| Can
Coffee Help Prevent Progression of Liver Fibrosis?  Chronic
hepatitis B and C, long-term heavy
alcohol use, and other conditions can cause progressive
liver fibrosis and cirrhosis
over the course of years or decades. But this does not happen all the time, and
the various factors that promote or protect against the development of advanced
liver disease are not well understood.
A
recent study published in the June 12, 2006 Archives of Internal Medicine
suggests that an ingredient in coffee may help protect against liver inflammation
and ultimately advanced fibrosis and cirrhosis.
Arthur Klatsky, MD, and
colleagues conducted a study of 125,580 members of a comprehensive prepaid healthcare
plan without known liver disease at baseline. Participants provided initial data
at health examinations between 1978 and 1985, and were followed through 2001.
The researchers used a Cox proportional hazards models with seven variables to
assess factors associated with development of cirrhosis.
Results 
During the follow-up period, 330 subjects developed liver cirrhosis; 199 had alcoholic
cirrhosis, and 131 had cirrhosis due to other causes (such as viral hepatitis)
or of unknown etiology.
Participants who regularly drank coffee had a lower risk of developing alcoholic
cirrhosis, and the risk appeared to go down the more coffee they drank.
Among the 199 patients who developed alcoholic cirrhosis, the relative risks were:
-
less than 1 cup of coffee per day: 0.7 (95% CI 0.4-1.1)
- 1 to 3 cups per day:
0.6 (95% CI 0.4-0.8; P < 0.001)
- 4 or more cups per day: 0.2 (95% CI 0.1-0.4;
P < 0.001).
The same relationship between coffee and reduced cirrhosis risk was not observed
among patients with nonalcoholic cirrhosis.
Among the 131 subjects with nonalcoholic cirrhosis, the relative risks were:
-
less than 1 cup per day: 1.2 (95% CI 0.6-2.2)
- 1 to 3 cups per day: 1.3 (95%
CI 0.8-2.1)
- 4 or more cups: 0.7 (95% CI 0.4-1.3).
Drinking coffee was associated with a lower rate of elevated serum aspartate
aminotransferase (AST) and alanine aminotransferase (ALT) levels.
The odds ratio of 4 or more cups of coffee per day (vs none) was 0.5 for high
AST (95% CI 0.4-0.6; P < 0.001), and 0.6 for high ALT (95% CI 0.6-0.7;
P < 0.001).
There was a stronger inverse relationship between coffee drinking and cirrhosis
among patients who consumed large quantities of alcohol.
Tea drinking was not associated with alcoholic or nonalcoholic cirrhosis
Conclusion
The authors concluded that these data support the hypothesis that
there is an ingredient in coffee that protects against cirrhosis, especially alcoholic
cirrhosis.
Past studies have also shown that coffee -- or, in some cases,
caffeine -- was associated with lower rates of advanced fibrosis or cirrhosis.
In this study, however, drinking tea was not linked to lower risk, suggesting
that another ingredient in coffee besides caffeine may be responsible for the
effect.
6/27/06
Reference
AL
Klatsky, C Morton, N Udaltsova, and others. Coffee, Cirrhosis, and Transaminase
Enzymes. Archives of Internal Medicine 166(11): 1190-1195. June 12, 2006.
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