霍山 山中老人刺客信条:Hepatology：适度饮用咖啡可预防肝纤维化

目前在全球范围内，糖尿病、肥胖、非酒精性肝炎等代谢疾病的发病率逐年稳步上升。在美国，科学家认为非酒精性肝炎（NAFLD）是导致机体慢性肝病的祸首。

咖啡因一直被认为能降低人们患上肝病的风险，降低慢性肝病患者纤维化程度。最近，一项发表在Hepatology杂志上新的研究证实：我们常喝的咖啡中咖啡因可以降低NAFLD患者早期纤维化的程度，多饮用咖啡有可能使非酒精性脂肪肝患者避免出现纤维化症状。

来自德克萨斯州布鲁克陆军医学中心的Stephen Harrison博士开展的这项研究所涉及到的病例包括：以往参加过NAFLD相关研究的参与者以及那些前往该医学中心肝病门诊部接受治疗的患者，人数共306人。

研究人员调查了这306位参与者咖啡使用情况，并通过超声检查将这些参与者分为四组：没有纤维化迹象的患者（对照组）、脂肪病变组、NASH 0-1阶段组、NASH 2-4阶段组。这四组参与者平均每天摄取总咖啡因的毫克数分别为307、229、351、252，平均每天摄取咖啡的毫克数分别为228、160、255、152。结果发现NASH 0-1组的参与者咖啡的摄取量明显要高于NASH 2-4组，并且NASH 0-1组的参与者体内58%的咖啡因来自于咖啡的摄取，而这一数据在NASH 2-4组仅有36%。

研究中的多元分析表明：咖啡的摄取和肝纤维化风险之间呈负相性。研究者称NASH患者适度摄入咖啡后，其肝脏早期肝纤维化发生的风险会有所降低。(生物谷 Bioon.com)

doi:10.1002/hep.24731
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Association of coffee and caffeine consumption with fatty liver disease, nonalcoholic steatohepatitis, and degree of hepatic fibrosis

Jeffrey W. Molloy1, Christopher J. Calcagno2, Christopher D. Williams1, Frances J. Jones1, Dawn M. Torres3, Stephen A. Harrison1,§,*

Coffee caffeine consumption (CC) is associated with reduced hepatic fibrosis in patients with chronic liver diseases, such as hepatitis C. The association of CC with nonalcoholic fatty liver disease (NAFLD) has not been established. The aim of this study was to correlate CC with the prevalence and severity of NAFLD. Patients involved in a previously published NAFLD prevalence study, as well as additional NASH patients identified in the Brooke Army Medical Center Hepatology clinic, were queried about their caffeine intake. A validated questionnaire for CC was utilized to assess for a relationship between caffeine and four groups: ultrasound negative (controls), bland steatosis/not-NASH, NASH stage 0-1, and NASH stage 2-4. A total of 306 patients responded to the CC questionnaire. Average milligrams of total caffeine/coffee CC per day in controls, bland steatosis/not-NASH, NASH stage 0-1, and NASH stage 2-4 were 307/228, 229/160, 351/255, and 252/152, respectively. When comparing patients with bland steatosis/not-NASH to those with NASH stage 0-1, there was a significant difference in CC between the two groups (P = 0.005). Additionally, when comparing patients with NASH stage 0-1 to those with NASH stage 2-4, there was a significant difference in coffee CC (P = 0.016). Spearman's rank correlation analysis further supported a negative relationship between coffee CC and hepatic fibrosis (r = ?0.215; P = 0.035). Conclusion: Coffee CC is associated with a significant reduction in risk of fibrosis among NASH patients.