Gastroenterology

Gastroenterology

Volume 128, Issue 1, January 2005, Pages 24-32
Gastroenterology

Clinical-liver, pancreas, and biliary tract
Coffee and caffeine consumption reduce the risk of elevated serum alanine aminotransferase activity in the United States

https://doi.org/10.1053/j.gastro.2004.09.075Get rights and content

Background & Aims: Based on experimental and epidemiologic studies, we investigated whether coffee and caffeine consumption reduced the risk of elevated alanine aminotransferase (ALT) activity in persons at high risk for liver injury in a national, population-based study. Methods: Participants were 5944 adults in the Third US National Health and Nutrition Examination Survey, 1988–1994, with excessive alcohol consumption, viral hepatitis, iron overload, overweight, or impaired glucose metabolism. Liver injury was indicated by abnormal serum ALT activity (>43 U/L). Results: Elevated ALT activity was found in 8.7% of this high-risk population. In unadjusted analysis, lower ALT activity was associated with increasing consumption of coffee (P = .001) and caffeine (P = .001). Multivariate logistic regression analyses showed that the risk of elevated ALT activity declined with increasing intake of coffee (P for trend = .034) and caffeine (P < .001). Comparing persons who drank more than 2 cups per day with noncoffee drinkers, the odds ratio was .56 (95% confidence interval, .31–1.0). Comparing persons in the highest caffeine quintile with the lowest, the odds ratio was .31 (95% confidence interval, .16–.61). These relationships were consistent across subgroups at risk for liver injury and were relatively unchanged when analyses included the entire population or when limited to persons without impaired liver function or right upper quadrant pain. Fasting insulin concentrations did not mediate the effects. Conclusions: In this large, national, population-based study, among persons at high risk for liver injury, consumption of coffee and especially caffeine was associated with lower risk of elevated ALT activity.

Section snippets

Patients and methods

The Third National Health and Nutrition Examination Survey (NHANES III) was conducted in the United States from 1988 to 1994 by the National Center for Health Statistics of the Centers for Disease Control and Prevention.27 It consisted of interview, examination, and laboratory data collected from a complex multistage, stratified, clustered probability sample of the civilian, noninstitutionalized population age 2 months and older, with oversampling of the elderly, non-Hispanic blacks, and

Results

Coffee consumption ranged from 0 to 20 cups per day. The median intake among persons drinking 0, <1, 1–2, and >2 cups/day was 0, .30, 1.0, and 3.0 cups/day, respectively. Consumption of caffeine from beverages ranged from 0 to 2954 mg/day. The median intake by quintile was 20, 104, 174, 278, and 570 mg/day, respectively. Fifty-one percent of caffeine intake was from coffee. Among this population at high risk for liver injury, elevated ALT activity was found in 8.7% and ALT activity of at least

Discussion

In this large, national, population-based study, among persons at high risk for liver injury, consumption of coffee and caffeine was associated with lower risk of abnormal ALT activity. Persons drinking more than 2 cups of coffee per day had approximately one half the risk of noncoffee drinkers, while participants with a caffeine intake in the highest quintile were only one third as likely to have elevated ALT activity as those in the lowest quintile. This result strengthens and extends to the

References (47)

  • T.P. Devasagayam et al.

    Caffeine as an antioxidantinhibition of lipid peroxidation induced by reactive oxygen species

    Biochim Biophys Acta

    (1996)
  • C. Lee

    Antioxidant ability of caffeine and its metabolites based on the study of oxygen radical absorbing capacity and inhibition of LDL peroxidation

    Clin Chim Acta

    (2000)
  • C.E. Ruhl et al.

    Relation of elevated serum alanine aminotransferase activity with iron and antioxidant levels in the United States

    Gastroenterology

    (2003)
  • P. He et al.

    Suppression of lipopolysaccharide-induced liver injury by various types of tea and coffee in D-galactosamine-sensitized rats

    Biosci Biotechnol Biochem

    (2001)
  • W.W. Huber et al.

    The coffee components kahweol and cafestol induce gamma-glutamylcysteine synthetase, the rate limiting enzyme of chemoprotective glutathione synthesis, in several organs of the rat

    Arch Toxicol

    (2002)
  • G. Scharf et al.

    Elevation of glutathione levels by coffee components and its potential mechanisms

    Adv Exp Med Biol

    (2001)
  • K.G. Lee et al.

    Antioxidative activities of aroma extracts isolated from natural plants

    Biofactors

    (2000)
  • E. Arnesen et al.

    The Tromso Heart Studydistribution of, and determinants for, gamma-glutamyltransferase in a free-living population

    Scand J Clin Lab Invest

    (1986)
  • O. Nilssen et al.

    The Tromso Study. Distribution and population determinants of gamma-glutamyltransferase

    Am J Epidemiol

    (1990)
  • E. Casiglia et al.

    Unexpected effects of coffee consumption on liver enzymes

    Eur J Epidemiol

    (1993)
  • S. Kono et al.

    Coffee and serum gamma-glutamyltransferasea study of self-defense officials in Japan

    Am J Epidemiol

    (1994)
  • O. Nilssen et al.

    Seven-year longitudinal population study of change in gamma-glutamyltransferasethe Tromso Study

    Am J Epidemiol

    (1994)
  • D.S. Sharp et al.

    Re: “Alcohol, smoking, coffee, and cirrhosis” and “coffee and serum gamma-glutamyltransferase: a study of self-defense officials in Japan”

    Am J Epidemiol

    (1995)
  • Cited by (222)

    • Predictive risk markers in alcoholism

      2023, Advances in Clinical Chemistry
    • Green coffee beans

      2021, Nutraceuticals: Efficacy, Safety and Toxicity
    • The effect of coffee consumption on the non-alcoholic fatty liver disease and liver fibrosis: A meta-analysis of 11 epidemiological studies

      2021, Annals of Hepatology
      Citation Excerpt :

      Five researchers were from the USA, two from Japan, one from France, one from Iran, and one from Israel. The total study population included 6519 cases and 66,561 non-cases [16–25]. We ran two separate analyses for NAFLD and liver fibrosis regarding coffee consumption.

    • Coffee, adenosine, and the liver

      2024, Purinergic Signalling
    View all citing articles on Scopus

    Supported by a contract from the National Institute of Diabetes and Digestive and Kidney Diseases (NO1-DK-1-2478).

    View full text