咖啡摄入量和咖啡因代谢与心律失常及心脏形态的关联：一项观察性、遗传学和孟德尔随机化研究。

Association of coffee consumption and caffeine metabolism with arrhythmias and cardiac morphology: An observational, genetic, and Mendelian randomization study.

作者信息

Zheng Jiazhen, Chen Haowen, Yang Quan, Zhou Zhen, Yang Chuang, Huang Jinghan, Tu Qiang, Wu Haisheng, Qiu Peng, Huang Wenbo, Shi Wenming, Chen Mifen, Liu Huamin, Shen Junchun, Tang Shaojun

机构信息

Bioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, Guangdong, China.

Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China.

出版信息

Heart Rhythm. 2024 Nov 27. doi: 10.1016/j.hrthm.2024.11.047.

DOI:10.1016/j.hrthm.2024.11.047

PMID:39613205

Abstract

BACKGROUND

The association of coffee intake and caffeine metabolism with arrhythmias and cardiac structure is not fully understood.

OBJECTIVE

We aim to explore the associations of coffee intake and caffeine metabolism with the risk of certain types of arrhythmias, a broad range of cardiovascular imaging phenotypes, and a potential gene-coffee interaction.

METHODS

On the basis of the UK Biobank imaging study, heart metrics were extracted via cardiovascular magnetic resonance using machine learning. Caffeine metabolism was determined by cytochrome P4501A2 gene (CYP1A2) or a polygenetic score of different genetic variants influencing caffeine metabolism. Genome-wide association data for 2-sample Mendelian randomization originated predominantly from individuals of European descent.

RESULTS

A total of 34,992 individuals (mean age 63.5 ± 7.5 years; 18,506 [52.9%] female) were assessed in the principal imaging analysis. Higher daily consumption of coffee was independently associated with higher left ventricular mass, larger global ventricular volume, higher ventricular stroke volume, and larger atrial volume. The results were further supported by Mendelian randomization analysis. CYP1A2 and genetic score for caffeine metabolism were not associated with cardiovascular measurements (P>.053 for all tests). Coffee consumption was associated with a lower risk of sinus rhythm with a short PR interval (per cup increase: odds ratio 0.90; 95% confidence interval 0.82-0.99) and atrial fibrillation (odds ratio 0.89; 95% confidence interval 0.84-0.93).

CONCLUSION

Coffee consumption was associated with a lower risk of atrial fibrillation, increased left ventricular mass, elevated ventricular volume, and larger atrial volume. Caffeine metabolism did not significantly alter the association. Our results suggest that customary caffeine consumption limitations aimed at arrhythmia risk reduction might be unnecessary.

摘要

背景

咖啡摄入量和咖啡因代谢与心律失常及心脏结构之间的关联尚未完全明确。

目的

我们旨在探讨咖啡摄入量和咖啡因代谢与某些类型心律失常风险、广泛的心血管成像表型以及潜在的基因 - 咖啡相互作用之间的关联。

方法

基于英国生物银行成像研究，通过机器学习利用心血管磁共振提取心脏指标。咖啡因代谢由细胞色素P4501A2基因（CYP1A2）或影响咖啡因代谢的不同基因变异的多基因评分来确定。两样本孟德尔随机化的全基因组关联数据主要来源于欧洲血统个体。

结果

在主要成像分析中评估了总共34992名个体（平均年龄63.5±7.5岁；18506名[52.9%]为女性）。每日咖啡摄入量较高与左心室质量增加、整体心室容积增大、心室每搏输出量增加以及心房容积增大独立相关。孟德尔随机化分析进一步支持了这些结果。CYP1A2和咖啡因代谢的基因评分与心血管测量指标无关（所有测试P>0.053）。咖啡摄入与短PR间期窦性心律风险降低（每增加一杯：比值比0.90；95%置信区间0.82 - 0.99）和房颤（比值比0.89；95%置信区间0.84 - 0.93）相关。