title: Coffee consumption in NAFLD patients with lower insulin resistance is associated with lower risk of severe fibrosis.
abstract: OBJECTIVE
  Coffee has inverse relationships with both type 2 diabetes and hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Relationships were explored between coffee intake and insulin resistance (IR) with respect to NAFLD histologic severity.
  
  
  METHODS
  We analyzed data from 782 adults (≥18 years) in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) from 2004 to 2008. IR was assessed using the HOMA-IR. We modeled associations between coffee intake and NAFLD histologic severity using multiple logistic regression; and interactions between coffee and IR on NAFLD histology were explored.
  
  
  RESULTS
  Among 782 participants, 38% (n = 295) were men, 12% (n = 97) were Latino, mean age (± standard deviation) was 48 ± 12 years. Median BMI was 33.5 kg/m(2) [interquartile range, 29.7-38.3] and median HOMA-IR was 4.3 [2.7-7.2]. Diabetes was present in 24% (n = 189). NASH was present in 79% (n = 616), and 25% (n = 199) had advanced fibrosis. The frequency of coffee intake (cups/day, cpd) was as follows: 0 cpd, n = 230 (29%); <1 cpd, n = 219 (28%); 1 to <2 cpd, n = 116 (15%); ≥2 cpd, n = 217 (28%). The effect of coffee on fibrosis varied with degree of IR (interaction P = 0.001). Coffee consumers with less IR, defined as HOMA-IR<4.3, had a lower odds of advanced fibrosis [OR = 0.64; 95% CI, (0.46-0.88), P = 0.001]. There was no protective effect of coffee on advanced fibrosis among individuals with higher HOMA-IR [OR = 1.06, 95% CI (0.87-1.28), P = 0.6].
  
  
  CONCLUSIONS
  Coffee intake is inversely associated with advanced fibrosis among NAFLD patients with lower HOMA-IR. Our findings warrant further investigation given the worldwide ubiquity of coffee intake.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Kiran
authors.initials: K
authors.lastname: Bambha
authors.forename: Laura A
authors.initials: LA
authors.lastname: Wilson
authors.forename: Aynur
authors.initials: A
authors.lastname: Unalp
authors.forename: Rohit
authors.initials: R
authors.lastname: Loomba
authors.forename: Brent A
authors.initials: BA
authors.lastname: Neuschwander-Tetri
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Brunt
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Bass
mesh_terms: D000328:Adult; D001774:Blood Chemical Analysis; D003069:Coffee; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008103:Liver Cirrhosis / Q000209:etiology / Q000503:physiopathology*; D016015:Logistic Models; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D028321:Plant Preparations / Q000494:pharmacology*; D018709:Statistics, Nonparametric; D014481:United States
chemical_list: D003069:Coffee; D028321:Plant Preparations
keywords: HOMA; diet; histology; lifestyle; nonalcoholic steatohepatitis