咖啡、茶或可预防肝癌 — 中国研究着眼于六种饮食习惯与 HC

StephenW

咖啡、茶或可预防肝癌
— 中国研究着眼于六种饮食习惯与 HCC 风险之间的关联

作者：Zaina Hamza，MedPage Today 特约撰稿人 2022 年 6 月 10 日
分享至Facebook
分享到推特
分享到linkedin
电子邮件文章
一张年轻女子在办公室端着一盘外卖咖啡的照片。

根据来自中国的一项大型孟德尔随机化研究，某些饮食习惯（例如较高的酒精摄入量）与较高的肝细胞癌 (HCC) 风险相关，而其他饮食习惯（例如喝咖啡和茶）与较低的风险相关。

据报道，在超过 200,000 名参与者中，经常饮酒与患 HCC 的风险相关（OR 1.57，95% CI 1.32-1.86），曾经饮酒也是如此（OR 1.11，95% CI 1.05-1.18；两者均 P<0.001）香港中文大学医学博士、公共卫生硕士 Martin Wong 及其同事。

另一方面，饮用咖啡与 HCC 风险呈负相关（OR 0.69, 95% CI 0.53-0.90, P=0.007），饮用绿茶或传统茶也是如此（OR 0.11, 95% CI 0.05） -0.26）以及牛奶和酸奶（OR 0.18, 95% CI 0.09-0.34；P<0.001），他们在 Hepatology Communications 中指出。

“我们的研究结果强调了保持健康饮食习惯在预防肝癌中的重要性，”Wong 告诉 MedPage Today。

“以前关于饮食习惯和肝癌风险的研究主要是观察性研究。饮食习惯可能只是相关因素，而不是肝癌的致病因素，因此限制了它们的影响，”他指出。

“本研究中使用的孟德尔随机化是作为一种研究设计来推断因果关系的，这可以判断饮食摄入是否可能导致肝癌，”他解释说。 “它对公共卫生实践产生了更重大的影响。”

作者说，由于酒精的第一种代谢产物乙醛会刺激氧化应激，产生 DNA 加合物并修饰相关基因，因此它还可以促进肝癌的发生。此外，长期大量饮酒通常会导致肝硬化，进而发展为 HCC。

咖啡先前已被证明对肝纤维化具有保护作用。 Wong 和团队认为，牛奶和酸奶的保护作用可能归因于抑制致癌作用的有毒次级胆汁酸和游离脂肪酸的钙结合。

此外，酸奶中的某些乳酸菌（嗜热链球菌）可防止致癌并刺激免疫系统。茶叶中的主要活性化合物是多酚类物质，如表儿茶素和表没食子儿茶素，可抑制肿瘤细胞生长，抑制血管生成和 DNA 甲基化，促进肿瘤细胞凋亡。

在这项研究中，Wong 及其同事检查了来自日本生物银行的全基因组关联研究的数据，这些数据涉及 200,000 多名 20 至 89 岁的东亚血统参与者在 2003 年至 2018 年期间的六种饮食习惯：曾经/从不饮酒 (n=165,084)、酒精消费量 (n=58,610)、咖啡消费量 (n=152,634)、茶消费量 (n=152,653)、牛奶消费量 (n=152,965) 和酸奶消费量 (n=152,097)。

在参与者中，1,866 人患有 HCC（1,384 名男性和 482 名女性，平均年龄 68 岁）；他们与 195,745 名对照组（97,655 名男性和 98,090 名女性，平均年龄 62 岁）进行了比较，这些对照组是从其他四个基于日本人群的前瞻性队列以及 BioBank Japan 中招募的。

Wong 和团队评估了与六种饮食习惯相关的单核苷酸多态性 (SNP)，这些饮食习惯被选为工具变量。五个、两个和六个 SNP 被确定为从不饮酒、饮酒和咖啡消费，而一个 SNP 被用于消费茶、牛奶和酸奶。分析表明，rs671 是 ALDH2 基因的一个变体，是关于从不饮酒和咖啡消费与 HCC 风险之间关联的最重要的 SNP。

Wong 及其同事指出，SNP 很少的饮食习惯无法通过多种孟德尔随机化方法进行测试，这是一项研究限制。由于 HCC 病例数较低，六种饮食习惯与 HCC 风险之间的每种关联的统计功效较低。此外，研究结果可能仅限于东亚人群。

    作者['full_name']

    Zaina Hamza 是《今日医学》杂志的特约撰稿人，报道胃肠病学和传染病。她常驻芝加哥。

披露

Wong 和合著者报告没有利益冲突。

主要资源

肝病通讯

来源参考：Deng Y, et al 《六种饮食习惯与肝细胞癌风险的关联：孟德尔随机化研究》Hepatol Commun 2022； DOI：10.1002/hep4.1960。

StephenW

Coffee, Tea May Be Protective Against Liver Cancer
— Chinese study looks at association between six dietary habits and HCC risk

by Zaina Hamza, Staff Writer, MedPage Today June 10, 2022
share to facebook
share to twitter
share to linkedin
email article
A photo of a young woman carrying a tray of take-out coffee in an office.

Certain dietary habits such as higher alcohol intake were associated with a higher risk of hepatocellular carcinoma (HCC), while others such as coffee and tea drinking were linked with a lower risk, according to a large Mendelian randomization study from China.

Among over 200,000 participants, regular consumption of alcohol was associated with risk of HCC (OR 1.57, 95% CI 1.32-1.86), as was ever drinking (OR 1.11, 95% CI 1.05-1.18; P<0.001 for both), reported Martin Wong, MD, MPH, of the Chinese University of Hong Kong, and colleagues.

On the other hand, consumption of coffee was inversely associated with HCC risk (OR 0.69, 95% CI 0.53-0.90, P=0.007), and the same was true for consumption of green or traditional tea (OR 0.11, 95% CI 0.05-0.26), and milk and yogurt (OR 0.18, 95% CI 0.09-0.34 for both; P<0.001 for all), they noted in Hepatology Communications.

"Our findings highlight the importance of maintaining healthy diet habits in the prevention of liver cancer," Wong told MedPage Today.

"Previous studies examining dietary habits and risk of liver cancer are mainly observational studies. The dietary habits may simply be associated factors, but not causal factors of liver cancer, hence limiting their implications," he noted.

"Mendelian randomization used in the present study was introduced as a study design to infer causality, which could tell whether dietary intake could possibly cause liver cancer," he explained. "It has a more significant impact on public health practices."

Because alcohol's first metabolic product, acetaldehyde, stimulates oxidative stress, generates DNA adducts, and modifies related genes, it could also promote liver carcinogenesis, the authors said. Moreover, long-term heavy alcohol use often results in cirrhosis, which progresses to HCC.

Coffee has previously been shown to have a protective effect against liver fibrosis. Wong and team suggested that the protective effect of milk and yogurt might be attributed to the calcium binding of toxic secondary bile acids and free fatty acids that inhibit carcinogenic effects.

Additionally, certain lactic acid bacteria (Streptococcus thermophilus) in yogurt prevent carcinogenesis and stimulate the immune system. The major active compounds in tea are polyphenols, such as epicatechin and epigallocatechin, which inhibit tumor cell growth, suppress angiogenesis and DNA methylation, and promote apoptosis of tumor cells.

For this study, Wong and colleagues examined data from genome-wide association studies from BioBank Japan on six dietary habits among over 200,000 participants of Eastern Asian descent ages 20 to 89 from 2003 to 2018: ever/never drinking (n=165,084), alcohol consumption (n=58,610), coffee consumption (n=152,634), tea consumption (n=152,653), milk consumption (n=152,965), and yogurt consumption (n=152,097).

Of the participants, 1,866 had HCC (1,384 men and 482 women, mean age 68); they were compared with 195,745 controls (97,655 men and 98,090 women, mean age 62), who were recruited from four other Japanese population-based prospective cohorts, as well as BioBank Japan.

Wong and team assessed single-nucleotide polymorphisms (SNPs) linked to the six dietary habits, which were selected as instrumental variables. Five, two, and six SNPs were identified for ever/never drinking, alcohol consumption, and coffee consumption, while one SNP was used for consumption of tea, milk, and yogurt. Analyses showed that rs671, a variant of the ALDH2 gene, was the most important SNP for the associations of ever/never drinking and coffee consumption with HCC risk.

Wong and colleagues noted that dietary habits that had few SNPs could not be tested across multiple Mendelian randomization methods, which was a study limitation. Since the number of HCC cases was low, the statistical power for each association between the six dietary habits and HCC risk was low. Furthermore, the findings may be limited to an Eastern Asian population.

    author['full_name']

    Zaina Hamza is a staff writer for MedPage Today, covering Gastroenterology and Infectious disease. She is based in Chicago.

Disclosures

Wong and co-authors reported no conflicts of interest.

Primary Source

Hepatology Communications

Source Reference: Deng Y, et al "Associations between six dietary habits and risk of hepatocellular carcinoma: a Mendelian randomization study" Hepatol Commun 2022; DOI: 10.1002/hep4.1960.