System Analysis Of The Relationship Between Coffee Consumption And Gallstone Disease

Background and objectiveGallstones represent one of the commonest digestive disorders.It affects many people's health conditions,increases their economic and psychological burden.Key mechanisms involved in the pathophysiology of gallstones include:(1)Bile salt-phospholipid-cholesterol ternary equilibrium be broken,leading to cholesterol supersaturation;(2)Presence of nucleating factors,thus nucleation time be shortened;(3)Impaired gallbladder motility,or enhanced gallbladder concentrating function;(4)Disorder of intestinal movement or enterohepatic circulation.Therapies for gallstones contain surgical and non-surgical methods.Non-surgical treatments are very limited,and even though laparoscopic cholecystectomy is skillfully used,bile leak and abdominal bleeding still exist because of bile duct and vascular injury.The long-term side effects of fatty diarrhea,bile reflux gastritis and intestinal adhesion also trouble patients with laparoscopic cholecystectomy.What is more,after cholecystectomy,bile flowing into intestinal continuously,it may induce intestinal tumour.So,exploring new prevention and therapy methods is necessary.Age,gender,race,parity,genetics,BMI,physical activity and diet are most common factors influencing gallstone disease.In these factors,Age,gender,race,and genetics cannot be controlled.Controllable factors such as physical activity and diet are significant for disease prevention.Coffee is one of the most widely consumed beverages in the world.Studies showed coffee is able to enhance gallbladder contractility,decrease gallbladder fluid absorption,increase intestinal motility,increase energy expenditure and reduce body fat store,and so on.These effects enable coffee as a matter which is able to reduce the risk of gallstone disease.But epidemiological studies on this issue are controversial.So we conduct this system review for the purpose of further clarified the relationship between coffee and risk of gallstones.MethodsSystematic and complete literature retrieval was carried out at first.Include database of PubMed?Web of Science,EMBASE,Cochrane Library,CNKI,WANFANG,CBM,VIP and manual search.Collect observational studies with respect to coffee consumption and risk of gallstone disease.Then,two reviewers screened and selected articles independently based on inclusion and exclusion criteria.All of the studies which meet inclusion criteria were include in the systematic review.And STATA 11.0 software was used for meta-analysis after data being extracted from studies containing useful data.In the meta-analysis,heterogeneity was evaluated by Q test and I2 statistic,publish bias was assessed by Egger's test and Begg's method,and publication bias was test by an alternative model.ResultsAfter screened and selected,nineteen studies about coffee consumption and risk of gallstones were obtained,and fourteen of them meet criteria for meta-analysis.System analysis of the nineteen studies showed,eight support coffee is a protect factor for gallstones,two of them hold a viewpoint that coffee increase risk of gallstones in men,others don't draw a clear conclusion.Fourteen studies in the meta-analysis are made up of five cohort studies and nine retrospective studies,with 226,432 and 29,111 participants respectively.Pooled result of cohort studies showed inverse relationship between coffee consumption and gallstone disease(RR=0.76,95%CI: 0.71~0.81,P=0.000).Pooled result of retrospective studies don't showed any statistical significance between coffee consumption and gallstone disease(OR=0.88,95%CI: 0.67~1.16,P=0.366).Subgroup analysis showed that,consumption of caffeinated coffee decrease risk of gallstone disease(OR=0.76,95%CI: 0.71~0.81,P=0.000);coffee drinking 2~3 cups/day or > 3 cups/day decrease risk of gallstone disease(OR=0.84,95%CI: 0.80~0.88,P=0.000)(OR=0.81,95%CI: 0.69~0.96,P=0.014).Drinking coffee is associated with decrease risk of symptomatic gallstone disease(OR=0.77,95%CI: 0.66~0.90,P=0.001)and gallstone disease for women(OR=0.77,95%CI: 0.72~0.83,P=0.000).ConclusionCoffee drinking is associated with reduction of gallstone disease,particularly the caffeinated coffee.The prevention effect of coffee is worked if consuming dose reach 2 cups/day.In addition,it's more powerful to prevent symptomatic gallstone disease and women with gallstone disease.