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标题: Coffee consumption reduces fibrosis risk in those with fatty liver disease [打印本页]

作者: StephenW    时间: 2012-2-3 12:44     标题: Coffee consumption reduces fibrosis risk in those with fatty liver disease

http://www.eurekalert.org/pub_releases/2012-02/w-ccr020212.php
Contact: Dawn Peters
[email protected]
781-388-8408
Wiley-Blackwell
Coffee consumption reduces fibrosis risk in those with fatty liver diseaseIncreased coffee intake significantly decreases risk in nonalcoholic steatohepatitis patients         Caffeine consumption has long been associated with decreased risk of liver disease and reduced fibrosis in patients with chronic liver disease. Now, newly published research confirms that coffee caffeine consumption reduces the risk of advanced fibrosis in those with nonalcoholic fatty liver disease (NAFLD). Findings published in the February issue of Hepatology, a journal of the American Association for the Study of Liver Diseases, show that increased coffee intake, specifically among patients with nonalcoholic steatohepatitis (NASH), decreases risk of hepatic fibrosis.
        The steady increase in rates of diabetes, obesity, and metabolic syndrome over the past 20 years has given rise to greater prevalence of NAFLD. In fact, experts now believe NAFLD is the leading cause of chronic liver disease in the U.S., surpassing both hepatitis B and C. The majority of patients will have isolated fatty liver which has a very low likelihood of developing progressive liver disease. However, a subset of patients will have NASH, which is characterized by inflammation of the liver, destruction of liver cells, and possibly scarring of the liver. Progression to cirrhosis (advanced scarring of the liver) may occur in about 10-11% of NASH patients over a 15 year period, although this is highly variable.
        To enhance understanding of the correlation between coffee consumption and the prevalence and severity of NAFLD, a team led by Dr. Stephen Harrison, Lieutenant Colonel, U.S. Army at Brooke Army Medical Center in Fort Sam Houston, Texas surveyed participants from a previous NAFLD study as well as NASH patients treated at the center's hepatology clinic. The 306 participants were asked about caffeine coffee consumption and categorized into four groups: patients with no sign of fibrosis on ultrasound (control), steatosis, NASH stage 0-1, and NASH stage 2-4.
        Researchers found that the average milligrams in total caffeine consumption per day in the control, steatosis, Nash 0-1, and Nash 2-4 groups was 307, 229, 351 and 252; average milligrams of coffee intake per day was 228, 160, 255, and 152, respectively. There was a significant difference in caffeine consumption between patients in the steatosis group compared to those with NASH stage 0-1. Coffee consumption was significantly greater for patients with NASH stage 0-1, with 58% of caffeine intake from regular coffee, than with NASH stage 2-4 patients at only 36% of caffeine consumption from regular coffee.
        Multiple analyses showed a negative correlation between coffee consumption and risk of hepatic fibrosis. "Our study is the first to demonstrate a histopatholgic relationship between fatty liver disease and estimated coffee intake," concludes Dr. Harrison. "Patients with NASH may benefit from moderate coffee consumption that decreases risk of advanced fibrosis. Further prospective research should examine the amount of coffee intake on clinical outcomes."
       

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Full Citation: "Association of Coffee and Caffeine Consumption with Fatty Liver Disease, Non-alcoholic Steatohepatitis, and Degree of Hepatic Fibrosis." Jeffrey W Molloy, Christopher J Calcagno, Christopher D Williams, Frances J Jones, Dawn M Torres, Stephen A Harrison. Hepatology; December 22, 2011 (DOI: 10.1002/hep.24731); Print Issue Date: February 2012. http://onlinelibrary.wiley.com/doi/10.1002/hep.24731/abstract.
        Author Contact: To arrange an interview with Dr. Harrison, please contact Dewey Mitchell, U.S. Army Public Affairs Officer at [email protected] or 210-916-5119.
        This study is published in Hepatology. Media wishing to receive a PDF of the article may contact [email protected].

作者: StephenW    时间: 2012-2-3 12:46

联系人:黎明彼得斯
[email protected]
781-388-8408
Wiley-Blackwell的
咖啡消费量降低这些疾病与脂肪肝纤维化的风险
增加咖啡的摄入量显著减少在非酒精性脂肪性肝炎患者的风险

咖啡因消耗量一直在慢性肝病患者的肝脏疾病和降低肝纤维化的风险降低相关。现在,新发表的研究证实,咖啡因的咖啡消费量减少与非酒精性脂肪性肝病(NAFLD)的晚期肝纤维化的风险。月在肝脏问题,美国肝病研究协会杂志“公布的调查结果,表明增加咖啡的摄入量,特别是在非酒精性脂肪性肝炎(NASH)患者,降低肝纤维化的风险。

在糖尿病,肥胖和代谢综合征的汇率在过去20年稳步增长,已引起更大的NAFLD的患病率。事实上,专家们现在认为,脂肪肝是慢性肝病的首要原因,在美国超过乙型和丙型肝炎,大多数患者将隔离脂肪肝,其中有一个非常低的发展进步肝病的可能性。然而,患者将有纳什,它的特点是由肝脏的炎症,肝细胞的破坏,并有可能肝脏上的疤痕。进展为肝硬化(先进的肝脏上的疤痕),可能会出现在大约10-11%的NASH患者超过15年期间,尽管这是充满变数。

要加强对咖啡消费量和脂肪肝的患病率和严重性,美国布鲁克陆军医疗中心在萨姆休斯敦堡陆军中校,由斯蒂芬·哈里森博士领导的研究小组之间的相互关系的理解,得克萨斯州调查从以前的非酒精性脂肪肝研究的参与者NASH患者,以及在该中心的肝病门诊治疗。关于咖啡因的咖啡消费量的306参与者被要求和分类分成四组:患者没有迹象纤维化超声(对照组),脂肪肝,NASH的阶段0-1和NASH阶段2-4。

研究人员发现,平均每天的总消费量的咖啡因控制,脂肪肝,纳什0-1和纳什2-4组毫克,307,229,351和252,平均每天摄入咖啡毫克,228,160, 255和152,分别。在脂肪肝组患者之间的咖啡因消费有一个显着性差异相比,那些与NASH的阶段0-1。咖啡消费量显着纳什阶段0-1的患者,从普通咖啡的咖啡因摄入量的58%,比纳什阶段2-4从普通咖啡的咖啡因消费只有36%的患者。

多元分析表明咖啡消费量和肝纤维化的风险之间的负相关关系。 “我们的研究是首次证明脂肪肝疾病和咖啡摄入量估计之间的病理组织学的关系,”哈里森博士的结论。 “NASH患者可能受益于温和的咖啡消费量降低晚期肝纤维化的风险。进一步的前瞻性研究,应检查对临床疗效的咖啡摄入量。”
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全部引用:“咖啡和咖啡因摄入,脂肪肝,非酒精性脂肪性肝炎,肝纤维化程度的协会。”杰弗里·W·莫洛伊,克里斯托弗J Calcagnoð克里斯托弗·威廉斯,弗朗西丝·J·琼斯,黎明中号托雷斯,斯蒂芬一个哈里森。肝病; 12月22日,2011(:10.1002/hep.24731);打印发行日期:2012年2月。 http://onlinelibrary.wiley.com/doi/10.1002/hep.24731/abstract~~V。

作者联系方式:要安排哈里森博士的采访,请联系杜威·米切尔,美军公共事务主任在dewey.mitchell @ us.army.mil或210-916-5119。

这项研究发表在肝病。媒体希望收到一个PDF格式的文章,可致电[email protected]
作者: StephenW    时间: 2012-2-3 12:51

http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2012/January/what-is-it-about-coffee
What is it about coffee? The Harvard Health Letter explains why it might have some health benefits        January 2012        Remember when people (and their doctors) used to worry that coffee was bad for the heart, would give them ulcers, and would make them overly nervous?
In excess, it can cause problems. But recent research has linked coffee to health benefits, not harm, including possible (it’s not a done deal) protective effects from everything from Parkinson’s disease to diabetes to some types of cancer.
The January 2012 issue of the Harvard Health Letter looks at some of the ingredients in coffee that might explain its possible positive effects:
Caffeine. Caffeine probably has multiple targets in the brain, but the main one seems to be adenosine receptors. A part of the brain affected by Parkinson’s disease, called the striatum, is loaded with adenosine receptors. By docking on them, caffeine may have some protective effects against the disease. Caffeine has some negative short-term effects on the cardiovascular system, raising blood pressure and perhaps making arteries stiffer. But habitual use may cause some of those effects to wear off.
Cafestol and kahweol. Coffee contains oily substances called diterpenes; the two main types are cafestol and kahweol. They may have anticancer effects, but they also have a downside, increasing cholesterol levels. Coffee filters trap most of the cafestol and kahweol so they don’t wind up in the beverage that people drink.
Antioxidants. Antioxidants are substances that sop up reactive molecules so they don’t harm sensitive tissues like those that line the inside of blood vessels. Coffee contains a fair amount of antioxidants, including a powerful one called chlorogenic acid.
Vitamins and minerals. Coffee isn’t a great source of vitamins and minerals, but it does contain small amounts of magnesium and potassium.


Research is showing benefits for everything from depression to liver disease. Is it just the caffeine?
Remember when people (and their doctors) used to worry that coffee would harm their hearts, give them ulcers, and make them overly nervous?
In excess, coffee, and more particularly, caffeine, can cause problems. But the fretting about two or three cups a day, or even more, is fading as study results suggestive of health benefits from coffee keep on coming in. In 2011, researchers reported findings that coffee drinking is associated with a lower risk of depression among women, a lower risk of lethal prostate cancer among men, and a lower risk of stroke among men and women. Go back a little further, and you'll come across reports of possible (it's not a done deal) protective effects against everything from Parkinson's disease to diabetes to some types of cancer (see sidebar below).
Caffeine has been studied more than any other ingredient in coffee, and it tends to get credit if the body part benefited is the brain. But coffee contains literally a thousand different substances, and some of the lesser lights are thought to be responsible for healthful effects in other parts of the body. Some studies show caffeinated and decaffeinated coffee as having the same effect, which suggests that something else in coffee is involved.
It gets complicated, though. Caffeine and some of these other substances in coffee seem to have their good and bad sides, and coffee's overall effect may depend on how much they cancel each other out.
Coffee: A disease-by-disease report card
Alzheimer's disease
Human and animal studies show hints of protection. Some preliminary evidence suggests activity against beta-amyloid plaque that may have a causative role in Alzheimer's.
Cancer
Studies suggest a lower risk for some cancers (endometrial, aggressive prostate, estrogen-negative breast), but not others (esophageal). Antioxidant and anti-inflammatory substances could be responsible for possible anticancer activity.
Diabetes
Effects on insulin and blood sugar levels that would promote diabetes seem to be temporary. Regular use is associated with lower risk, and high intake (3–6 cups a day) seems to have a greater effect. Protection may come from increases in the hormone adiponectin and other factors that affect insulin and blood sugar levels.
Heart attack
Coffee drinking increases some factors (homocysteine) associated with higher risk. But moderate consumption (1–3 cups a day) has been linked to a small decrease in risk. The evidence for a possible protective effect is stronger for women.
Liver disease
Coffee drinking is associated with lower levels of enzymes that indicate liver damage and inflammation. Coffee may improve response to some treatments for hepatitis C. Findings suggest some protection against liver cancer. Cafestol and kahweol, substances found in unfiltered coffee, may be responsible for liver benefits.
Parkinson's disease
Studies show a moderate (25%) decrease in risk for coffee drinkers. The effect is less in women. Research has found evidence of activity in the part of the brain affected by Parkinson's.
Stroke
Moderate consumption (3–4 cups a day) is associated with lower risk. But chance of a stroke may increase immediately after intake, particularly among infrequent consumers.


Caffeine: Good for the brain, bad for other parts?Caffeine is the most commonly consumed psychoactive drug in the world, and some of its behavioral effects (such as arousal) may resemble those produced by cocaine, amphetamines, and other stimulants. Coffee consumption accounts for about 75% of the adult intake of caffeine in the United States, although that might be changing among younger adults with the growing popularity of energy drinks.
The caffeine content of coffee varies greatly, depending on the beans, how they're roasted, and other factors, but the average for an 8-ounce cup is about 100 milligrams (mg). Tea has about half as much caffeine as coffee. Decaffeinated coffee has some caffeine, but the 2 to 4 mg in an 8-ounce cup is a smidgen compared with the caffeinated version. The lethal dose of caffeine is about 10 grams, which is equivalent to the amount of caffeine in 100 cups of coffee.
Caffeine gets absorbed in the stomach and small intestine and then distributed throughout the body, including the brain. The amount circulating in the blood peaks 30 to 45 minutes after it's ingested and only small amounts are around eight to 10 hours later. In between, the amount circulating declines as caffeine gets metabolized in the liver.
Tobacco and marijuana accelerate caffeine metabolism, which reduces the time caffeine circulates in the body. Oral contraceptives slow it down, so they have the opposite effect. Researchers have identified genes that influence a person's natural risk of caffeine metabolism, which might explain why some people are exquisitely sensitive to caffeine while others are not.
Caffeine probably has multiple targets in the brain, but the main one seems to be adenosine receptors. Adenosine is a brain chemical that dampens brain activity. By hogging adenosine's receptors, caffeine sets off a chain of events that affects the activity of dopamine, another important brain chemical, and the areas of the brain involved in arousal, pleasure, and thinking. A part of the brain affected by Parkinson's disease, called the striatum, has many adenosine receptors; by docking on them, caffeine seems to have some protective effects.
Outside the brain, caffeine can be a performance enhancer, boosting the strength of muscle contraction and offsetting some of the physiological and psychological effects of physical exertion. But, especially in the short term, it also has negative effects, which include raising blood pressure, making arteries stiffer, and increasing levels of homocysteine, insulin, and possibly cholesterol. Habitual use may cause some of these effects to wear off. For some conditions, though, coffee may have some benefit despite, rather than because of, caffeine.
Caffeine content
*35 mg presumes a single tea bag steeped in 8-ounce cup
**Per 8.4-ounce can


Cafestol and kahweol: Filtering out cholesterol boostersCoffee drinkers concerned about cholesterol weren't happy about some early study results showing that coffee seems to increase cholesterol levels, and "bad" LDL cholesterol levels in particular. But upon closer inspection, the bad news turned out to be not so bad, because the cholesterol-raising effect seems to be limited to coffee that hasn't been filtered, which includes Turkish coffee, coffee brewed in a French press, and the boiled coffee consumed in Scandinavia.
The cholesterol-raising ingredients in coffee are oily substances called diterpenes, and the two main types in coffee are cafestol (pronounced CAF-es-tol) and kahweol (pronounced KAH-we-awl). They are present either as oily droplets or in the grounds floating in the coffee. But a paper filter traps most of the cafestol and kahweol, so coffee that's been filtered probably has little, if any, effect on cholesterol levels.
The best evidence is for paper filters, but an interesting study published in 2011 showed that filtering methods used in Singapore (the so-called sock method, which uses a cotton-nylon cloth) and India (metal mesh) were also effective at trapping cafestol.
Espresso contains more cafestol and kahweol than paper-filtered coffee, but because it is consumed in smaller amounts, it may not have much of an effect on people's LDL level.
There is a twist to this aspect of the coffee story, because cafestol and kahweol may also have some health benefits that are lost when they're filtered out. The research is in the preliminary stages, but cafestol and kahweol could have some anticancer effects and be good for the liver.
Chlorogenic acid and other antioxidantsExplanations for the association between coffee consumption and lower rates of heart disease and diabetes often point to chlorogenic acid and other obscure antioxidant substances as the responsible parties. Antioxidants are substances that sop up reactive molecules before they have a chance to harm sensitive tissue like the lining of blood vessels. Chlorogenic acid was probably the main antioxidant in your cup of coffee this morning. Some experiments have shown that it may also inhibit absorption of glucose in the digestive system and even out insulin levels.
Chlorogenic acid might be another coffee ingredient with a split personality. Along with caffeine, it seems to push up levels of homocysteine, an amino acid that has been associated with artery-clogging atherosclerosis.
Vitamins and mineralsCoffee isn't a great source of vitamins and minerals, but as a plant-based drink, it contains some, and a few that we should be getting more of.
Let's start with magnesium. A cup of coffee contains about 7 mg, which is a drop in the daily-requirement bucket (420 mg for men, 320 mg for women). But because we don't eat enough fruit, vegetables, and whole grains, the average American's intake falls about 100 mg short of the daily goal. A cup of coffee or two can help close that gap a little bit.
Potassium can offset some of the negative consequences of sodium. At about 116 mg per cup, coffee's contribution toward the 4,700 mg of the potassium that we're supposed to get daily is a widow's mite, but it's something. A cup of coffee also has small amounts of niacin (0.5 mg) and choline (6.2 mg).
A health drink? Not quite.It is one thing to say that coffee may be good for you; it's another to say it's so good for you that drinking it should be recommended. And we're not there yet.
All of the favorable studies and all of the seemingly healthful ingredients in coffee are good news for coffee drinkers. They can relax and enjoy their habit. And people who don't drink coffee can find plenty of other things to do to help keep themselves healthy.
                                                                               




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