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• W2294579280 abstract "Coffee is the most popular beverage in the world. Consumption of coffee has been shown to benefit health in general, and liver health in particular. This article reviews the effects of coffee intake on development and progression of liver disease due to various causes. We also describe the putative mechanisms by which coffee exerts the protective effect. The clinical evidence of benefit of coffee consumption in Hepatitis B and C, as well as nonalcoholic fatty liver disease and alcoholic liver disease, has also been presented. Coffee consumption is associated with improvement in liver enzymes (ALT, AST, and GGTP), especially in individuals with risk for liver disease. Coffee intake more than 2 cups per day in patients with preexisting liver disease has been shown to be associated with lower incidence of fibrosis and cirrhosis, lower hepatocellular carcinoma rates, as well as decreased mortality. Coffee is the most popular beverage in the world. Consumption of coffee has been shown to benefit health in general, and liver health in particular. This article reviews the effects of coffee intake on development and progression of liver disease due to various causes. We also describe the putative mechanisms by which coffee exerts the protective effect. The clinical evidence of benefit of coffee consumption in Hepatitis B and C, as well as nonalcoholic fatty liver disease and alcoholic liver disease, has also been presented. Coffee consumption is associated with improvement in liver enzymes (ALT, AST, and GGTP), especially in individuals with risk for liver disease. Coffee intake more than 2 cups per day in patients with preexisting liver disease has been shown to be associated with lower incidence of fibrosis and cirrhosis, lower hepatocellular carcinoma rates, as well as decreased mortality. Coffee is the most commonly consumed beverage in the world. Recently, a lot of interest has been generated in the overall beneficial effects of coffee consumption in reducing total and cause-specific mortality.1Freedman N.D. Park Y. Abnet C.C. et al.Association of coffee drinking with total and cause-specific mortality.N Engl J Med. 2012; 366: 1891-1904Crossref PubMed Scopus (400) Google Scholar, 2Lopez-Garcia E. Van Dam R.M. Li T.Y. et al.The relationship of coffee consumption with mortality.Ann Intern Med. 2008; 148: 904-914Crossref PubMed Scopus (156) Google Scholar Coffee is a very rich source of antioxidants and the protective effects of coffee have been proposed in a variety of conditions ranging from heart disease to stroke to type 2 diabetes, as well as Parkinson disease.3Gomez-Ruiz J.A. Leake D.S. Ames J.M. In vitro antioxidant activity of coffee compounds and their metabolites.J Agric Food Chem. 2007; 55: 6962-6969Crossref PubMed Scopus (182) Google Scholar, 4Huxley R. Lee C.M. Barzi F. et al.Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis.Arch Intern Med. 2009; 169: 2053-2063Crossref PubMed Scopus (397) Google Scholar, 5Wu J.N. Ho S.C. Zhou C. et al.Coffee consumption and risk of coronary heart diseases: a meta-analysis of 21 prospective cohort studies.Int J Cardiol. 2009; 137: 216-225Abstract Full Text Full Text PDF PubMed Scopus (142) Google Scholar, 6Ascherio A. Zhang S.M. Hernan M.A. et al.Prospective study of caffeine consumption and risk of Parkinson's disease in men and women.Ann Neurol. 2001; 50: 56-63Crossref PubMed Scopus (553) Google Scholar There is increasing evidence in favor of protective effects of coffee consumption in development and progression of liver disease. This article will analyze the effects of coffee on liver disease in detail and also briefly mention other effects on health. Coffee fruits (cherries) are harvested and undergo pulp extraction to obtain green coffee seeds, which can then be either roasted or processed for decaffeination. It is only through roasting that the seeds gain the characteristic aroma and flavor of coffee. Another factor that can affect the chemical composition of coffee is the method of brewing, which can be percolation, boiling, French press or electric coffee maker, espresso machine, or Italian coffee maker.7Farah A. Coffee constituents.in: Chu Y.-F. Coffee: Emerging Health Effects and Disease Prevention. Ist edition. Blackwell Publishing Ltd., 2012: 21-58Crossref Scopus (250) Google Scholar Instant coffee production typically involves treating ground-roast coffee with hot water and use of high pressure to extract the water-soluble compounds. This soluble material is then cooled and sometimes centrifuged, again concentrated by heating, and dried through freeze-drying to reduce moisture to approximately 5%. The basic chemical composition of green coffee depends primarily on genetic aspects (species of plant), and on physiologic aspects, such as degree of maturation. Chemical composition on an average and proposed beneficial effects of coffee are shown in Table 1, Table 2, respectively. Most studies on pharmacology of coffee have focused on the effects of caffeine (1,3,7-trimethylxanthine), a purine alkaloid, which is just one of the myriads of chemicals that are contained in coffee. Diterpenes, cafestol, and kahweol have also been studied to a varying extent. Diterpenes have been blamed for coffee-induced rise in cholesterol levels in human studies.8Higdon J.V. Frie B. Coffee and health: a review of recent human research.Crit Rev Food Sci Nutr. 2006; 46: 101-123Crossref PubMed Scopus (785) Google Scholar, 9Gressner O.A. About coffee, cappuccino and connective tissue growth factor—or how to protect your liver?.Environ Toxicol Pharmacol. 2009; 28: 1-10Crossref PubMed Scopus (6) Google Scholar There are at least 30 organic compounds that have been shown to impact the typical aroma of coffee. A detailed review of chemical constituents of coffee is outside the purview of this paper and has been discussed elsewhere.10Mussatto S.I. Machado E.M.S. Martin S. Teixeira J.A. Production, composition and application of coffee and its industrial residues.Food Bioprocess Technol. 2011; 4: 661-672Crossref Scopus (626) Google ScholarTable 1A Representative Composition per 100 ml of Coffee Brew from Medium-Roasted Coffee. Composition of Coffee Varies According to Blend, Roasting Degree, Grid, and Method of Preparation.Modified from Farah et al.7Farah A. Coffee constituents.in: Chu Y.-F. Coffee: Emerging Health Effects and Disease Prevention. Ist edition. Blackwell Publishing Ltd., 2012: 21-58Crossref Scopus (250) Google ScholarConstituentAmountCaffeine50–380 mgMelanoidins500–1500 mgSoluble fiber200–800 mgProtein100 mgNiacin10 mgLipids0.8 mgTrigonelline40–50 mgChlorogenic acids35–500 mgMinerals250–700 mg Open table in a new tab Table 2Proposed Mechanisms of Main Beneficial Effects of Coffee on the Liver.Modified from Saab et al.77Saab S. Mallam D. Cox-ll G.A. Tong M.J. Impact of coffee on liver diseases: a systematic review.Liver Int. 2014; 34: 495-504Crossref PubMed Scopus (135) Google ScholarEffect on liverSite of actionChemical involvedMechanismsAntifibroticHepatic Stellate Cell (HSC)CaffeineInhibit focal adhesion kinase (FAK) and actin synthesisIncrease HSC apoptosis and intracellular F-actin and cAMP expressionInhibit procollagen type 1C and alpha-SMA expressionHepatocyteCaffeineDecrease transforming growth factor beta (TGF-B)Stimulate ARE-regulated signalingCancer preventionHepatocyteCafestol and KehweolInhibit phase I activating enzyme expression and activityInduce phase II detoxifying enzymes (i.e. glutathione S-transferase)Stimulate antioxidant responsive element (ARE)-regulated signalingInduction of gamma-glutamyl cysteine synthetase (GCS)Antioxidant effectHepatocytesHydrophilic (caffeine and polyphenols, such as chlorogenic acids); hydrophobic (cafestol, kahweol, and trigenolline), including MRPPreventing inflammatory reaction downregulation of immune and inflammatory markers, such as interferon-gamma (IFN-γ), chemokine coded by CX3CL1 or fractalkine, chemokine ligand4 or CCL4 also called macrophage inhibitory protein (MIP-1b), fibroblast growth factor-2 (FGF-2), and tumor necrosis factor receptors (sTNFRII) Open table in a new tab The exact mechanism of beneficial effects of coffee is not clear. Coffee contains more than 1000 substances, including caffeine, diterphenoic alcohols, potassium, niacin, magnesium, and the antioxidants like chlorogenic acid (CGA), and tocopherols.11Bonita J.S. Mandarano M. Shuta D. et al.Coffee and cardiovascular disease: in vitro, cellular, animal, and human studies.Pharmacol Res. 2007; 55: 187-198Crossref PubMed Scopus (225) Google Scholar It should be noted that caffeine may not be the most important component, as other caffeinated drinks do not provide similar protection against liver disease. The polyphenols (CGA, etc.) may be responsible for the positive metabolic effects of coffee. There is experimental evidence that coffee with high CGA concentrations can modulate glucose intolerance and improve/decrease nonalcoholic fatty liver disease (NAFLD) development in obese rats.12Panchal S.K. Poudyal H. Waanders J. et al.Coffee extract attenuates changes in cardiovascular function and hepatic structure and function without decreasing obesity in high-carbohydrate, high-fat diet-fed male rats.J Nutr. 2012; 142: 690-697Crossref PubMed Scopus (87) Google Scholar Coffee is a rich source of dietary antioxidants. The antioxidant capacities of both hydrophilic components (like caffeine and CGA) and hydrophobic components (like cafestol, kahweol, and trigenolline) have been extensively investigated using both chemical assays and biological systems, including cell culture and animal and human studies.13Liang N. Kitts D.D. Antioxidant property of coffee components: assessment of methods that define mechanisms of action.Molecules. 2014; 19: 19180-19208Crossref PubMed Scopus (275) Google Scholar Maillard reaction products (MRP) that provide the aroma, flavor, and color of different brewed coffees are generated during the roasting process and significantly contribute to its antioxidant activity.14Rufián-Henares J.A. Morales F.J. Functional properties of melanoidins: in vitro antioxidant, antimicrobial and antihypertensive activities.Food Res Int. 2007; 40: 995-1002Crossref Scopus (221) Google Scholar, 15Liu Y. Kitts D.D. Confirmation that the Maillard reaction is the principle contributor to the antioxidant capacity of coffee brews.Food Res Int. 2011; 44: 2418-2424Crossref Scopus (93) Google Scholar There are various studies linking the lower circulating levels of inflammatory biomarkers in coffee drinkers. A recently published study used luminex-based bead assays to measure 77 immune and inflammatory markers in more than 1700 adults. This trial reported significantly lower levels of IFN-γ, CX3CL1/fractalkine, CCL4/MIP-1b, FGF-2, and sTNFRII in coffee drinkers than noncoffee drinkers.16Loftfield E. Shiels M.S. Graubard B.I. et al.Associations of coffee drinking with systemic immune and inflammatory markers.Cancer Epidemiol Biomark Prev. 2015; 24: 1052-1060Crossref PubMed Scopus (58) Google Scholar Another European nested case–control study has suggested an inverse association of coffee intake with HCC risk that was partly accounted for by biomarkers (IL-6, etc.) of inflammation and hepatocellular injury.17Aleksandrova K. Bamia C. Drogan D. et al.The association of coffee intake with liver cancer risk is mediated by biomarkers of inflammation and hepatocellular injury: data from the European Prospective Investigation into Cancer and Nutrition.Am J Clin Nutr. 2015; 102: 1498-1508Crossref PubMed Scopus (54) Google Scholar The role of biomarkers in protection provided by coffee against various diseases requires further investigation. Recently, autophagy has gained a lot of attention as a global health-promoting and antiaging property. Autophagy is a lysosomal degradation pathway responsible for the selective renewal of cytoplasmic organelles. Autophagy preferentially targets damaged proteins and organelles (such as dysfunctional mitochondria), thus contributing to getting rid of aged structures in the cytoplasm. Hence, autophagy is responsible for renewal of nonnuclear portions of the cell. There is some evidence to suggest that coffee may be acting partially by inducing autophagy in vivo.18Pietrocola F. Malik S.A. Marino G. et al.Coffee induces autophagy in vivo.Cell Cycle. 2014; 13: 1987-1994Crossref PubMed Scopus (37) Google Scholar Effect of coffee on evolution of liver disease has also been attributed to its antifibrotic effects. In a rat model, coffee has been shown to attenuate thioacetamide-induced liver inflammation and fibrosis.19Furtado K.S. Prado M.G. Aguiar E. et al.Coffee and caffeine protect against liver injury induced by thioacetamide in male Wistar rats.Basic Clin Pharmacol Toxicol. 2012; 111: 339-347Crossref PubMed Scopus (57) Google Scholar Animal studies have shown that coffee decreases expression of transforming growth factor-β and connective tissue growth factor, thus contributing to reduced fibrosis.20Arauz J. Moreno MGMalik S.A. Cortes-Reynosa P. et al.Coffee attenuates fibrosis by decreasing the expression of TGF-β and CTGF in a murine model of liver damage.J Appl Toxicol. 2013; 33: 970-979Crossref PubMed Scopus (72) Google Scholar Furthermore, in rat models of alcohol-induced liver injury, caffeine has been shown to be protective against alcohol-induced liver fibrosis by dampening the cAMP/PKA/CREB pathway in rat hepatic stellate cells.21Wang Q. Dai X. Yang W. et al.Caffeine protects against alcohol-induced liver fibrosis by dampening the cAMP/PKA/CREB pathway in rat hepatic stellate cells.Int Immunopharmacol. 2015; 25: 340-352Crossref PubMed Scopus (63) Google Scholar Coffee consumption has been associated with lower liver enzyme levels (AST, ALT, and GGTP). The first study to demonstrate this effect was published from Norway in 1986; GGTP levels were reported to be lower in coffee drinkers.22Arnesen E. Huseby N.E. Brenn T. et al.The Tromso heart study: distribution of, and determinants for, gamma-glutamyltransferase in a free-living population.Scand J Clin Lab Investig. 1986; 46: 63-70Crossref PubMed Scopus (88) Google Scholar Subsequently, a number of studies have demonstrated a similar effect on AST, ALT, as well as GGTP levels.23Nilssen O. Førde O.H. Brenn T. The Tromsø study: distribution and population determinants of gamma-glutamyltransferase.Am J Epidemiol. 1990; 132: 318-326PubMed Google Scholar, 24Casiglia E. Spolaore P. Ginocchio G. et al.Unexpected effects of coffee consumption on liver enzymes.Eur J Epidemiol. 1993; 9: 293-297Crossref PubMed Scopus (118) Google Scholar, 25Urgert R. Meyboom S. Kuilman M. et al.Comparison of effect of cafetiere and filtered coffee on serum concentrations of liver aminotransferases and lipids: six month randomized controlled trial.BMJ. 1996; 313: 1362-1366Crossref PubMed Scopus (81) Google Scholar, 26Pintus F. Mascia P. Distribution and population determinants of gamma-glutamyltransferase in a random sample of Sardinian inhabitants.Eur J Epidemiol. 1996; 12: 71-76Crossref PubMed Scopus (47) Google Scholar, 27Poikolainen K. Vartiainen E. Determinants of gammaglutamyltransferase: positive interaction with alcohol and body mass index, negative association with coffee.Am J Epidemiol. 1997; 146: 1019-1024Crossref PubMed Scopus (85) Google Scholar, 28Nakanishi N. Nakamura K. Nakajima K. et al.Coffee consumption and decreased serum gamma-glutamyltransferase: a study of middle-aged Japanese men.Eur J Epidemiol. 2000; 16: 419-423Crossref PubMed Scopus (62) Google Scholar, 29Honjo S. Kono S. Ogawa S. et al.Coffee consumption and serum aminotransferases in middle-aged Japanese men.J Clin Epidemiol. 2001; 54: 823-829Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar, 30Ruhl C.E. Everhart J.E. Coffee and caffeine consumption reduce the risk of elevated serum alanine aminotransferase activity in the United States.Gastroenterology. 2005; 128: 24-32Abstract Full Text Full Text PDF PubMed Scopus (204) Google Scholar, 31Klatsky A.L. Morton C. Udaltsova N. et al.Coffee, cirrhosis, and transaminase enzymes.Arch Intern Med. 2006; 166: 1190-1195Crossref PubMed Scopus (173) Google Scholar, 32Ikeda M. Maki T. Yin G. et al.Relation of coffee consumption and serum liver enzymes in Japanese men and women with reference to effect modification of alcohol use and body mass index.Scand J Clin Lab Investig. 2010; 70: 171-179Crossref PubMed Scopus (26) Google Scholar Many of these are population-based studies, published from all parts of the world (Italy, Mexico, US, Japan, etc.), thus validating the findings and giving more strength to the reported association. The effect of lowering enzymes is even more pronounced in patients at highest risk of liver injury (overweight patients, significant alcohol intake, impaired glucose metabolism, and viral hepatitis).33Tanaka K. Tokunaga S. Kono S. et al.Coffee consumption and decreased serum gamma-glutamyltransferase and aminotransferase activities among male alcohol drinkers.Int J Epidemiol. 1998; 27: 438-443Crossref PubMed Scopus (127) Google Scholar, 34La Vecchia C.L. Coffee, liver enzymes, cirrhosis and liver cancer.J Hepatol. 2005; 42: 444-446Abstract Full Text Full Text PDF PubMed Scopus (65) Google Scholar, 22Arnesen E. Huseby N.E. Brenn T. et al.The Tromso heart study: distribution of, and determinants for, gamma-glutamyltransferase in a free-living population.Scand J Clin Lab Investig. 1986; 46: 63-70Crossref PubMed Scopus (88) Google Scholar, 27Poikolainen K. Vartiainen E. Determinants of gammaglutamyltransferase: positive interaction with alcohol and body mass index, negative association with coffee.Am J Epidemiol. 1997; 146: 1019-1024Crossref PubMed Scopus (85) Google Scholar, 28Nakanishi N. Nakamura K. Nakajima K. et al.Coffee consumption and decreased serum gamma-glutamyltransferase: a study of middle-aged Japanese men.Eur J Epidemiol. 2000; 16: 419-423Crossref PubMed Scopus (62) Google Scholar The data on association between hepatitis B and coffee consumption are very limited. There are at least two experimental studies linking the coffee constituents to inhibition of hepatitis B virus in vivo and in vitro.35Wang G.F. Shi L.P. Ren Y.D. et al.Anti-hepatitis B virus activity of chlorogenic acid, quinic acid and caffeic acid in vivo and in vitro.Antivir Res. 2009; 83: 186-190Crossref PubMed Scopus (298) Google Scholar, 36Ma Y. Wang X. Tang N. Downregulation of mPGES-1 expression via EGR1 plays an important role in inhibition of caffeine on PGE2 synthesis of HBx(+) hepatocytes.Mediat Inflamm. 2015; 2015: 372750PubMed Google Scholar One study showed lower HBsAg and HBV DNA levels in HEP G2 cell lines, as well as duck hepatitis B virus infection models. The other study showed inhibition of replication of HBV in HBx(+) hepatocytes by downregulating PGE2 synthesis. However, there is only one study evaluating the clinical effect of coffee in HBV-positive patients.37Ong A. Wong V.W. Wong G.L. Chan H.L. The effect of caffeine and alcohol consumption on liver fibrosis—a study of 1045 Asian hepatitis B patients using transient elastography.Liver Int. 2011; 31: 1047-1053Crossref PubMed Scopus (28) Google Scholar This study found no influence of coffee on the severity of hepatitis B as measured by transient elastography. However, this trial had several limitations. First, significant alcohol consumption was much higher in the coffee consumers; the results may have been confounded against coffee by this fact. Secondly, the value of transient elastography in patients with raised transaminases is in question. Considering the positive effects of coffee in almost all types of liver disease, the association with hepatitis B is worthy of further investigation. The interplay between coffee and hepatitis C virus is much better studied than hepatitis B. Caffeine has been shown to inhibit replication of hepatitis C virus in Huh-7.5 cell lines in a dose-dependent manner at noncytotoxic concentrations.38Batista M.N. Carneiro B.M. Braga A.C.S. et al.Caffeine inhibits hepatitis C virus replication in vitro.Arch Virol. 2015; 160: 399-407Crossref PubMed Scopus (32) Google Scholar Freedman et al.39Freedman N.D. Everhart J.E. Hoefs J.C. et al.Coffee intake is associated with lower rates of liver disease progression in chronic hepatitis C.J Hepatol. 2009; 50: 1360-1369Crossref Scopus (142) Google Scholar in the HALT-C cohort of hepatitis C patients treated with peg-interferon and ribavirin first showed the beneficial effect of coffee on disease progression in hepatitis C patients. The coffee drinker cohort in this trial had higher consumption of alcohol, as well as smoking. Moreover, noncoffee drinkers had higher serum insulin levels, as well as higher insulin resistance. Despite that, the incidence of advanced fibrosis, as well as cirrhosis, was lower in coffee drinkers as compared to noncoffee drinkers. Also the degree of steatosis (grade 3–4) was lower in the coffee drinkers. The same authors in the follow-up retrospective analysis in the same cohort further validated this protective effect of coffee against hepatitis C.40Freedman N.D. Curto T.M. Lindsay K.L. et al.Coffee consumption is associated with response to peginterferon and ribavirin therapy in patients with chronic hepatitis C.Gastroenterology. 2011; 140: 1961-1969Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar The HCV RNA levels were significantly lower in the coffee drinkers, and the SVR rates on treatment were significantly higher in the coffee drinkers. On multivariate analysis, coffee consumption was significantly predictive of SVR in this cohort. Cardin et al.41Cardin R. Piciocchi M. Martines D. et al.Effects of coffee consumption in chronic hepatitis C: a randomized controlled trial.Dig Liver Dis. 2013; 45: 499-504Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar demonstrated a reduced oxidative DNA damage, increased apoptosis, and reduced procollagen III deposition in HCV patients who drink coffee compared to noncoffee drinkers. Modi et al.42Modi A.A. Feld J.J. Park Y. et al.Increased caffeine consumption is associated with reduced hepatic fibrosis.J Hepatol. 2010; 51: 201-209Crossref Scopus (194) Google Scholar evaluated the relationship of coffee intake and liver fibrosis in patients undergoing liver biopsy for hepatitis C. One hundred and twenty-eight patients undergoing liver biopsy completed a detailed caffeine questionnaire on three occasions over a 6-month period. The investigators showed that coffee consumption more than 2 coffee cup equivalents per day was associated with less severe hepatic fibrosis. There are a number of other trials showing a beneficial effect of coffee on evolution of chronic hepatitis C with or without treatment, as well as better tolerability of therapy with interferon and ribavirin.42Modi A.A. Feld J.J. Park Y. et al.Increased caffeine consumption is associated with reduced hepatic fibrosis.J Hepatol. 2010; 51: 201-209Crossref Scopus (194) Google Scholar, 43Costentin C.E. Roudot-Thoraval F. Zafrani E.S. et al.Association of caffeine intake and histological features of chronic hepatitis C.J Hepatol. 2011; 54: 1123-1129Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar, 44Carrieri M.P. Cohen J. Salmon-Ceron D. et al.Coffee consumption and reduced self-reported side effects in HIV-HCV co-infected patients during PEG-IFN and ribavirin treatment: results from ANRS CO13 HEPAVIH.J Hepatol. 2012; 56: 745-747Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar, 45Khalaf N. White D. Kanwal F. et al.Coffee and caffeine are associated with decreased risk of advanced hepatic fibrosis among patients with hepatitis C.Clin Gastroenterol Hepatol. 2015; 13: 1521-1531Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar The available experimental, as well as clinical, evidence suggests that coffee consumption has protective effects against metabolic syndrome, as well as development of NAFLD. In rat models of experimental studies, coffee has been shown to decrease inflammatory cytokines, modify adipose tissue gene expression, protect against development of adverse metabolic profile, as well as decrease of liver fat and collagen deposition.46Murase T. Misawa K. Minegishi Y. et al.Coffee polyphenols suppress diet induced body fat accumulation by downregulating SREBP-1c and related molecules in C57BL/6J mice.Am J Physiol Endocrinol Metab. 2011; 300: E122-E133Crossref PubMed Scopus (170) Google Scholar, 47Yamauchi R. Kobayashi M. Matsuda Y. et al.Coffee and caffeine ameliorate hyperglycemia, fatty liver, and inflammatory adipocytokine expression in spontaneously diabetic KK-Ay mice.J Agric Food Chem. 2010; 58: 5597-5603Crossref PubMed Scopus (70) Google Scholar, 48Fukushima Y. Kasuga M. Nakao K. Shimomura I. Matsuzawa Y. Effects of coffee on inflammatory cytokine gene expression in mice fed high-fat diets.J Agric Food Chem. 2009; 57: 11100-11105Crossref PubMed Scopus (41) Google Scholar, 49Vitaglione 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: 1652-1661Crossref PubMed Scopus (176) Google Scholar The clinical evidence for beneficial effect of coffee against NAFLD is also overwhelming. There are published population-based case–control studies and population-based cohort, as well as cross-sectional studies, supporting the usefulness of coffee in NAFLD. The first evidence came from Japan that coffee is associated with lower incidence of metabolic syndrome.50Hino A. Adachi H. Enomoto M. et al.Habitual coffee but not green tea consumption is inversely associated with metabolic syndrome: an epidemiological study in a general Japanese population.Diabetes Res Clin Pract. 2007; 76: 383-389Abstract Full Text Full Text PDF PubMed Scopus (94) Google Scholar This was followed by a case–control study published by Catalano et al., which showed lower fatty liver severity in coffee drinkers. These authors also showed an inverse association of coffee consumption with obesity and insulin resistance. Subsequently, a number of clinical trials from across the globe showed that coffee protects against metabolic syndrome, as well as NAFLD/NASH.51Anty R. Marjoux S. Iannelli A. et al.Regular coffee but not espresso drinking is protective against fibrosis in a cohort mainly composed of morbidly obese European women with NAFLD undergoing bariatric surgery.J Hepatol. 2012; 57: 1090-1096Abstract Full Text Full Text PDF PubMed Scopus (106) Google Scholar, 52Catalano D. Martines G.F. Tonzuso A. et al.Protective role of coffee in nonalcoholic fatty liver disease (NAFLD).Dig Dis Sci. 2010; 55: 3200-3206Crossref PubMed Scopus (81) Google Scholar, 53Gutierrez-Grobe Y. Chavez-Tapia N. Sanchez-Valle V. et al.High coffee intake is associated with lower grade nonalcoholic fatty liver disease: the role of peripheral antioxidant activity.Ann Hepatol. 2012; 11: 350-355PubMed Google Scholar, 54Birerdinc A. Stepanova M. Pawloski L. Younossi Z.M. Caffeine is protective in patients with non-alcoholic fatty liver disease.Aliment Pharmacol Ther. 2012; 35: 76-82Crossref PubMed Scopus (114) Google Scholar, 55Molloy 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: 429-436Crossref PubMed Scopus (244) Google Scholar Many of these trials were histology based and showed a protective effect of coffee consumption on development of hepatic fibrosis. A very important community-based cohort study investigated the effect of dietary behavior on NAFLD utilizing four continuous cycles of the National Health and Nutrition Examination Surveys (NHANES 2001–2008).54Birerdinc A. Stepanova M. Pawloski L. Younossi Z.M. Caffeine is protective in patients with non-alcoholic fatty liver disease.Aliment Pharmacol Ther. 2012; 35: 76-82Crossref PubMed Scopus (114) Google Scholar Multivariate analysis found five factors independently associated with NAFLD—race, male gender, obesity, caffeine intake, and total plain water consumption. Their analysis showed that caffeine intake is independently associated with a lower risk for NAFLD. Another very recent cross-sectional, multicentric, prospective population-based study has shown a protective effect of coffee consumption on fibrosis development in NAFLD patients.56Zelber-Sagi S. Salomone F. Webb M. et al.Coffee consumption and nonalcoholic fatty liver onset: a prospective study in the general population.Transl Res. 2015; 165: 428-436Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar This trial demonstrated no association between coffee consumption and new onset NAFLD. However, in patients with NAFLD, the severity of fibrosis was inversely related to coffee consumption on a multivariate regression analysis. Experimental studies validating the role of coffee in fibrosis prevention have already been discussed above. The clinical evidence for the same has been recently reviewed in a meta-analysis.57Liu F. Wang X. Wu G. et al.Coffee consumption decreases risks for hepatic fibrosis and cirrhosis: a meta-analysis.PLOS ONE. 2015; (0142457)Crossref Google Scholar Of 1657 citations concerning fibrosis and/or cirrhosis with coffee, 16 were selected. Of these, there were 7 case–control studies45Khalaf N. White D. Kanwal F. et al.Coffee and caffeine are associated with decreased risk of advanced hepatic fibrosis among patients with hepatitis C.Clin Gastroenterol Hepatol. 2015; 13: 1521-1531Abstract Full Text Full Text PDF PubMed Scopus (33) Googl" @default.
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• W2294579280 title "Coffee and Liver Disease" @default.
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• W2294579280 doi "https://doi.org/10.1016/j.jceh.2016.02.003" @default.
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