10个欧洲国家的咖啡饮用与死亡率：一项多国队列研究
Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study.
作者信息
Gunter Marc J, Murphy Neil, Cross Amanda J, Dossus Laure, Dartois Laureen, Fagherazzi Guy, Kaaks Rudolf, Kühn Tilman, Boeing Heiner, Aleksandrova Krasimira, Tjønneland Anne, Olsen Anja, Overvad Kim, Larsen Sofus Christian, Redondo Cornejo Maria Luisa, Agudo Antonio, Sánchez Pérez María José, Altzibar Jone M, Navarro Carmen, Ardanaz Eva, Khaw Kay-Tee, Butterworth Adam, Bradbury Kathryn E, Trichopoulou Antonia, Lagiou Pagona, Trichopoulos Dimitrios, Palli Domenico, Grioni Sara, Vineis Paolo, Panico Salvatore, Tumino Rosario, Bueno-de-Mesquita Bas, Siersema Peter, Leenders Max, Beulens Joline W J, Uiterwaal Cuno U, Wallström Peter, Nilsson Lena Maria, Landberg Rikard, Weiderpass Elisabete, Skeie Guri, Braaten Tonje, Brennan Paul, Licaj Idlir, Muller David C, Sinha Rashmi, Wareham Nick, Riboli Elio
机构信息
From International Agency for Research on Cancer, Lyon, France; Imperial College London, London, United Kingdom; Institut Gustave Roussy, Villejuif, France; German Cancer Research Center, Heidelberg, Germany; German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Danish Cancer Society Research Center, Copenhagen, Denmark; Aarhus University, Aarhus, Denmark; Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark; Public Health Directorate, Asturias, Spain; Catalan Institute of Oncology, Barcelona, Spain; Andalusian School of Public Health, Granada, Spain; Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastián, Spain; Murcia Regional Health Council, Murcia, Spain; Navarre Public Health Institute, Pamplona, Spain; University of Cambridge and MRC Epidemiology Unit, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom; Hellenic Health Foundation, Athens, Greece; Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Cancer Research and Prevention Institute-ISPO, Florence, Italy; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Federico II University, Naples, Italy; "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Ragusa, Italy; National Institute for Public Health and the Environment, Bilthoven, the Netherlands; University Medical Centre, Utrecht, the Netherlands; Malmö University Hospital, Malmö, Sweden; Umeå University, Umeå, Sweden; Swedish University of Agricultural Sciences, Uppsala, Sweden; University of Tromsø, The Arctic University of Norway, Tromsø, Norway; and National Cancer Institute, Bethesda, Maryland.
出版信息
Ann Intern Med. 2017 Aug 15;167(4):236-247. doi: 10.7326/M16-2945. Epub 2017 Jul 11.
BACKGROUND
The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear.
OBJECTIVE
To examine whether coffee consumption is associated with all-cause and cause-specific mortality.
DESIGN
Prospective cohort study.
SETTING
10 European countries.
PARTICIPANTS
521 330 persons enrolled in EPIC (European Prospective Investigation into Cancer and Nutrition).
MEASUREMENTS
Hazard ratios (HRs) and 95% CIs estimated using multivariable Cox proportional hazards models. The association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers subcohort (n = 14 800).
RESULTS
During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with nonconsumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality (men: HR, 0.88 [95% CI, 0.82 to 0.95]; P for trend < 0.001; women: HR, 0.93 [CI, 0.87 to 0.98]; P for trend = 0.009). Inverse associations were also observed for digestive disease mortality for men (HR, 0.41 [CI, 0.32 to 0.54]; P for trend < 0.001) and women (HR, 0.60 [CI, 0.46 to 0.78]; P for trend < 0.001). Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality (HR, 0.78 [CI, 0.68 to 0.90]; P for trend < 0.001) and cerebrovascular disease mortality (HR, 0.70 [CI, 0.55 to 0.90]; P for trend = 0.002) and a positive association with ovarian cancer mortality (HR, 1.31 [CI, 1.07 to 1.61]; P for trend = 0.015). In the EPIC Biomarkers subcohort, higher coffee consumption was associated with lower serum alkaline phosphatase; alanine aminotransferase; aspartate aminotransferase; γ-glutamyltransferase; and, in women, C-reactive protein, lipoprotein(a), and glycated hemoglobin levels.
LIMITATIONS
Reverse causality may have biased the findings; however, results did not differ after exclusion of participants who died within 8 years of baseline. Coffee-drinking habits were assessed only once.
CONCLUSION
Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country.
PRIMARY FUNDING SOURCE
European Commission Directorate-General for Health and Consumers and International Agency for Research on Cancer.
背景
在咖啡冲泡方法各异的不同欧洲人群中，咖啡摄入量与死亡率之间的关系尚不清楚。
目的
研究咖啡摄入量是否与全因死亡率及特定病因死亡率相关。
设计
前瞻性队列研究。
地点
10个欧洲国家。
参与者
521330名参与欧洲癌症与营养前瞻性调查（EPIC）的人员。
测量指标
使用多变量Cox比例风险模型估计风险比（HRs）和95%置信区间（CIs）。在EPIC生物标志物亚组（n = 14800）中评估咖啡摄入量与肝功能、炎症和代谢健康的血清生物标志物之间的关联。
结果
在平均16.4年的随访期间，发生了41693例死亡。与不喝咖啡者相比，咖啡摄入量处于最高四分位数的参与者全因死亡率在统计学上显著更低（男性：HR，0.88 [95% CI，0.82至0.95]；趋势P < 0.001；女性：HR，0.93 [CI，0.87至0.98]；趋势P = 0.009）。男性（HR，0.41 [CI，0.32至0.54]；趋势P < 0.001）和女性（HR，0.60 [CI，0.46至0.78]；趋势P < 0.001）的消化系统疾病死亡率也呈负相关。在女性中，喝咖啡与循环系统疾病死亡率（HR，0.78 [CI，0.68至0.90]；趋势P < 0.001）和脑血管疾病死亡率（HR，0.70 [CI，0.55至0.90]；趋势P = 0.002）呈统计学显著负相关，与卵巢癌死亡率呈正相关（HR，1.31 [CI，1.07至1.61]；趋势P = 0.015）。在EPIC生物标志物亚组中，较高的咖啡摄入量与较低的血清碱性磷酸酶、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶水平相关，在女性中还与C反应蛋白、脂蛋白(a)和糖化血红蛋白水平相关。
局限性
反向因果关系可能使研究结果产生偏差；然而，在排除基线后8年内死亡的参与者后，结果并无差异。咖啡饮用习惯仅评估了一次。
结论
喝咖啡与降低各种原因导致的死亡风险相关。这种关系在不同国家之间没有差异。
主要资金来源
欧盟卫生与消费者总司以及国际癌症研究机构。
Zotero 插件