Prev: Nanu Nanu
Next: breath test rather than Biopsy?
From: Cactus Jammies on 9 Nov 2008 10:16
From http://www.medscape.com/viewarticle/583121

AASLD 2008: High Coffee Consumption May Slow Hepatitis C Progression CME
News Author: Laurie Bouck
CME Author: Laurie Barclay, MD




November 6, 2008 (San Francisco, California) - Increased coffee consumption
may slow the progression of liver damage caused by hepatitis C virus
infection, researchers reported in a poster here at The Liver Meeting 2008:
59th Annual Meeting of the American Association for the Study of Liver
Diseases (AASLD). Patients who self-reported drinking 3 or more cups of
coffee per day were less likely to have liver disease progression than those
who drank less coffee daily.

"In population studies, coffee intake has been inversely associated with
cirrhosis, chronic liver disease, and hepatocellular carcinoma. But, no
studies have examined the relationship between coffee consumption and
progression of advanced liver disease," wrote Neal D. Freedman, MD, of the
National Cancer Institute at the National Institutes of Health, Department
of Health and Human Services, in Rockville, Maryland, and colleagues.

To study this relationship, Freedman analyzed patient questionnaire data
about food frequency, including coffee and tea consumption, from the
3.5-year HALT-C randomized trial of 1050 hepatitis C patients at Ishak stage
3 or higher who were unresponsive to standard drug therapies. Some patients
in the HALT-C trial received no treatment, and others received 90 �g/week of
pegylated interferon alfa-2a.

Of the 808 patients who responded to the questionnaire at baseline, 711
drank zero to 2 cups of coffee a day, and 97 drank 3 or more cups of coffee
daily. Those who drank the most coffee also consumed the most alcohol and
cigarettes. These coffee drinkers, however, had healthier livers than the
other participants, with less steatosis (evaluated by biopsy) and lower
bilirubin levels, ?-fetoprotein levels, and aspartate
aminotransferase/alanine aminotransferase ratios (P < .05).

Liver disease had progressed in 208 patients at the 13-month follow-up, but
outcome rates decreased from 10.4/100 person-years (no coffee daily) to
6.0/100 person-years (3 or more cups of coffee daily; P = 0.002). The hazard
ratio for coffee consumption ranged from 1.21 (0.81 - 1.79) for no coffee
daily to 0.53 (0.29 - 0.95) for 3 or more cups daily (95% confidence
intervals; P = .0005). The results show that "coffee consumption may slow
the progression of fibrotic liver disease," Freedman wrote in the abstract.

"This is an observational study," Freedman told Medscape Gastroenterology,
"so it may be that coffee is a marker for some other activity," he said. "It
may be that people who are feeling sicker don't drink as much coffee." He
looked at tea drinkers as well but did not find an association between tea
consumption and liver disease, he said.

The questionnaire did not ask about the strength of the coffee, what people
put in their coffee, or whether people drank caffeinated or decaffeinated
coffee, Freedman said. About 85% of coffee consumed nationally is
caffeinated. Freedman said that hypotheses about what part of coffee is
beneficial to the liver are "pretty speculative" although "maybe the best
data is for caffeine." Of the 1000-plus compounds in coffee, several of them
may be influencing liver disease, he said.

One advantage of the study was its focus on "the natural history of
clinically significant disease progression, which other studies have not
been able to do," said Freedman's colleague James Everhart, MD, of the
National Institute of Diabetes and Digestive and Kidney Diseases, National
Institutes of Health, Department of Health and Human Services, in Bethesda,
Maryland. The study also benefited from a homogenous population. "They all
started off with liver disease, so we knew they had liver disease and were
able to then look at progression of liver disease from that point on," he
told Medscape Gastroenterology.

Actual coffee consumption can be difficult to measure. Samir Rouabhia, MD,
from the University Hospital Center Touhami Benflis, Department of Internal
Medicine, in Batna, Algeria, said that people tend to drink coffee unevenly.
"One day you take one cup and one day you take three cups," he told Medscape
Gastroenterology, which makes it difficult to measure coffee's effect on the
liver. He also pointed out that it's unclear how the coffee was prepared and
how strong it was.

Drs. Freedman, Everhart, and Rouabhia have disclosed no relevant financial
relationships. The study received no commercial support.

The Liver Meeting 2008: 59th Annual Meeting of the American Association for
the Study of Liver Diseases: Abstract 1778. Presented November 4, 2008.

Pearls for Practice
a.. Although patients with hepatitis C virus infection who drank the most
coffee (3 or more cups daily) also consumed the most alcohol and cigarettes,
they had slower progression of fibrotic liver disease. Hazard ratio for
progression of liver disease was 1.21 for no coffee daily to 0.53 for 3 or
more cups daily (95% confidence intervals; P = .0005).
b.. Those who consumed 3 or more cups of coffee daily had less evidence of
liver damage than did other participants with hepatitis C virus infection,
with less steatosis on biopsy, and significantly lower bilirubin levels,
?-fetoprotein levels, and aspartate aminotransferase/alanine
aminotransferase ratio

I prefer my coffee arabica fresh ground with about 20% expresso on top,
otherwise caf� con leche (like a double shot latt�) I was in Spain for
almost three weeks recently and the first thing I did when I got back was
buy a little stove top expresso maker! All I saw in the campos were huge
wind mills and olive trees horizon to horizon. hope that answers your
question Elmo. lol welcome back, hombre.

para un h�gado sano, para la vida
coffee and cigarettes, breakfast of champions!
cactus jammies


 | 
Pages: 1
Prev: Nanu Nanu
Next: breath test rather than Biopsy?