咖啡对慢性乙型肝炎患者肝纤维化的积极作用

StephenW

咖啡对慢性乙型肝炎患者肝纤维化的积极作用
巴雷 T、方丹 H、拉米尔 C 等人
临床营养|2022 年 1 月 25 日
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期刊摘要

注意，原始文章标题：在接受慢性乙型肝炎治疗的患者中，咖啡摄入量增加与肝纤维化生物标志物升高的风险降低相关（ANRS CO22 Hepather 队列）

尽管最近的治疗取得了进展，但在慢性感染乙型肝炎病毒 (HBV) 的患者中观察到肝纤维化、肝硬化和肝癌的高风险。研究人员旨在通过使用来自 ANRS CO22 Hepather 队列的横断面数据来确定慢性乙型肝炎病毒 (HBV) 患者显着纤维化的社会人口统计学和可改变的风险因素。

    共有 2,065 名未接受治疗和 1,727 名接受治疗的慢性 HBV 患者构成了研究人群。

    正如在接受治疗的慢性 HBV 患者中通过三种非侵入性标志物所评估的那样，咖啡摄入量的增加与显着肝纤维化的风险降低之间似乎存在一致的关联。

    在现实世界的情况下，可以立即使用这一结果，因为有晚期肝病风险的患者可能会从增加咖啡摄入量中受益。
概括
背景和目标
尽管最近的治疗取得了进展，但慢性感染乙型肝炎病毒 (HBV) 的患者仍处于肝纤维化、肝硬化和肝癌的高风险中。因此，在该人群中找到预防肝纤维化的非药物选择至关重要。使用来自 ANRS CO22 Hepather 队列的横断面数据，我们旨在确定慢性 HBV 患者显着纤维化的社会人口统计学和可改变的风险因素。
方法
逻辑回归或 Firth 惩罚最大似然逻辑回归（根据结果流行率）多变量模型用于测试解释变量与显着纤维化之间的关联，由三种非侵入性标志物评估：AST 与血小板比率指数 (APRI)、FIB- 4、γ谷氨酰转移酶与血小板的比值（GPR）。分析按 HBV 治疗状态进行分层。
结果
研究人群包括 2065 名未接受治疗和 1727 名接受治疗的慢性 HBV 患者。在所有三个接受治疗的参与者模型中，咖啡摄入量升高始终与纤维化生物标志物升高的风险降低相关，这表明存在剂量反应关系（≥ 3 杯/天与 0 杯/天的调整优势比：0.16、0.35 和 0.62， p≤0.002，分别根据 APRI、FIB-4 和 GPR）。其他可改变的风险因素包括烟草和酒精的使用。
结论
根据接受治疗的慢性 HBV 患者的三种非侵入性标志物评估，咖啡摄入量升高始终与显着肝纤维化风险降低相关。这一结果可以立即用于现实情况，因为增加咖啡摄入量可能对有晚期肝病风险的患者有益。
关键词

    咖啡
    乙型肝炎
    肝纤维化
    咖啡因
    法国

StephenW

Positive effects of coffee on liver fibrosis in patients with chronic hepatitis B
Barré T, Fontaine H, Ramier C, et al
Clinical Nutrition|January 25, 2022
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Journal Summary

NOTE, original article title: Elevated coffee consumption is associated with a lower risk of elevated liver fibrosis biomarkers in patients treated for chronic hepatitis B (ANRS CO22 Hepather cohort)

Despite recent therapeutic advances, high risk of liver fibrosis, cirrhosis and liver cancer has been observed among patients chronically infected with hepatitis B virus (HBV). Researchers aimed at determining the socio-demographic and modifiable risk factors for significant fibrosis in chronic hepatitis B virus (HBV) patients by using cross-sectional data from the ANRS CO22 Hepather cohort.

    A total of 2,065 untreated and 1,727 treated chronic HBV patients formed the study population.

    As assessed by three non-invasive markers in treated chronic HBV patients, there appeared a consistent association of increased coffee consumption with a lower risk of significant liver fibrosis.

    In real-world situations, immediate use of this result can be made, as patients at risk of advanced liver disease may benefit from increasing coffee consumption.
Summary
Background and aims
Patients chronically infected with hepatitis B virus (HBV) are at high risk of liver fibrosis, cirrhosis and liver cancer, despite recent therapeutic advances. It is therefore crucial to find non-pharmaceutical options for liver fibrosis prevention in this population. Using cross-sectional data from the ANRS CO22 Hepather cohort, we aimed to identify socio-demographic and modifiable risk factors for significant fibrosis in chronic HBV patients.
Methods
Logistic regression or Firth’s penalized maximum likelihood logistic regression (according to outcome prevalence) multivariable models were used to test for associations between explanatory variables and significant fibrosis, as assessed by three non-invasive markers: AST to platelet ratio index (APRI), FIB-4, and gamma glutamyltransferase to platelet ratio (GPR). Analyses were stratified by HBV treatment status.
Results
The study population comprised 2065 untreated and 1727 treated chronic HBV patients. Elevated coffee consumption was consistently associated with a lower risk of elevated fibrosis biomarkers in all three treated-participant models, suggesting a dose-response relationship (adjusted odds ratios for ≥ 3 cups/day versus 0 cups/day: 0.16, 0.35 and 0.62, p≤0.002, according to APRI, FIB-4 and GPR, respectively). Other modifiable risk factors included tobacco and alcohol use.
Conclusion
Elevated coffee consumption was consistently associated with a lower risk of significant liver fibrosis, as assessed by three non-invasive markers in treated chronic HBV patients. This result can be immediately used in real-world situations, as increasing coffee consumption may be beneficial for patients at risk of advanced liver disease.
Keywords

    coffee
    hepatitis B
    liver fibrosis
    caffeine
    France