Caffeine Intake Is Associated with a Lower Risk of Nonalcoholic Fatty Liver Disease-Related Fibrosis in Patients with Type 2 Diabetes

Background: Type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) are conditions closely associated, the prevalence of which is continuously growing, providing a heavier socioeconomic and disease burden. Lifestyle modification is still considered the cornerstone of nonalcoholic liver steatohepatitis (NASH). We aimed to investigate the association between caffeine and NAFLD-related fibrosis in populations with different diabetes conditions. Methods: Adult participants in NHANES from 2005 to March 2020 pre-pandemic were included with three group: T2DM group, prediabetes group and diabetes-free group. Liver fibrosis was assessed by Fibrosis-4 (FIB-4) index. Logistic regression was employed to interrogate the association between caffeine and liver fibrosis. Finds: A total of 23711 participants were included. The proportions of high risk (FIB-4>2.67) for liver fibrosis in T2DM group was significantly higher than that of prediabetes group and diabetes-free group (5.9% vs 3.2% vs 2.4%, P<0.001). However, the proportions of high risk in prediabetes group is equal with that of diabetes-free group (3.2% vs 2.4%, P>0.05). Notably, the proportions of intermedium risk (FIB-4>1.3, and< 2.67) for liver fibrosis in prediabetes group was significantly higher than that of diabetes-free group (32.3% vs 24.2%, P<0.001). Participants with caffeine intake≤78mg/day had a high risk for liver fibrosis than that with caffeine intake >78mg/day in all groups (Diabetes-free group: OR 1.312[1.086-1.585]; Prediabetes group: OR 1.641[1.192-2.259]; T2DM group: OR 1.373[1.066-1.769]; all P<0.05). Interpretation: Prevalence of liver fibrosis is high in patients with T2DM and prediabetes. And caffeine intake more than 78mg per day is associated with a lower risk for liver fibrosis in T2DM and prediabetes. Disclosure J.Han: None. C.Liu: None. H.Yang: None. R.Gao: None. Z.Li: None. J.Li: None. X.Qi: None.