肥胖症患者的非酒精性脂肪性肝炎：咖啡摄入量与疾病严重程度的关系

Nonalcoholic steatohepatitis in morbid obese patients: coffee consumption vs. disease severity.

作者信息

Barros Raffaelle K, Cotrim Helma P, Daltro Carla, Alves Erivaldo, de Freitas Luiz A R, Daltro Claudia, Oliveira Yanaihara

机构信息

Programa de Pós-graduação em Medicina e Saúde (PPgMS) and GNASH/CNPq-Faculdade de Medicina-Universidade Federal da Bahia (UFBA), Salvador-Bahia, Brazil; Núcleo de Tratamento e Cirurgia da Obesidade (NTCO), Salvador- Bahia, Brazil.

Programa de Pós-graduação em Medicina e Saúde (PPgMS) and GNASH/CNPq-Faculdade de Medicina-Universidade Federal da Bahia (UFBA), Salvador-Bahia, Brazil.

出版信息

Ann Hepatol. 2016 May-Jun;15(3):350-5. doi: 10.5604/16652681.1198804.

DOI:10.5604/16652681.1198804

PMID:27049488

Abstract

INTRODUCTION

Obesity correlates with nonalcoholic fatty liver disease (NAFLD) and occurs in 90 to 100% of severely obese individuals (body mass index [BMI] > 35 kg/m2). Coffee consumption (CC) has been associated with reduced progression of fibrosis in both hepatitis C infection and NAFLD; however, this topic is still under discussion when this liver disease affects severely obese individuals.

OBJECTIVE

To assess the association between CC, insulin resistance (IR) and histological NAFLD morbid obese patients.

MATERIAL AND METHODS

Cross-sectional study, including obese individuals undergoing bariatric surgery, liver biopsy and histological diagnosis between September 2013 and August 2014. The patients were classified into 3 groups according to their weekly CC: 0- 239.9 mL; 240-2099.9 mL and ≥ 2100 mL.

RESULTS

A total of 112 obese individuals were included (BMI = 41.9 ± 4.3 kg/m2), with a mean age of 34.7 ± 7.4 years; 68.6% were women. CC was reported by 72.3% of patients. There were no statistical significant differences between groups regarding the presence of IR (84.8% vs. 74.2% vs. 75.9%; p = 0.536). Progressively higher percentages of individuals with normal liver histology were observed (14.7% vs. 21.9% vs. 24.3%). NASH (65.7% vs. 70.3% vs. 57.5%) were observed among those who consumed greater coffee volumes (p = 0.812). In conclusion, obese individuals with elevated CC exhibited lower frequencies of NASH, although with no statistical significance in this sample.

摘要

引言

肥胖与非酒精性脂肪性肝病（NAFLD）相关，90%至100%的重度肥胖个体（体重指数[BMI]>35kg/m²）会出现肥胖。咖啡消费（CC）与丙型肝炎感染和NAFLD患者纤维化进展减缓有关；然而，当这种肝脏疾病影响重度肥胖个体时，这个话题仍在讨论中。

目的

评估CC、胰岛素抵抗（IR）与病态肥胖的NAFLD患者组织学之间的关联。

材料与方法

横断面研究，纳入2013年9月至2014年8月期间接受减肥手术、肝活检和组织学诊断的肥胖个体。根据患者每周的CC量将其分为3组：0 - 239.9mL；240 - 2099.9mL和≥2100mL。

结果

共纳入112名肥胖个体（BMI = 41.9±4.3kg/m²），平均年龄为34.7±7.4岁；68.6%为女性。72.3%的患者报告有CC。各组之间在IR存在方面无统计学显著差异（84.8%对74.2%对75.9%；p = 0.536）。观察到肝脏组织学正常的个体比例逐渐升高（14.7%对21.9%对24.3%）。在咖啡消费量较大的人群中观察到非酒精性脂肪性肝炎（NASH）（65.7%对70.3%对57.5%）（p = 0.812）。总之，CC升高的肥胖个体NASH发生率较低，尽管在本样本中无统计学意义。