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Coffee Consumption Is Associated With Lower Liver Stiffness: A Nationally Representative Study

Published:October 05, 2021DOI:https://doi.org/10.1016/j.cgh.2021.09.042

      Background & Aims

      Coffee is associated with a reduced risk of liver disease. This association is limited by important sources of confounding such as recall bias, healthy user bias, and indirect measures of liver outcomes or health. We aimed to examine the impact of coffee consumption with liver fibrosis and steatosis in a nationally representative sample.

      Methods

      We evaluated 4510 subjects 20 years and older from the 2017 to 2018 National Health and Nutrition Examination Survey study who underwent both transient elastography and two 24-hour dietary recall examinations. We tested the associations between liver stiffness measurements (LSM) of 9.5 kpa or greater or controlled attenuation parameter (CAP) and coffee consumption. We used decaffeinated coffee and tea consumption as controls. As a sensitivity analysis, we included all drinks in 1 model, examined the impact of caffeine consumption, and adjusted for the Healthy Eating Index-2015 and sugar-sweetened beverage consumption as separate models.

      Results

      The study sample described was aged 48 ± 0.6 years, 73% were overweight or obese, 10.6% had diabetes, 47.5% reported participation in vigorous physical activity, and 23% drank 2 or more alcoholic drinks per day. After multivariate adjustment, there was no association between coffee and controls with CAP. Subjects who drank more than 3 cups of coffee, but not other drinks, had a 0.9 lower kPa (95% CI, -1.6 to -0.1; P = .03). More than 3 cups of coffee were protective for LSM of 9.5 kpa or higher (odds ratio, 0.4; 95% CI, 0.2–1.0; P = .05). Accounting for all beverages in the same model, only consuming more than 3 cups of coffee remained independently associated with LSM (odds ratio, 0.5; 95% CI, 0.2–0.9; P = .03). Caffeine was not associated significantly with LSM at any dose. Finally, adjusting for sugar-sweetened beverage consumption and Healthy Eating Index-2015, coffee consumption remained associated with a lower LSM. The protective nature of coffee consumption therefore is not attributable to caffeine and persists in participants regardless of their diet quality.

      Conclusions

      Coffee is associated with lower liver stiffness, but not steatosis, as measured by CAP among US adults.

      Keywords

      Abbreviations used in this paper:

      BMI (body mass index), CAP (controlled attenuation parameter), LSM (liver stiffness measurement), NHANES (National Health and Nutrition Examination Survey), USDA (US Department of Agriculture)
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      References

        • Moon A.M.
        • Singal A.G.
        • Tapper E.B.
        Contemporary epidemiology of chronic liver disease and cirrhosis.
        Clin Gastroenterol Hepatol. 2020; 18: 2650-2666
        • Bravi F.
        • Bosetti C.
        • Tavani A.
        • et al.
        Coffee reduces risk for hepatocellular carcinoma: an updated meta-analysis.
        Clin Gastroenterol Hepatol. 2013; 11: 1413-1421. e1
        • Freedman N.D.
        • Everhart J.E.
        • Lindsay K.L.
        • et al.
        Coffee intake is associated with lower rates of liver disease progression in chronic hepatitis C.
        Hepatology. 2009; 50: 1360-1369
        • Kennedy O.
        • Roderick P.
        • Buchanan R.
        • et al.
        Systematic review with meta-analysis: coffee consumption and the risk of cirrhosis.
        Aliment Pharmacol Ther. 2016; 43: 562-574
        • Molloy J.W.
        • Calcagno C.J.
        • Williams C.D.
        • et al.
        Association of coffee and caffeine consumption with fatty liver disease, nonalcoholic steatohepatitis, and degree of hepatic fibrosis.
        Hepatology. 2012; 55: 429-436
        • Setiawan V.W.
        • Wilkens L.R.
        • Lu S.C.
        • et al.
        Association of coffee intake with reduced incidence of liver cancer and death from chronic liver disease in the US multiethnic cohort.
        Gastroenterology. 2015; 148: 118-125
        • Shrank W.H.
        • Patrick A.R.
        • Brookhart M.A.
        Healthy user and related biases in observational studies of preventive interventions: a primer for physicians.
        J Gen Intern Med. 2011; 26: 546-550
        • Leung C.W.
        • Tapper E.B.
        Sugar-sweetened beverages are associated with increased liver stiffness and steatosis among apparently healthy adults in the United States.
        Clin Gastroenterol Hepatol. 2021; (Epub ahead of print)
        • Singh S.
        • Muir A.J.
        • Dieterich D.T.
        • et al.
        American Gastroenterological Association Institute technical review on the role of elastography in chronic liver diseases.
        Gastroenterology. 2017; 152: 1544-1577
        • Krebs-Smith S.M.
        • Pannucci T.E.
        • Subar A.F.
        • et al.
        Update of the healthy eating index: HEI-2015.
        J Acad Nutr Diet. 2018; 118: 1591-1602
        • Wiltberger G.
        • Wu Y.
        • Lange U.
        • et al.
        Protective effects of coffee consumption following liver transplantation for hepatocellular carcinoma in cirrhosis.
        Aliment Pharmacol Ther. 2019; 49: 779-788
        • Kennedy O.J.
        • Fallowfield J.A.
        • Poole R.
        • et al.
        All coffee types decrease the risk of adverse clinical outcomes in chronic liver disease: a UK Biobank study.
        BMC Public Health. 2021; 21: 970
        • Vitaglione P.
        • Morisco F.
        • Mazzone G.
        • et al.
        Coffee reduces liver damage in a rat model of steatohepatitis: the underlying mechanisms and the role of polyphenols and melanoidins.
        Hepatology. 2010; 52: 1652-1661
        • Chan E.S.
        • Montesinos M.C.
        • Fernandez P.
        • et al.
        Adenosine A2A receptors play a role in the pathogenesis of hepatic cirrhosis.
        Br J Pharmacol. 2006; 148: 1144-1155
      1. Feng L, Tapper EB, Sun X, et al. Purinergic modulation and CD39/ENTPD1 in cancer. Frontiers in anti-cancer drug discovery. Beijing, China: Bentham Science Publishers, 2014:229–292.

        • Cardin R.
        • Piciocchi M.
        • Martines D.
        • et al.
        Effects of coffee consumption in chronic hepatitis C: a randomized controlled trial.
        Dig Liver Dis. 2013; 45: 499-504
        • Xiao Q.
        • Sinha R.
        • Graubard B.I.
        • et al.
        Inverse associations of total and decaffeinated coffee with liver enzyme levels in National Health and Nutrition Examination Survey 1999-2010.
        Hepatology. 2014; 60: 2091-2098

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