Simon Tracey G, Trejo Maria Esther Perez, Zeb Irfan, Frazier-Wood Alexis C, McClelland Robyn L, Chung Raymond T, Budoff Matthew J
Liver Center, Gastrointestinal Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
Department of Biostatistics, University of Washington, Seattle, WA, United States.
Metabolism. 2017 Oct;75:1-5. doi: 10.1016/j.metabol.2017.06.007. Epub 2017 Jun 24.
Atherosclerosis and its clinical sequelae represent the leading cause of mortality among patients with nonalcoholic fatty liver disease (NAFLD). While epidemiologic data support the hepatoprotective benefits of coffee in NAFLD, whether coffee improves NAFLD-associated CVD risk is unknown.
We examined 3710 ethnically-diverse participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, without history of known liver disease, and with available coffee data from a validated 120-item food frequency questionnaire. All participants underwent baseline non-contrast cardiac CT from which NAFLD was defined by liver:spleen ratio (L:S<1.0), and subclinical CVD was defined by coronary artery calcium (CAC)>0. Major CVD events were defined by the first occurrence of myocardial infarction, cardiac arrest, angina, stroke, or CVD death. We used log-binomial regression to calculate the adjusted prevalence ratio (PR) for CAC>0 by coffee intake and NAFLD status, and events were compared between groups using frequency of events within adjusted Cox proportional hazard regression models.
Seventeen percent (N=637) of participants met criteria for NAFLD. NAFLD participants were more likely to have elevated BMI (mean 31.1±5.5kg/m vs. 28.0±5.2kg/m, p<0.0001), and diabetes (22% vs. 11%, p<0.0001), but did not differ in daily coffee consumption (p=0.97). Among NAFLD participants, coffee consumption was not associated with prevalent, baseline CAC>0 (PR=1.02 [0.98-1.07]). Over 12.8years of follow-up, 93 NAFLD and 415 non-NAFLD participants experienced a CV event. However, coffee intake was not associated with incident CVD events, in either NAFLD (HR=1.05 [0.91-1.21]) or non-NAFLD participants (HR=1.03 [0.97-1.11]).
In a large, population-based cohort, coffee consumption was not associated with the prevalence of subclinical CVD, nor did coffee impact the future risk of major CVD events, regardless of underlying NAFLD status.
动脉粥样硬化及其临床后果是非酒精性脂肪性肝病（NAFLD）患者死亡的主要原因。虽然流行病学数据支持咖啡对NAFLD有肝脏保护作用，但咖啡是否能降低与NAFLD相关的心血管疾病（CVD）风险尚不清楚。
我们对来自动脉粥样硬化多民族研究（MESA）队列的3710名不同种族参与者进行了研究，这些参与者无已知肝脏疾病史，且有通过一份经验证的包含120项内容的食物频率问卷获得的咖啡摄入数据。所有参与者均接受了基线非增强心脏CT检查，根据肝脏与脾脏比值（L:S<1.0）定义NAFLD，根据冠状动脉钙化（CAC）>0定义亚临床CVD。主要CVD事件定义为首次发生心肌梗死、心脏骤停、心绞痛、中风或CVD死亡。我们使用对数二项回归计算按咖啡摄入量和NAFLD状态分层的CAC>0的校正患病率比（PR），并在调整后的Cox比例风险回归模型中使用事件频率比较组间事件。
17%（n = 637）的参与者符合NAFLD标准。NAFLD参与者更有可能BMI升高（平均31.1±5.5kg/m²对28.0±5.2kg/m²，p<0.0001）以及患有糖尿病（22%对11%，p<0.0001），但每日咖啡摄入量无差异（p = 0.97）。在NAFLD参与者中，咖啡消费与基线时普遍存在的CAC>0无关（PR = 1.02 [0.98 - 1.07]）。在12.8年的随访中，93名NAFLD参与者和415名非NAFLD参与者发生了心血管事件。然而，咖啡摄入与NAFLD参与者（HR = 1.05 [0.91 - 1.21]）或非NAFLD参与者（HR = 1.03 [0.97 - 1.11]）的新发CVD事件均无关。
在一个基于人群的大型队列中，无论潜在的NAFLD状态如何，咖啡消费与亚临床CVD的患病率无关，也不会影响未来发生主要CVD事件的风险。
