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Title: Coffee consumption is not associated with prevalent subclinical cardiovascular disease (CVD) or the risk of CVD events, in nonalcoholic fatty liver disease: Results from the multi-ethnic study of atherosclerosis

Author
item SIMON, TRACEY - Massachusetts General Hospital
item TREJO, MARIA - University Of Washington
item ZEB, IFRAN - St Luke'S Roosevelt Hospital
item FRAZIER-WOOD, ALEXIS - Children'S Nutrition Research Center (CNRC)
item MCCLELLAND, ROBYN - University Of Washington
item CHUNG, RAYMOND - Massachusetts General Hospital
item BUDOFF, MATTHEW - Harbor-Ucla Medical Center

Submitted to: Metabolism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/17/2017
Publication Date: 10/1/2017
Citation: Simon, T.G., Trejo, M.E., Zeb, I., Frazier-Wood, A.C., McClelland, R.L., Chung, R.T., Budoff, M.J. 2017. Coffee consumption is not associated with prevalent subclinical cardiovascular disease (CVD) or the risk of CVD events, in nonalcoholic fatty liver disease: Results from the multi-ethnic study of atherosclerosis. Metabolism. 75:1-5. https://doi.org/10.1016/j.metabol.2017.06.007.

Interpretive Summary: Nonalcoholic fatty liver disease (NAFLD) is an umbrella term for a range of problems with the liver, which occur in people who drink little or no alcohol. NAFLD is associated with an increased risk of cardiovascular disease (CVD), which is the leading cause of death in NAFLD patents. A moderate coffee intake may help CVD risk in general, but the problem is that it is not known whether coffee reduces CVD risk in patents who have already been diagnosed with NAFLD. To address this question, we analyzed data on 3710 adults from the United States, across a period of ten years. We found that adults with NAFLD were at increased CVD risk, but coffee intake did not reduce this risk. We concluded that coffee consumption was not associated with a reduction of CVD in those with NAFLD. This information is useful for clinicians and dieticians who need to advise patents with NAFLD how to stay healthy.

Technical Abstract: Atherosclerosis and its clinical sequelae represent the leading cause of mortality among patients with nonalcoholic fatty liver disease (NAFLD). While epidemiologic data support the hepatoprotective benefits of coffee in NAFLD, whether coffee improves NAFLD-associated Cardiovascular Disease (CVD) risk is unknown. We examined 3710 ethnically-diverse participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, without history of known liver disease, and with available coffee data from a validated 120-item food frequency questionnaire. All participants underwent baseline non-contrast cardiac CT from which NAFLD was defined by liver:spleen ratio (L:S<1.0), and subclinical CVD was defined by coronary artery calcium (CAC)>0. Major CVD events were defined by the first occurrence of myocardial infarction, cardiac arrest, angina, stroke, or CVD death. We used log-binomial regression to calculate the adjusted prevalence ratio (PR) for CAC>0 by coffee intake and NAFLD status, and events were compared between groups using frequency of events within adjusted Cox proportional hazard regression models. Seventeen percent (N=637) of participants met criteria for NAFLD. NAFLD participants were more likely to have elevated BMI (mean 31.1+/-5.5kg/m2 vs. 28.0+/-5.2kg/m2, p<0.0001), and diabetes (22% vs. 11%, p<0.0001), but did not differ in daily coffee consumption (p=0.97). Among NAFLD participants, coffee consumption was not associated with prevalent, baseline CAC>0 (PR=1.02 [0.98-1.07]). Over 12.8 years of follow-up, 93 NAFLD and 415 non-NAFLD participants experienced a CV event. However, coffee intake was not associated with incident CVD events, in either NAFLD (HR=1.05 [0.91-1.21]) or non-NAFLD participants (HR=1.03 [0.97-1.11]). In a large, population-based cohort, coffee consumption was not associated with the prevalence of subclinical CVD, nor did coffee impact the future risk of major CVD events, regardless of underlying NAFLD status.