B肝帶原者喝咖啡 有效降低肝炎風險 東森新聞-2014年04月07日 上午10:44台灣肝炎病毒帶原者超過300萬人，新光醫院腎臟科主治醫師江守山引述國外研究，建議B、C肝帶原者可多喝咖啡，依攝取量不同可讓帶原者罹患肝炎、肝硬化的風險，降低22%至75%，其中又以美式咖啡效果最好，但醫生建議咖啡喝太多會刺激腸胃，所以一天至少適量，不要喝超過三杯以上。很多人早上都喜歡來一杯咖啡，只是你知道這咖啡還有護肝的功效嗎？根據江守山醫生從國外研究發現，咖啡對於肝炎病毒帶原者能夠有抑制肝炎的效果，因為咖啡豆含有種綠原酸，接觸熱水就會釋放護肝效力，像是用濾紙沖泡的美式咖啡效果最好，其次是高溫沖泡的義式咖啡，再來虹吸咖啡，冰滴咖啡效果最差，新光腎臟科醫生江守山：「其實它是不能治療肝炎，有幫忙的是它可以預防肝硬化跟肝炎的形成，而且這部分研究做得很廣泛，包括B肝C肝帶原者以及酒精肝，這些明顯的肝硬化跟肝炎的風險族咖啡都有幫忙」。日本研究也顯示，每天喝一杯咖啡，帶原者發生肝硬化肝炎的風險會降低22%，喝兩杯則降50%，但一般人喝咖啡卻沒護肝效用，只有對帶原者有益，新光腎臟科醫生江守山：「但是考慮到衛福部(每天)三百毫克的建議，如果你的咖啡豆種類是阿拉比卡的話，事實上三百毫克可以喝到十杯，可是如果你是羅布斯卡你只能喝三杯，那個便宜的咖啡都是羅布斯卡，所以就不能喝超過三杯」，雖然喝咖啡能夠有效降低肝硬化風險，但醫生也建議咖啡一天最好別喝太多以免刺激腸胃，導致胃食道逆流，而且咖啡因會導致失眠跟心跳加速，怕晚上睡不著下午五點後也別喝，如果心律不整的民眾也不建議多喝，以免過量傷身。
Moderate coffee consumption reduces the risk of hepatocellular carcinoma in hepatitis B chronic carriers: a case-control study. J Epidemiol Community Health. 2011 Jun;65(6):556-8. BACKGROUND: Recent epidemiological studies have reported a dose-dependent protective effect of coffee on hepatocellular carcinoma (HCC) with risk reduction ranging from 30% to 80% in daily coffee drinkers compared with non-drinkers. This study examined whether coffee has a similar protective effect when consumed in moderate quantities in chronic hepatitis B virus (HBV) carriers, a group at high risk of developing liver cancer. METHODS: A case-control design was employed. 234 HBV chronic carriers (109 cases and 125 controls) were recruited from the Prince of Wales Hospital in Hong Kong from December 2007 to May 2008. Data collection included review of medical records and face-to-face interview. Univariate and multivariate logistic regressions adjusting for age, gender, cigarette smoking, alcohol use, tea consumption and physical activity were conducted with dose-response analysis. RESULTS: Moderate coffee consumption significantly reduced the risk of HCC by almost half (OR 0.54, 95% CI 0.30 to 0.97) with a significant dose-response effect (χ²=5.41, df=1, p=0.02), reducing the risk for moderate drinkers by 59% (OR 0.41, 95% CI 0.19 to 0.89).
CONCLUSION: The findings provided evidence to support the protective effect of coffee consumption in moderate quantities in HBV chronic carriers.
The effect of coffee consumption on the development of hepatocellular carcinoma in hepatitis B virus endemic area
The effect of coffee consumption on the development of hepatocellular carcinoma in hepatitis B virus endemic area Liver International Volume 33, Issue 7, pages 1092–1099, August 2013 Background & Aims Coffee consumption is inversely related to the risk of cirrhosis or hepatocellular carcinoma (HCC). However, the protective effect of coffee drinking against the risk of HCC was not established in HBV-prevalent region. To elucidate the relationship between lifetime coffee consumption and the risk of HCC development under the consideration of replication status of HBV. Methods A hospital-based case–control study was performed in 1364 subjects. A total of 258 HCC patients, 480 health-check examinees (control 1, HCE) and 626 patients with chronic liver disease other than HCC (control 2, CLD) were interviewed on smoking, alcohol and coffee drinking using a standardized questionnaire. HBV e-antigen (HBeAg) status and serum HBV DNA levels were measured in patients infected with HBV. Results After adjustment for age, gender, obesity, DM, presence of hepatitis virus (except for HCE) and lifetime alcohol drinking/smoking, a high lifetime coffee consumption (≥20 000 cups) was an independent protective factor against HCC, in each analyses using healthy and risky control groups respectively (HCE group, OR 0.56, 95% CI 0.33–0.95; CLD group, OR 0.55, 95% CI 0.36–0.85). However, the high coffee consumption did not affect the HCC risk in patients with HBV (OR 0.64, 95% CI 0.36–1.14) after adjustment for HBeAg status, serum HBV DNA level and antiviral therapy. Conclusions A high lifetime coffee consumption was negatively associated with a HCC development. However, this difference of coffee exposure with the HCC group was reduced in chronic hepatitis B patients by the dominant role of viral replication.