title: Protective role of coffee in non-alcoholic fatty liver disease (NAFLD).
abstract: OBJECTIVE
  The benefits of coffee on abnormal liver biochemistry, cirrhosis and hepatocellular carcinoma have been reported, but there is a lack of satisfactory explanation. Thus, this study aims to investigate if coffee use has any relationship with bright liver, measured by ultrasound bright liver score (BLS), in patients with non-alcoholic fatty liver disease (NAFLD), and which relationship, if any, is present with BMI and insulin resistance.
  
  
  METHODS
  This study was performed on 245 patients, 137 with NAFLD and 108 controls. Coffee drinking was defined according to the absolute number of cups of coffee (only espresso coffee), and also graded as 1 (0 cups of coffee/day), 2 (1-2 cups of coffee/day) 3 (≥3 cups of coffee/day). Insulin resistance was assessed by homoeostasis model-insulin resistance index (HOMA).
  
  
  RESULTS
  Less fatty liver involvement is present in coffee vs. non-coffee drinkers. Odds ratios show that obesity, higher insulin resistance, lower HDL cholesterol, older age and arterial hypertension are associated with a greater risk of more severe BLS; to the contrary, coffee drinking is associated with less severe BLS. In the multiple logistic regression (MLR) model, number of cups of coffee, HOMA and BMI account for 35.8% of the variance to BLS. Coffee use is inversely associated with the degree of bright liver, along with insulin resistance and obesity, which, to the contrary, are directly associated with greater likelihood and severity of bright liver appearance.
  
  
  CONCLUSIONS
  A possible opposite, if not antagonistic, role of coffee with regard to overweightness and insulin resistance, similar to that reported in hepatocarcinoma and cirrhosis, is envisaged in the natural history of NAFLD.
authors.affiliation: Clinica di Medicina Interna e Terapia Medica, Dipartimento di Medicina Interna, Facoltà di Medicina e Chirurgia, Università di Catania, Catania, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Catalano
authors.forename: Giuseppe Fabio
authors.initials: GF
authors.lastname: Martines
authors.forename: Antonia
authors.initials: A
authors.lastname: Tonzuso
authors.forename: Clara
authors.initials: C
authors.lastname: Pirri
authors.forename: Francesca M
authors.initials: FM
authors.lastname: Trovato
authors.forename: Guglielmo M
authors.initials: GM
authors.lastname: Trovato
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D016009:Chi-Square Distribution; D003069:Coffee; D005234:Fatty Liver / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D008099:Liver / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D014463:Ultrasonography
chemical_list: D003069:Coffee