咖啡链接到减少肝纤维化的人与HBV，HCV和NAFLD

StephenW

                                                                                AASLD 2015: Coffee Linked to Reduced Liver Fibrosis in People with HBV, HCV, and NAFLD                                                               

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                 Details                                                                                Category: Fibrosis & Cirrhosis                                                                Published on Wednesday, 25 November 2015 00:00                                                        Written by Liz Highleyman               
                                                                                               

Image: Dreamstime

                                       
               
               
                Drinking coffee was associated with lower liver stiffness -- a non-invasive measure used to estimate liver fibrosis -- in people with hepatitis B, hepatitis C, and non-alcoholic fatty liver disease (NAFLD), researchers reported at the 2015 AASLD Liver Meeting last week in San Francisco. The study also showed a trend toward less liver fat build-up in people with NAFLD.
        Over years or decades chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection can lead to serious liver disease including cirrhosis (scarring), hepatocellular carcinoma (a type of liver cancer), and liver failure necessitating a transplant. NAFLD -- fat in the liver not related to alcohol use -- can lead to the same outcomes. As HBV vaccination and effective new treatments for hepatitis C reduce liver disease due to viral hepatitis, NAFLD is expected to become a major indication for liver transplantation given rising rates of obesity.
        Alexander Hodge from Monash Medical Centre and colleagues conducted a retrospective cross-sectional study to see whether coffee consumption leads to improvements in non-invasive markers of liver fibrosis and steatosis (fat accumulation).
        In prior studies coffee consumption has been linked to a wide range of health benefits including reduced risk of type 2 diabetes, metabolic syndrome, and several types of cancer, the researchers noted as background. It may have a particularly beneficial effect on the liver, being associated with lower liver enzyme levels and reduced cirrhosis and liver cancer. It is not yet known whether these benefits are related to caffeine or other components of coffee such as antioxidants or other phytochemicals. Some studies suggest caffeine and other chemicals in coffee may dampen inflammation and reduce collagen production.
        In this study liver health was assessed using transient elastography or FibroScan. Although liver biopsy has traditionally been considered the ''gold standard" for determining the extent of liver injury, clinicians are increasingly using less expensive non-invasive methods.
        Transient elastography uses shear waves to assess liver elasticity or "stiffness." Higher liver stiffness scores (expressed in kiloPascals or kPa) indicate more extensive liver damage. A score below 6-7 kPa suggests absent or mild fibrosis (stage F0-F1) while a score above 13-14 kPa suggests cirrhosis (stage F4) in people with viral hepatitis. Another transient elastography measure, the controlled attenuation parameter or CAP (expressed in decibels per meter or dB/m), is used to assess liver steatosis. Fat blocks propagation of ultrasound waves, so greater attenuation suggests more steatosis. Scores range from 100 to 400, with a score above 250 suggesting significant steatosis.
        The researchers collected data on self-reported coffee and alcohol consumption -- as well as the type of coffee (instant, espresso, filtered, or boiled) -- among all patients with hepatitis B, hepatitis C, or NAFLD undergoing transient elastometry at their hospital clinic between May 2012 and November 2013. They also obtained information about demographic characteristics, weight and body mass index (BMI), smoking, and alanine aminotransferase (ALT) liver enzyme levels.
        Over 18 months they evaluated 1130 people, including 529 (47%) with hepatitis B, 434 (38%) with hepatitis C, and 167 (15%) with NAFLD. Overall, 57% were men, the average age was 48 years, and a quarter were smokers. The average BMI was 25.7 kg/m2and the mean ALT level was 39 IU/L among people with available measurements.
        Most participants reported that they consumed some coffee, with a median of 1 cup per day but ranging up to 20 cups daily; 72% reported drinking instant coffee and 24% drank espresso, with only a small number (1%-2%) drinking filtered, boiled, or decaf coffee. Average daily alcohol consumption was about 5 g/day.
        Results

•                 The median liver stiffness score across all participants was 6.1 kPa, suggesting absent to mild fibrosis. However, people with HBV had lower scores than those with HCV or NAFLD (median 5.3, 7.1, and 7.4, respectively).
•                 Among people with available controlled attenuation parameter data, the overall mean CAP score was 214 dB/m, rising above the steatosis threshold only for those with NAFLD (mean 201, 210, and 258, respectively).
•                 People with hepatitis C who drank 2 or more cups of coffee daily had a 13% reduction in liver stiffness, after taking into account confounding factors including age, sex, weight, alcohol consumption, and smoking -- a significant association.
•                 People with hepatitis B who drank 4 or more cups of coffee had a significant 18% reduction in liver stiffness in an adjusted analysis including ALT.
•                 There were no significant associations between coffee consumption and CAP scores among people with hepatitis B or C.
•                 Among people with NAFLD, those who drank 4 or more cups of coffee daily had a 24% decrease in liver stiffness in an adjusted analysis.
•                 Greater coffee consumption showed a trend towards a association with lower CAP scores in people with NAFLD, but this fell short of statistical significance.
•                 Coffee consumption had no effect on CAP in people with hepatitis B or C.
  

        Based on these findings, the researchers concluded, "coffee consumption is associated with less liver stiffness in patients with NAFLD, HCV, and HBV, [and a] trend to less hepatic steatosis in [patients with] NAFLD."
        These findings, they said, "add to the growing body of evidence suggesting coffee may be a beneficial supplement in some liver diseases."
        11/25/15
        Reference
        A Hodge, SP Lim, E Goh, et al. Coffee consumption reduces liver stiffness in those with hepatitis C and a non-invasive marker of steatosis in those with non-alcoholic fatty liver disease. AASLD Liver Meeting 2015. San Francisco, November 13-17, 2015. Abstract 47.
       

StephenW

AASLD 2015：咖啡链接到减少肝纤维化的人与HBV，HCV和NAFLD

  

详细信息
    类别：纤维化和肝硬化
    周三公布，2015年00月25日
    撰稿利兹Highleyman

ALT

图片：误。

喝咖啡与降低肝脏硬度有关 - 用来评估肝纤维化无创性的措施 - 在人与乙型肝炎，丙型肝炎和非酒精性脂肪性肝病（NAFLD），研究人员报告在2015年AASLD肝病会议上周在旧金山。这项研究还显示，对少肝脏脂肪积聚在人与NAFLD的趋势。

过几年或几十年的慢性乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）感染可导致严重的肝脏疾病，包括肝硬化（疤痕），肝细胞癌（一种肝癌的），和肝功能衰竭因而必须使用移植。 NAFLD - 脂肪不相关的酒精使用肝脏 - 可导致相同的结果。由于乙肝疫苗和有效的新的治疗为丙型肝炎减轻肝脏疾病，由于病毒性肝炎，脂肪肝，有望成为给定的肥胖率上升肝移植的一大标志。

莫纳什医学中心和同事亚历山大·霍奇进行了回顾性横断面研究，看看咖啡消费是否会导致改善肝纤维化，脂肪变性（脂肪堆积）的非侵入性的标志物。

在以前的研究咖啡消费已被链接到一个广泛的健康益处，包括2型糖尿病的风险降低，代谢综合征，与几种类型的癌症，研究人员指出作为背景。它可以具有一个特别有益的作用，对肝脏，被低级肝酶水平相关联，并且降低了肝硬化和肝癌。它目前还不知道这些好处是否与咖啡因或咖啡其它组分，例如抗氧化剂或其它植物化学物质。一些研究表明，咖啡因和咖啡中的其他化学物质可能会抑制炎症反应，减少胶原蛋白的生产。

在这项研究中肝脏健康使用瞬时弹性成像或肝纤维评估。虽然肝活检历来被认为是“金标准”，用于确定肝损伤的程度，临床医生越来越多地使用更便宜的非侵入性的方法。

瞬时弹性成像利用横波来评估肝脏弹性或“刚性”。更高的肝脏硬度得分（以千帕或千帕）表示更广泛的肝损害。以下6-7千帕的成绩表明，无或轻度纤维化（阶段F0-F1），而高于13-14千帕的成绩表明，肝硬化（阶段F4）在人与病毒性肝炎。另一瞬时弹性测量中，受控衰减参数或CAP（表示为每米或分贝/米分贝），用于评估肝脏脂肪变性。超声波脂肪块的传播，让更多的衰减意味着更多的脂肪。得分范围为100至400，具有高于250的分数表明显著脂肪变性。

研究人员收集了自报的咖啡和酒精消费的数据 - 以及咖啡的种类（瞬间，浓咖啡，过滤，或煮沸） - 在所有患者的乙肝，丙肝，脂肪肝，或在经历短暂elastometry其医院门诊部2012年5月和2013年11月间，他们还获得了有关人口学特征，体重和身体质量指数（BMI），吸烟，和丙氨酸氨基转移酶（ALT），肝酶水平的信息。

超过18个月他们评估1130人，其中529（47％）与B型肝炎，434（38％）与C型肝炎，及167（15％）与NAFLD。总体而言，57％为男性，平均年龄为48岁，而有四分之一是烟民。平均体重指数为25.7公斤/ m2and平均ALT水平为39 IU / L的人与现有的测量中。

大多数与会者报告说，他们食用了一些咖啡，以每天1杯，但每天范围可达20杯位; 72％的受访喝速溶咖啡和24％，喝咖啡，只有一小部分（1％-2％）饮水过滤，煮，或无咖啡因咖啡。平均每日饮酒量为约5克/天。

结果

    在所有参与者中位数肝脏硬度得分为6.1千帕，这表明不存在轻度纤维化。然而，人乙肝有分数比那些HCV或NAFLD更低（中位数5.3，7.1，和7.4，分别）。
    在人与现有控制衰减参数数据，整体平均CAP分值为214分贝/米，上面只为那些与NAFLD的脂肪变性门槛不断提高（分别指201，210，258，）。
    以丙型肝炎的人谁喝2以上杯咖啡每日曾在肝脏硬度降低13％，同时考虑到混淆因素，包括年龄，性别，体重，饮酒，吸烟后 - 一个显著关联。
    乙型肝炎的人谁喝咖啡4杯或更多有在肝刚度显著减少在调整后的分析，包括ALT 18％。
    有患有乙肝或丙肝之间饮用咖啡和CAP分数之间没有显著协会
    在人与NAFLD，那些谁喝4杯或更多咖啡，每天有下降24％，肝脏硬度经调整的分析。
    大咖啡消费表明对与人NAFLD下盖分数关联的趋势，但是这没有达到统计学显着性。
    咖啡消费量曾在患有乙肝或丙肝对CAP无影响

基于这些发现，研究人员得出结论，“咖啡消费量较少的肝脏硬度的[例] NAFLD相关的NAFLD患者，HCV和HBV，[和]趋势，少脂肪肝”。

这些研究结果，他们说，“增加的证据表明咖啡可能在某些肝脏疾病的有益补充的越来越多。”

15年11月25日

参考

杂牌，SP林，E吴作栋等。咖啡消耗量降低肝脏硬度在那些与丙型肝炎和脂肪变性的在那些与非酒精性脂肪肝疾病的非侵入性的标志物。 AASLD肝病会议2015年旧金山十一月13-17日2015年47抽象。

fs2002

就是说喝咖啡能够降低肝脏硬度？

StephenW

fs2002 发表于 2015-12-1 08:24
就是说喝咖啡能够降低肝脏硬度？

不能说: 能够降低肝脏硬度.
只能说: 喝咖啡相关低肝脏硬度.