要进一步研究以确定咖啡因暴露是否是观察到的关联的基础,如果是,则评估其作用机制。