HBeAg阴性慢性乙型肝炎患者的咖啡摄入量与肝纤维化进展关系

StephenW

J Formos Med Assoc. 2018 Aug 16. pii: S0929-6646(18)30211-0. doi: 10.1016/j.jfma.2018.08.002. [Epub ahead of print]
Association of coffee consumption and liver fibrosis progression in patients with HBeAg-negative chronic hepatitis B: A 5-year population-based cohort study.
Chen CL1, Chang WC2, Yi CH1, Hung JS1, Liu TT1, Lei WY1, Hsu CS3.
Author information

1
    School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
2
    Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
3
    Liver Diseases Research Center, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan. Electronic address: [email protected].

Abstract
BACKGROUND/PURPOSE:

Although coffee consumption has been associated with decreased risk of liver fibrosis progression, cirrhosis or hepatocellular carcinoma in patients with HCV infection or fatty liver diseases, its effect on hepatitis B patients remains unclear. We aimed to examine the effect of coffee consumption on liver fibrosis progression and cirrhosis-related complications in patients with chronic HBV infection.
METHODS:

Coffee consumption was assessed in 2604 participants who were previously recruited from a population-based GERD survey. The primary endpoints of this study were the impact of coffee consumption on the development of cirrhosis-related complications, including liver cirrhosis, esophageal varices, or hepatocellular carcinoma at the end of 5-year follow-up. The secondary endpoints were the declines of serum predicting indices of liver fibrosis (AST/ALT, APRI, FIB-4, Hui score) or liver function tests (AST, ALT).
RESULTS:

328 patients with chronic HBV infection were enrolled into this study. At baseline, coffee consumption was associated with higher education level, more frequent tobacco use and normal blood pressure (p < 0.05 for all). Patients with higher coffee consumption had a significant lower serum AST, APRI and FIB-4 index value than non-coffee drinkers [adjusted HR 0.30, 95% CI(0.11-0.82) for AST; 0.30, 95% CI (0.11-0.84) for APRI; 0.30, 95% CI (0.13-0.69) for FIB-4]. However, higher coffee consumption didn't change serum AST levels, APRI, FIB-4 index values or incidences of cirrhosis-related complications at the end of 5-year follow-up.
CONCLUSIONS:

Coffee consumption was not associated with fibrosis progression or HCC risk in chronic hepatitis B patients over the 5-year observation period.

Copyright © 2018. Published by Elsevier B.V.
KEYWORDS:

Coffee; Follow-up studies; Hepatitis B; Humans; Questionnaires

PMID:
    30122312
DOI:
    10.1016/j.jfma.2018.08.002

StephenW

J Formos Med Assoc。 2018年8月16日.pii：S0929-6646（18）30211-0。 doi：10.1016 / j.jfma.2018.08.002。 [提前打印]
HBeAg阴性慢性乙型肝炎患者的咖啡摄入量与肝纤维化进展关系：基于5年人群的队列研究。
Chen CL1，Chang WC2，Yi CH1，Hung JS1，Liu TT1，Lei WY1，Hsu CS3。
作者信息

1
    台湾花莲市慈济大学医学院;台湾花莲，佛教慈济医学基金会花莲慈济医院内科，消化内科。
2
    台湾花莲，佛教慈济医学基金会花莲慈济医院医学研究室。
3
    台湾慈济医院基金会台北慈济医院肝病研究中心，台湾台北;台湾花莲市慈济大学中学后中医学院;台湾慈济医学基金会，台北慈济医院内科，消化内科，台湾台北。电子地址：[email protected]。

抽象
背景/目的：

虽然咖啡消费与HCV感染或脂肪肝疾病患者肝纤维化进展，肝硬化或肝细胞癌风险降低有关，但其对乙型肝炎患者的影响仍不清楚。我们的目的是检查咖啡消费对慢性HBV感染患者肝纤维化进展和肝硬化相关并发症的影响。
方法：

在2604名参与者中评估了咖啡消费量，这些参与者之前是从基于人群的GERD调查中招募的。本研究的主要终点是咖啡消费对5年随访结束时肝硬化相关并发症（包括肝硬化，食管静脉曲张或肝细胞癌）发展的影响。次要终点是血清预测肝纤维化指数（AST / ALT，APRI，FIB-4，回归评分）或肝功能检查（AST，ALT）的下降。
结果：

328名慢性HBV感染患者参加了这项研究。在基线时，咖啡消费与较高的教育水平，更频繁的烟草使用和正常血压相关（所有人的p <0.05）。咖啡摄入量较高的患者血清AST，APRI和FIB-4指数值显着低于非咖啡饮用者[AST调整HR 0.30,95％CI（0.11-0.82）; APRI为0.30,95％CI（0.11-0.84）; FIB-4的0.30,95％CI（0.13-0.69）。然而，在5年随访结束时，较高的咖啡摄入量并未改变血清AST水平，APRI，FIB-4指数值或肝硬化相关并发症的发生率。
结论：

在5年的观察期内，咖啡消费与慢性乙型肝炎患者的纤维化进展或HCC风险无关。

版权所有©2018。Elsevier B.V.
关键词：

咖啡;后续研究;乙型肝炎;人类;问卷调查

结论：
    30122312
DOI：
    10.1016 / j.jfma.2018.08.002