喝咖啡可以阻止硬化有道理吗 - 肝胆相照论坛

每天喝咖啡能减少肝硬化风险

2009年06月08日15:08 来源：《扬子晚报》
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　　美国科研人员研究发现，每日饮用一杯咖啡可以降低肝硬化的发生率22%，有饮咖啡习惯的人因为肝硬化的原因而住院的比普通人低一半左右。瑞典的最新研究显示，每天喝两杯咖啡，可以使罹患肝癌的风险降低43%。

　　有关专家指出，尽管咖啡能养肝，但仍不能多喝。因为咖啡中的咖啡碱能促进钙的排出，容易引起骨质疏松症，特别是处于更年期的妇女更应该慎重。另外，咖啡碱是通过肝脏分解的物质之一，而肝功能不健全者咖啡碱的新陈代谢能力亦弱，所以若饮用大量咖啡，则有诱发脉搏加快、心律不齐等症的危险。此外，孕妇、老年妇女、患有严重胃病、高血压、冠心病、动脉硬化、癌症及维生素B1缺乏者都不宜喝咖啡。

Coffee May Protect Against Alcoholic Cirrhosis

News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD, FAAFP

Authors and Disclosures

CME Released: 06/13/2006; Reviewed and Renewed: 06/13/2007; Valid for credit through 06/13/2008

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June 13, 2006 — Coffee may be protective of cirrhosis, particularly alcoholic cirrhosis, according to the results of a cohort study reported in the June 12 issue of the Archives of Internal Medicine.

"A minority of persons at risk develop liver cirrhosis, but knowledge of risk modulators is sparse," write Arthur L. Klatsky, MD, from the Kaiser Permanente Medical Care Program in Oakland, Calif, and colleagues. "Several reports suggest that coffee drinking is associated with lower cirrhosis risk."

In this study, 125,580 multiethnic members of a comprehensive prepaid healthcare plan who had no known liver disease supplied baseline data at voluntary health examinations from 1978 to 1985. Through 2001, 330 of these members were diagnosed as having liver cirrhosis, including 199 members with alcoholic cirrhosis and 131 subjects with nonalcoholic cirrhosis, confirmed by medical record review. The investigators used Cox proportional hazards models with 7 covariates to estimate the association of coffee drinking with cirrhosis, and they used logistic regression for cross-sectional analysis of baseline aspartate aminotransferase and alanine aminotransferase levels.

Relative risks for alcoholic cirrhosis for coffee drinking (vs none) were 0.7 for less than 1 cup per day (95% confidence interval [CI], 0.4 - 1.1); 0.6 for 1 to 3 cups, (95% CI, 0.4 - 0.8; P < .001); and 0.2 for 4 or more cups, (95% CI, 0.1 - 0.4; P < .001). For nonalcoholic cirrhosis, relative risks were 1.2 for less than 1 cup (95% CI, 0.6 - 2.2); 1.3 for 1 to 3 cups (95% CI, 0.8 - 2.1); and 0.7 for 4 or more cups (95% CI, 0.4 - 1.3).

These relative risks for coffee drinking were consistent in different subgroups. Tea drinking was not related to alcoholic or nonalcoholic cirrhosis. Cross-sectional analyses revealed that coffee drinking was related to lower prevalence of high aspartate aminotransferase and alanine aminotransferase levels. The odds ratio of 4 or more cups per day (vs none) for a high aspartate aminotransferase level was 0.5 (95% CI, 0.4 - 0.6; P < .001), and it was 0.6 for a high alanine aminotransferase level, (95% CI, 0.6 - 0.7; P < .001). Inverse relations were stronger in those who drank large quantities of alcohol.

"These data support the hypothesis that there is an ingredient in coffee that protects against cirrhosis, especially alcoholic cirrhosis," the authors write. "The absent relation of tea drinking to cirrhosis might mean that the relation is less likely due to caffeine than to some other coffee ingredient."

Study limitations include possible underreporting of intake by some heavy drinkers; substantial tea drinking relatively uncommon in the study population; ascertainment of habits only at baseline; lack of information about changes in coffee drinking habits before baseline evaluation; use of hospitalization and death as end points; incomplete follow-up of the cohort; inability to account for changes in alcohol drinking or inaccurate reporting of alcohol drinking; observational nature of the data; and the absence of an established mechanism.

"There are also no clear therapeutic implications; even if coffee is protective, the primary approach to reduction of alcoholic cirrhosis is avoidance or cessation of heavy alcohol drinking," the authors write. "Assuming causality, the data do suggest that coffee intake may partly explain the variability of cirrhosis risk in alcohol consumers. Basic research about hepatic coffee-ethanol interactions is warranted, but we should keep in mind that coffee might represent only one of a number of potential cirrhosis risk modulators."

The authors have disclosed no relevant financial relationships. The Kaiser Foundation Research Institute and the Alcoholic Beverage Medical Research Foundation supported this study.

Arch Intern Med. 2006;166:1190-1195

Coffee Lowers Risk of Cirrhosis?
Tea Does Not Reduce Liver Disease Risk

By Buddy T, About.com

Updated: June 29, 2006

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Drinking coffee may reduce the risk of developing alcohol-related liver disease, but authors of a new study warn that the best way to reduce the risk of cirrhosis is to stop drinking alcohol.

Researchers at Kaiser Permanente Medical Care Program, Oakland, California studied 125,580 people and found that for each cup of coffee they drank per day, participants were 22 percent less likely to develop alcoholic cirrhosis.

Long-term heavy drinking is the most common cause of cirrhosis, but many other factors play a role in whether or not a chronic drinker develops the liver disease, such as genetics, diet and nutrition, smoking and the interaction of alcohol with other toxins, the authors said.

Arthur L. Klatsky, M.D., and colleagues analyzed data from 125,580 individuals (55,247 men and 70,333 women) who did not report liver disease when first examined between 1978 and 1985. Participants were surveyed about how much alcohol, coffee and tea they drank per day during the past year. Some had their blood tested for levels of certain liver enzymes which are detected when the liver is diseased or damaged.

By 2001, 330 of the study participants were diagnosed with cirrhosis, 199 of them with alcoholic cirrhosis.

Lower Risk of Cirrhosis
The results of the research included:

* For each cup of coffee they drank per day, participants were 22 percent less likely to develop alcoholic cirrhosis.

* Drinking coffee was also associated with a slight reduction in risk for other types of cirrhosis, other than alcoholic cirrhosis.

* Participants who drank both alcohol and coffee had lower liver enzyme levels than those who only drank alcohol.

* The difference in liver enzyme levels was greatest for those who were the heaviest alcohol drinkers.

* Tea drinking was not related to reduced risk, suggesting that it is not caffeine that is responsible for the relationship between coffee and reduced cirrhosis risk.

The authors said their study had not resolved the issue of ingredient or property in coffee offers protection against developing liver disease. "Previous reports are disparate with respect to whether the apparently protective coffee ingredient is caffeine; in our opinion this issue is quite unresolved," the authors said in a news release.

"Even if coffee is protective, the primary approach to reduction of alcoholic cirrhosis is avoidance or cessation of heavy alcohol drinking," Klatsky said. "Assuming causality, the data do suggest that coffee intake may partly explain the variability of cirrhosis risk in alcohol consumers. Basic research about hepatic coffee-ethanol interactions is warranted, but we should keep in mind that coffee might represent only one of a number of potential cirrhosis risk modulators."

Source: The study was published the June 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.