Barré Tangui, Fontaine Hélène, Ramier Clémence, Di Beo Vincent, Pol Stanislas, Carrieri Patrizia, Marcellin Fabienne, Cagnot Carole, Dorival Céline, Zucman-Rossi Jessica, Zoulim Fabien, Carrat Fabrice, Protopopescu Camelia
Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Address: 27 Bd Jean Moulin, 13385, Marseille, Cedex 5, France.
Université de Paris, Département d'Hépatologie et Addictologie, Hôpital Cochin, APHP, Address: 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
Clin Nutr. 2022 Mar;41(3):610-619. doi: 10.1016/j.clnu.2022.01.016. Epub 2022 Jan 24.
Patients chronically infected with hepatitis B virus (HBV) are at high risk of liver fibrosis, cirrhosis and liver cancer, despite recent therapeutic advances. It is therefore crucial to find non-pharmaceutical options for liver fibrosis prevention in this population. Using cross-sectional data from the ANRS CO22 Hepather cohort, we aimed to identify socio-demographic and modifiable risk factors for significant fibrosis in chronic HBV patients.
Logistic regression or Firth's penalized maximum likelihood logistic regression (according to outcome prevalence) multivariable models were used to test for associations between explanatory variables and significant fibrosis, as assessed by three non-invasive markers: aspartate aminotransferase to platelet ratio index (APRI), FIB-4, and gamma glutamyltransferase to platelet ratio (GPR). Analyses were stratified by HBV treatment status.
The study population comprised 2065 untreated and 1727 treated chronic HBV patients. Elevated coffee consumption was consistently associated with a lower risk of elevated fibrosis biomarkers in all three treated-participant models, suggesting a dose-response relationship (adjusted odds ratios for ≥3 cups/day versus 0 cups/day: 0.16, 0.35 and 0.62, p ≤ 0.002, according to APRI, FIB-4 and GPR, respectively). Other modifiable risk factors included tobacco and alcohol use.
Elevated coffee consumption was consistently associated with a lower risk of significant liver fibrosis, as assessed by three non-invasive markers in treated chronic HBV patients. This result can be immediately used in real-world situations, as increasing coffee consumption may be beneficial for patients at risk of advanced liver disease.
尽管近期治疗取得进展，但慢性感染乙型肝炎病毒（HBV）的患者仍面临肝纤维化、肝硬化和肝癌的高风险。因此，在这一人群中寻找预防肝纤维化的非药物选择至关重要。利用法国国家艾滋病研究机构（ANRS）CO22 Hepather队列的横断面数据，我们旨在确定慢性HBV患者发生显著纤维化的社会人口学和可改变的风险因素。
采用逻辑回归或Firth惩罚最大似然逻辑回归（根据结局患病率）多变量模型，以检验解释变量与显著纤维化之间的关联，显著纤维化通过三种非侵入性标志物评估：天冬氨酸氨基转移酶与血小板比值指数（APRI）、FIB-4以及γ-谷氨酰转移酶与血小板比值（GPR）。分析按HBV治疗状态分层。
研究人群包括2065例未治疗和1727例已治疗的慢性HBV患者。在所有三个已治疗参与者模型中，咖啡摄入量增加始终与纤维化生物标志物升高风险较低相关，提示存在剂量反应关系（根据APRI、FIB-4和GPR，≥3杯/天与0杯/天相比的调整比值比分别为0.16、0.35和0.62，p≤0.002）。其他可改变的风险因素包括吸烟和饮酒。
根据已治疗慢性HBV患者的三种非侵入性标志物评估，咖啡摄入量增加始终与显著肝纤维化风险较低相关。这一结果可立即应用于实际情况，因为增加咖啡摄入量可能对晚期肝病风险患者有益。
