Lu Xujia, Zhu Xiaohong, Li Guochen, Wu Luying, Shao Liping, Fan Yulong, Pan Chen-Wei, Wu Ying, Borné Yan, Ke Chaofu
Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, Suzhou 215123, China.
MOE Key Laboratory of Geriatric Diseases and Immunology, Soochow University, Suzhou 215123, Jiangsu, China.
J Clin Endocrinol Metab. 2025 May 19;110(6):e1845-e1855. doi: 10.1210/clinem/dgae552.
Cardiometabolic multimorbidity (CM) is an increasing public health concern. Previous observational studies have suggested inverse associations between coffee, tea, and caffeine intake and risks of individual cardiometabolic diseases; however, their associations with CM and related biological markers are unknown.
This prospective study involved 172 315 (for caffeine analysis) and 188 091 (tea and coffee analysis) participants free of any cardiometabolic diseases at baseline from the UK Biobank; 168 metabolites were measured among 88 204 and 96 393 participants. CM was defined as the coexistence of at least 2 of the following conditions: type 2 diabetes, coronary heart disease, and stroke.
Nonlinear inverse associations of coffee, tea, and caffeine intake with the risk of new-onset CM were observed. Compared with nonconsumers or consumers of less than 100 mg caffeine per day, consumers of moderate amount of coffee (3 drinks/d) or caffeine (200-300 mg/d) had the lowest risk for new-onset CM, with respective hazard ratios (95% CIs) of 0.519 (0.417-0.647) and 0.593 (0.499-0.704). Multistate models revealed that moderate coffee or caffeine intake was inversely associated with risks of almost all developmental stages of CM, including transitions from a disease-free state to single cardiometabolic diseases and subsequently to CM. A total of 80 to 97 metabolites, such as lipid components within very low-density lipoprotein, histidine, and glycoprotein acetyls, were identified to be associated with both coffee, tea, or caffeine intake and incident CM.
Habitual coffee or caffeine intake, especially at a moderate level, was associated with a lower risk of new-onset CM and could play important roles in almost all transition phases of CM development. Future studies are warranted to validate the implicated metabolic biomarkers underlying the relation between coffee, tea, and caffeine intake and CM.
心脏代谢共病（CM）日益引起公众健康关注。既往观察性研究提示，咖啡、茶和咖啡因摄入量与个体心脏代谢疾病风险之间存在负相关；然而，它们与CM及相关生物标志物的关联尚不清楚。
这项前瞻性研究纳入了英国生物银行中172315名（用于咖啡因分析）和188091名（用于茶和咖啡分析）基线时无任何心脏代谢疾病的参与者；在88204名和96393名参与者中测量了168种代谢物。CM被定义为同时存在以下至少2种情况：2型糖尿病、冠心病和中风。
观察到咖啡、茶和咖啡因摄入量与新发CM风险之间存在非线性负相关。与不饮用者或每天咖啡因摄入量低于100mg的饮用者相比，适量饮用咖啡（3杯/天）或咖啡因（200 - 300mg/天）的人新发CM风险最低，相应的风险比（95%CI）分别为0.519（0.417 - 0.647）和0.593（0.499 - 0.704）。多状态模型显示，适量饮用咖啡或咖啡因与CM几乎所有发展阶段的风险均呈负相关，包括从无疾病状态转变为单一心脏代谢疾病，随后发展为CM。共鉴定出80至97种代谢物，如极低密度脂蛋白中的脂质成分、组氨酸和糖蛋白乙酰化物，与咖啡、茶或咖啡因摄入量以及CM发病均相关。
习惯性饮用咖啡或咖啡因，尤其是适量饮用，与新发CM风险较低相关，且在CM发展的几乎所有过渡阶段都可能起重要作用。未来有必要开展研究以验证咖啡、茶和咖啡因摄入量与CM之间关系背后的相关代谢生物标志物。
