Coffee and Non-alcoholic Fatty Liver Disease: Brewing Evidence for Hepatoprotection?

Shaohua Chen; Narci C Teoh; Shiv Chitturi; Geoffrey C Farrell

J Gastroenterol Hepatol. 2014;29(3):435-441.

Sources of Information

This systematic review is the first that we are aware of to focus on the epidemiology, magnitude, and mechanisms of possible beneficial effects of coffee consumption in patients with NAFLD. Using "liver disease" and "coffee" as search terms in the PubMed database, 240 articles were returned. The abstracts of all these articles were reviewed, and 12 studies that evaluated relationship between NAFLD and coffee were examined in detail. Specific questions pertaining to this area of research were evaluated, as indicated below. The number of articles published about coffee and liver disease has increased steadily since 2003 (Fig. 1).

(Enlarge Image)

Figure 1.

Number of publications related to coffee intake and liver disease in the past decade.

1 2 3 4 5

Next Section

Table 1. Relationship between coffee consumption and non-alcoholic fatty liver disease (NAFLD) in community studies
Authors (Reference)	Subjects	Design	Results	Comments
Birerdinc A et al.²⁴ 2012; USA	1 782 NAFLD; 16 768 controls from 4 continuous cycles of NHANES	NAFLD defined by ALT/AST exclusive of other liver disease	Caffeine intake in NAFLD 165 ± 6.55 mg, controls 188 ± 4.90 mg (P = 0.0006). MVA showed caffeine intake an independent predictor of NAFLD (OR = 0.999, 95% CI: 0.999–1.00, P = 0.0003)	Minor effect in lowering prevalence of NAFLD
Catalano D et al.²⁵ 2010; Italy	137 NAFLD; 108 controls.	Assessed by ultrasound BLS, with exclusion criteria	BLS less in coffee drinkers than in non-coffee drinkers. Coffee consumption as cups/day (0/< 3/≥ 3) per groups by BLS: severe: 9/7/0; moderate: 12/37/33; light: 9/21/29 (P < 0.0001)	Inverse association between coffee intake and degree of BLS
Gutierrez-Grobe, Y et al.²⁶ 2012; Mexico	57 NAFLD 73 controls.	Case control study Assessed by ultrasonography Dietary history questionnaire.	Coffee intake(log caffeine) between different severity of NAFLD: severe steatosis: 0.15 ± 0.05; moderate steatosis: 1.58 ± 0.72; mild steatosis: 1.61 ± 0.79; no steatosis: 1.75 ± 0.70(P ≤ 0.05)	High coffee intake associated with lower grade NAFLD
Molloy JW et al.²⁷ 2012; USA	36 NASH stage 2–4; 61 NASH stage 0–1; 83 bland steatosis; 126 controls	Biopsied NAFLD cases. Validated caffeine questionnaire	Coffee caffeine intake (mg/day): NASH stage 2–4: 153; NASH stage 0–1: 256; bland steatosis: 160; controls: 228. (r = −0.215, P = 0.035).	Negative correlation between caffeine intake and stage of fibrosis

ALT, alanine aminotransferase; AST, aspartate aminotransferase; BLS, bright liver score; MVA, multivariate analysis; NASH, non-alcoholic steatohepatitis; NHANES, National Health and Nutrition Examination Surveys.

Table 2. List of chemical composition of coffee proposed biological effects
Constituents	Effects	References
Carbohydrates and fiber Sucrose Reducing sugars	Most non-digestible, the digestible carbohydrate fraction is negligible.	²⁸
Nitrogenous compounds Protein/peptides Free amino acids Caffeine Trigonelline	Caffeine: stimulation of hepatic lipid metabolism, induction of thermogenesis, anti-oxidative stress, anti-fibrosis	^24,27,28
Lipids Coffee oil Diterpenes (Cafestol and Kahweol)	Cafestol and Kahweol: cholesterol raising, anti-carcinogenesis	^29,30
Minerals	Potassium: reducing hypertension but in minimal amount	²⁸
Acids and esters/polyphenol Chlorogenic acids Aliphatic acids Quinic acid	CPP: enhancing energy metabolism, reducing lipogenesis, downregulating SREBP-1c Chlorogenic acids: the predominant antioxidant in coffee; reducing hepatic glucose output, lowering cholesterol, attenuating fatty liver and upregulating PPAR-α	^28,31–33
Melanoidins	Anti-oxidation, anti-inflammation, and increase expression of adiponectin receptor and PPAR-α	^34,35