Nygård O, Refsum H, Ueland P M, Stensvold I, Nordrehaug J E, Kvåle G, Vollset S E
Department of Clinical Biology, University of Bergen, Norway.
Am J Clin Nutr. 1997 Jan;65(1):136-43. doi: 10.1093/ajcn/65.1.136.
The health consequences of coffee drinking remain controversial. We report on an association between coffee consumption and the concentration of total homocysteine (tHcy) in plasma, a risk factor for cardiovascular disease and for adverse pregnancy outcome. The study population consisted of 7589 men and 8585 women 40-67 y of age and with no history of hypertension, diabetes, ischemic heart disease, or cerebrovascular disease. They were recruited from Hordaland county of western Norway in 1992-1993. Daily use of coffee was reported by 89.1% of the participants, of whom 94.9% used caffeinated filtered coffee. There was a marked positive dose-response relation between coffee consumption and plasma tHcy, which was stronger than the relation between coffee and total serum cholesterol. In 40-42-y-old men, mean tHcy was 10.1 mumol/L for nonusers and 12.0 mumol/L for drinkers of > or = 9 cups of coffee/d. Corresponding tHcy concentrations in 40-42-y-old women were 8.2 and 10.5 mumol/L, respectively. Although coffee drinking was associated with smoking and lower intake of vitamin supplements and fruit and vegetables, the coffee-tHcy association was only moderately reduced after these variables were adjusted for. The combination of cigarette smoking and high coffee intake was associated with particularly high tHcy concentrations. A strong inverse relation between tea and tHcy concentration in univariate analysis was substantially attenuated after smoking and coffee drinking were adjusted for. The results of the present report should promote future studies on tHcy as a possible mediator of adverse clinical effects related to heavy coffee consumption.
喝咖啡对健康的影响仍存在争议。我们报告了咖啡摄入量与血浆总同型半胱氨酸（tHcy）浓度之间的关联，血浆总同型半胱氨酸是心血管疾病和不良妊娠结局的一个风险因素。研究人群包括7589名男性和8585名年龄在40 - 67岁之间、无高血压、糖尿病、缺血性心脏病或脑血管疾病病史的女性。他们于1992 - 1993年从挪威西部的霍达兰郡招募而来。89.1%的参与者报告了每日咖啡饮用情况，其中94.9%饮用含咖啡因的过滤咖啡。咖啡摄入量与血浆tHcy之间存在明显的正剂量反应关系，这一关系比咖啡与血清总胆固醇之间的关系更强。在40 - 42岁的男性中，不喝咖啡者的平均tHcy为10.1μmol/L，每天饮用≥9杯咖啡者为12.0μmol/L。40 - 42岁女性相应的tHcy浓度分别为8.2和10.5μmol/L。尽管喝咖啡与吸烟、维生素补充剂以及水果和蔬菜摄入量较低有关，但在对这些变量进行调整后，咖啡与tHcy的关联仅略有减弱。吸烟与高咖啡摄入量相结合与特别高的tHcy浓度相关。在单变量分析中，茶与tHcy浓度之间的强负相关在对吸烟和咖啡饮用进行调整后大幅减弱。本报告的结果应推动未来对tHcy作为重度咖啡消费相关不良临床影响的可能介导因素的研究。
