Coffee May Reduce the Risk of Alcoholic Hepatitis in Heavy Drinkers
SAN FRANCISCO, CA—Drinking coffee might reduce the risk of alcoholic hepatitis (AH) among heavy alcohol drinkers, according to a study reported at The Liver Meeting® 2015
“Among heavy drinkers, white race predisposes to—while coffee consumption protects against—development of AH,” reported Ashwani K. Singal, MD, Gastroenterology & Hepatology, University of Alabama Birmingham, Birmingham, AL, and colleagues.
Alcoholic hepatitis occurs in people with chronic and active alcohol abuse and has a high socioeconomic burden in the US; 1-month mortality is approximately 40% to 50%, Dr. Singal noted, adding that “about 20% of heavy drinkers develop alcoholic liver disease and AH.”
However, few data have suggested what might predict AH development among heavy drinkers.
To identify such factors, the Translational Research and Evolving Alcoholic Hepatitis Treatment (TREAT) Consortium prospective multicenter observational study enrolled well characterized patients with AH (n=151) who were frequency matched by age, gender, and race with controls (n=125) having a comparable history of alcohol consumption but no clinical evidence of liver disease.
Alcohol use was self reported using an NIAAA questionnaire.
"The diagnosis of AH was established with history of alcohol use >40g/d for women and >60g/d for men for >6 months, and within 6 weeks prior to enrollment, serum bilirubin >2mg/dL, and AST >50U/L, and exclusion of other liver diseases,” explained Dr. Singal. Liver biopsy was used to confirm AH diagnosis when clinical diagnosis was uncertain. Study participants were followed at baseline and at 6 and 12 months.
A logistic regression model found that MELD score, ALT, AST, and albumin levels were significant predictors for AH among the cases vs. the controls (all P<0.0001).
A total of 35 deaths were observed, 34 among patients with AH; of these, patient demographics did not differ when compared with the 117 survivors, they found.
Among patients with AH, coffee drinking predisposes to recidivism at 6 months, while black tea drinking is protective. If confirmed in larger studies, the biologic mechanisms of these findings need to be determined, the authors reported. They also found that "drinkers without college or higher education are more likely to relapse to drinking again."
"Studies are needed among heavy drinkers with specific aims of identifying a) genetic modifiers or predictors for development of AH and b) strategies to decrease the risk of recidivism and development of alcoholic liver disease," the authors concluded.