Café, cirrhose et enzymes transaminases
Etude statistique pour corréler l’ingestion de régulière de différentes quantités de café, thé ou alcool avec le développement d’une cirrhose, alcoolique ou non, à échéance de 30 ans ainsi que le taux de deux enzymes (AST et ALT).
La corrélation est négative avec la cirrhose alcoolique pour le café, mais il n’y en a pas pour le thé : la caféine n’est donc pas la molécule active. La consommation de café étant elle-même corrélée positivement à celles d’alcool et de tabac, ces résultats doivent être pris avec une grande prudence, d’autres études ayant relevé des résultats contradictoires. Il n’y a pas de corrélation pour la cirrhose non alcoolique. Les niveaux d’enzymes hépatiques dans le sang sont anticorrélés à la consommation de café.
Selon les auteurs eux-mêmes, le caractère observatoire des données et l’absence d’identification d’un mécanisme empêchent toute interprétation en termes de cause et effet, et il n’y a pas d’implication thérapeutique. La meilleure façon de prévenir la cirrhose du foie consiste à limiter la consommation d’alcool.
Une justification pour une étude fondamentale sur les interactions café-alcool avec le foie.
BACKGROUND:
A minority of persons at risk develop liver cirrhosis, but knowledge of risk modulators is sparse. Several reports suggest that coffee drinking is associated with lower cirrhosis risk.
METHODS:
We studied 125,580 multiethnic members of a comprehensive prepaid health care plan without known liver disease who supplied baseline data at voluntary health examinations from 1978 to 1985. Subsequently, through 2001, 330 of them were diagnosed with liver cirrhosis. Review of medical records confirmed the diagnosis of cirrhosis and ascertained probable etiology. The association of coffee drinking with cirrhosis was estimated by Cox proportional hazards models with 7 covariates. We also did a cross-sectional analysis of baseline aspartate aminotransferase and alanine aminotransferase levels, studied by logistic regression.
RESULTS:
In the cohort study, relative risks of alcoholic cirrhosis (199 subjects) for coffee drinking (vs none) were less than 1 cup per day, 0.7 (95% confidence interval [CI], 0.4-1.1); 1 to 3 cups, 0.6 (95% CI, 0.4-0.8; P<.001); and 4 or more cups, 0.2 (95% CI, 0.1-0.4; P<.001). For 131 subjects with nonalcoholic cirrhosis, relative risks were less than 1 cup, 1.2 (95% CI, 0.6-2.2); 1 to 3 cups, 1.3 (95% CI, 0.8-2.1); and 4 or more cups, 0.7 (95% CI, 0.4-1.3). These relative risks for coffee drinking were consistent in subsets. Tea drinking was unrelated to alcoholic or nonalcoholic cirrhosis. In the cross-sectional analyses, coffee drinking was related to lower prevalence of high aspartate aminotransferase and alanine aminotransferase levels; for example, the odds ratio of 4 or more cups per day (vs none) for a high aspartate aminotransferase level was 0.5 (95% CI, 0.4-0.6; P<.001) and for a high alanine aminotransferase level, 0.6 (95% CI, 0.6-0.7; P<.001), with stronger inverse relations in those who drink large quantities of alcohol.
CONCLUSION:
These data support the hypothesis that there is an ingredient in coffee that protects against cirrhosis, especially alcoholic cirrhosis.
