大量喝咖啡增加失明风险？新研究提醒一类人应减少咖啡因摄入

Intraocular Pressure, Glaucoma, and Dietary Caffeine Consumption: A Gene–Diet Interaction Study from the UK Biobank

作者：Jihye Kim, Hugues Aschard, Jae H. Kang, Marleen A.H. Lentjes, Ron Do, Janey L. Wiggs, Anthony P. Khawaja, Louis R. Pasquale, on behalf of theModifiable Risk Factors for Glaucoma Collaboration

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期刊：Ophthalmology

发表时间：2020/12/14

Purpose

We examined the association of habitual caffeine intake with intraocular pressure (IOP) and glaucoma and whether genetic predisposition to higher IOP modified these associations. We also assessed whether genetic predisposition to higher coffee consumption was related to IOP.

Design

Cross-sectional study in the UK Biobank.

Participants

We included 121 374 participants (baseline ages, 39–73 years) with data on coffee and tea intake (collected 2006–2010) and corneal-compensated IOP measurements in 2009. In a subset of 77 906 participants with up to 5 web-based 24-hour-recall food frequency questionnaires (2009–2012), we evaluated total caffeine intake. We also assessed the same relationships with glaucoma (9286 cases and 189 763 controls).

Methods

We evaluated multivariable-adjusted associations with IOP using linear regression and with glaucoma using logistic regression. For both outcomes, we examined gene–diet interactions using a polygenic risk score (PRS) that combined the effects of 111 genetic variants associated with IOP. We also performed Mendelian randomization using 8 genetic variants associated with coffee intake to assess potential causal effects of coffee consumption on IOP.

Main Outcome Measures

Intraocular pressure and glaucoma.

Results

Mendelian randomization analysis did not support a causal effect of coffee drinking on IOP (P > 0.1). Greater caffeine intake was associated weakly with lower IOP: the highest (≥232 mg/day) versus lowest (<87 mg/day) caffeine consumption was associated with a 0.10-mmHg lower IOP (Ptrend = 0.01). However, the IOP PRS modified this association: among those in the highest IOP PRS quartile, consuming > 480 mg/day versus < 80 mg/day was associated with a 0.35-mmHg higher IOP (Pinteraction = 0.01). The relationship between caffeine intake and glaucoma was null (P ≥ 0.1). However, the IOP PRS also modified this relationship: compared with those in the lowest IOP PRS quartile consuming no caffeine, those in the highest IOP PRS quartile consuming ≥ 321 mg/day showed a 3.90-fold higher glaucoma prevalence (Pinteraction = 0.0003).

Conclusions

Habitual caffeine consumption was associated weakly with lower IOP, and the association between caffeine consumption and glaucoma was null. However, among participants with the strongest genetic predisposition to elevated IOP, greater caffeine consumption was associated with higher IOP and higher glaucoma prevalence.

图片来源：Unsplash

很多人现在都有喝咖啡的习惯，尤其是在睡意昏沉的早晨，来上一杯香浓的咖啡，整个人都清醒了不少。

有大量科学证据显示，咖啡（因）的健康好处很多，比如改善肥胖、降低心血管疾病风险等。但是，喝咖啡也是有“风险”的，需要根据身体情况“量力而行”。最近，一项新研究指出，对于一部分人来说，摄入咖啡因过多——比如，每天喝3-4杯咖啡，可能增加失明的风险！

这项研究近日发表在眼科权威期刊Ophthalmology上。由美国西奈山伊坎医学院（Icahn School of Medicine at Mount Sinai）领衔开展的一项国际研究发现，对于有高眼压遗传倾向的人群来说，每天大量摄入咖啡因可能使青光眼（glaucoma）的患病风险增加3倍以上。

据报道，这是科学家首次证明饮食-基因相互作用对青光眼的影响。研究人员建议有严重青光眼家族史的人群应减少咖啡因的摄入。值得说明的是，咖啡因和青光眼风险之间的联系只有在那些具有高眼压遗传风险、并伴有大量咖啡因摄入的人群身上观察到。

青光眼是一种以视神经损害为特征的进行性、不可逆性视力丧失的眼病，是世界上排名第二的主要致盲性眼病。这种眼部疾病在多数情况下没有症状，但却会给患者的视力造成不可逆转的损害。眼内压（IOP）升高是青光眼的一个主要风险因素，通常情况下，青光眼与眼压（IOP）过高有关，不过青光眼也可能出现在IOP正常的情况下。青光眼患者常需终生控制眼压，降眼压眼药水最为常用，有时可能还需要手术治疗。

“青光眼患者经常问他们是否可以通过改变生活方式来帮助保护视力，这项研究表明，那些青光眼遗传高风险的人可能通过减少咖啡因的摄入获益。”该研究主要作者之一Anthony Khawaja博士表示。

▲该研究通讯作者Louis R. Pasquale博士 （图片来源：Mount Sinai官网）

研究团队利用大型生物医学数据库BioBank，分析了2006年至2010年间超过12万名年龄在39到73岁之间的志愿者记录，包括他们的健康记录及DNA样本，还有一份饮食调查问卷。问卷内容包括他们每天喝多少含咖啡因的饮料，吃多少含咖啡因的食物，饮料食物的具体类型和份量，以及视力相关问题，包括是否患有青光眼或是否有青光眼家族史。3年后，这些志愿者接受了IOP检查和眼部测试。

研究结果分析表明，高咖啡因摄入量与高IOP或青光眼的总体风险增加无关。然而，在具有IOP升高最强遗传倾向（前25%）的志愿者中，高咖啡因摄入量与高IOP和更高的青光眼患病率相关，而每天摄入咖啡因量最高的人（超过480 mg，约等于4杯咖啡），IOP高0.35 mmHg。

此外，与那些不摄入或很少摄入咖啡因以及遗传风险评分最低的人群相比，遗传风险评分最高的人群若每天摄入超过321 mg咖啡因（约等于3杯咖啡），青光眼患病率将升高3.9倍！

▲咖啡因摄入与IOP升高及青光眼风险间的关系（图片来源：参考资料 [1]）

“我们先前发表的研究表明，在有家族病史的人群中，高咖啡因摄入量增加了高眼压性开角型青光眼的风险。而这项研究强调，只有在那些具有眼压升高遗传风险高的人群中，咖啡因摄入量多和青光眼患病风险之间的负面关系才明显存在。”该研究通讯作者、眼科研究专家Louis R. Pasquale博士总结。

青光眼是导致失明的一个主要原因。为了更好保护眼部健康，美国眼科学会（American Academy of Ophthalmology）建议，40至54岁的人应该每2到4年检查一次眼睛；55岁至65岁的人应该每1到3年检查一次眼睛；而超过65岁的人应该每1到2年就检查一次眼睛。当然，存在青光眼危险因素的人群应进行更频繁的全面眼部检查，包括眼压、视野等。

参考资料:

[1] Jihye Kim et al., (2020) Intraocular Pressure, Glaucoma, and Dietary Caffeine Consumption: A Gene-Diet Interaction Study from the UK Biobank. Ophthalmology

[2] High Caffeine Consumption may be Associated with Increased Risk of Blinding Eye Disease. Retrieved June 7, 2021 from https://www.mountsinai.org/about/newsroom/2021/high-caffeine-consumption-may-be-associated-with-increased-risk-of-blinding-eye-disease

[3] If You Drink This Much Coffee a Day, It Could Increase Your Risk of Going Blind. Retrieved June 7, 2021, from https://bestlifeonline.com/glaucoma-risk-news/