咖啡摄入对门诊成年人健康的急性影响。
Acute Effects of Coffee Consumption on Health among Ambulatory Adults.
机构信息
From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.).
出版信息
N Engl J Med. 2023 Mar 23;388(12):1092-1100. doi: 10.1056/NEJMoa2204737.
BACKGROUND
Coffee is one of the most commonly consumed beverages in the world, but the acute health effects of coffee consumption remain uncertain.
METHODS
We conducted a prospective, randomized, case-crossover trial to examine the effects of caffeinated coffee on cardiac ectopy and arrhythmias, daily step counts, sleep minutes, and serum glucose levels. A total of 100 adults were fitted with a continuously recording electrocardiogram device, a wrist-worn accelerometer, and a continuous glucose monitor. Participants downloaded a smartphone application to collect geolocation data. We used daily text messages, sent over a period of 14 days, to randomly instruct participants to consume caffeinated coffee or avoid caffeine. The primary outcome was the mean number of daily premature atrial contractions. Adherence to the randomization assignment was assessed with the use of real-time indicators recorded by the participants, daily surveys, reimbursements for date-stamped receipts for coffee purchases, and virtual monitoring (geofencing) of coffee-shop visits.
RESULTS
The mean (±SD) age of the participants was 39±13 years; 51% were women, and 51% were non-Hispanic White. Adherence to the random assignments was assessed to be high. The consumption of caffeinated coffee was associated with 58 daily premature atrial contractions as compared with 53 daily events on days when caffeine was avoided (rate ratio, 1.09; 95% confidence interval [CI], 0.98 to 1.20; P = 0.10). The consumption of caffeinated coffee as compared with no caffeine consumption was associated with 154 and 102 daily premature ventricular contractions, respectively (rate ratio, 1.51; 95% CI, 1.18 to 1.94); 10,646 and 9665 daily steps (mean difference, 1058; 95% CI, 441 to 1675); 397 and 432 minutes of nightly sleep (mean difference, 36; 95% CI, 25 to 47); and serum glucose levels of 95 mg per deciliter and 96 mg per deciliter (mean difference, -0.41; 95% CI, -5.42 to 4.60).
CONCLUSIONS
In this randomized trial, the consumption of caffeinated coffee did not result in significantly more daily premature atrial contractions than the avoidance of caffeine. (Funded by the University of California, San Francisco, and the National Institutes of Health; CRAVE ClinicalTrials.gov number, NCT03671759.).
背景
咖啡是世界上最常饮用的饮料之一，但咖啡摄入对健康的急性影响仍不确定。
方法
我们进行了一项前瞻性、随机、病例交叉试验，以研究含咖啡因咖啡对心脏异位搏动和心律失常、每日步数、睡眠分钟数和血清葡萄糖水平的影响。共有 100 名成年人佩戴了连续记录心电图仪、腕戴式加速度计和连续血糖监测器。参与者下载了智能手机应用程序以收集地理位置数据。我们使用每日短信，在 14 天的时间内随机指示参与者饮用含咖啡因咖啡或避免咖啡因。主要结局是每日房性期前收缩的平均次数。通过参与者记录的实时指标、每日调查、咖啡因购买日期戳收据的报销以及对咖啡店访问的虚拟监控（地理围栏）来评估对随机分组的遵守情况。
结果
参与者的平均（±SD）年龄为 39±13 岁；51%为女性，51%为非西班牙裔白人。对随机分组的遵守情况评估为高。与避免咖啡因的日子相比，饮用含咖啡因咖啡与每日发生 58 次房性期前收缩相关（率比，1.09；95%置信区间[CI]，0.98 至 1.20；P=0.10）。与不饮用咖啡因相比，饮用含咖啡因咖啡分别与每日发生 154 次和 102 次室性期前收缩相关（率比，1.51；95%CI，1.18 至 1.94）；每日 10646 步和 9665 步（平均差异，1058；95%CI，441 至 1675）；每晚 397 分钟和 432 分钟的睡眠时间（平均差异，36；95%CI，25 至 47）；以及血清葡萄糖水平分别为 95 毫克/分升和 96 毫克/分升（平均差异，-0.41；95%CI，-5.42 至 4.60）。
结论
在这项随机试验中，饮用含咖啡因咖啡并没有导致每日房性期前收缩明显多于避免咖啡因。（由加利福尼亚大学旧金山分校和美国国立卫生研究院资助；CRAVE 临床试验。gov 编号，NCT03671759。）
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