Context: The association between coffee intake and risk of myocardial infarction(MI) remains controversial. Coffee is a major source of caffeine, which is metabolized by the polymorphic cytochrome P450 1A2(CYP1A2) enz...Context: The association between coffee intake and risk of myocardial infarction(MI) remains controversial. Coffee is a major source of caffeine, which is metabolized by the polymorphic cytochrome P450 1A2(CYP1A2) enzyme. Individuals who are homozygous for the CYP1A2* 1A allele are “ rapid” caffeine metabolizers, whereas carriers of the variant CYP1A2* 1F are “ slow” caffeine metabolizers. Objective: To determine whether CYP1A2 genotype modifies the association between coffee consumption and risk of acute nonfatal MI. Design, Setting, and Participants: Cases(n=2014) with a first acute nonfatal MI and population-based controls(n=2014) living in Costa Rica between 1994 and 2004, matched for age, sex, and area of residence, were genotyped by restriction fragment-length polymorphism polymerase chain reaction. A food frequency questionnaire was used to assess the intake of caffeinated coffee. Main Outcome Measure: Relative risk of nonfatal MI associated with coffee intake, calculated using unconditional logistic regression. Results: Fifty-five percent of cases(n=1114) and 54% of controls(n=1082) were carriers of the slow * 1F allele. For carriers of the slow * 1F allele, the multivariate-adjusted odds ratios(ORs) and 95% confidence intervals(CIs) of nonfatal MI associated with consuming less than 1, 1, 2 to 3, and 4 or more cups of coffee per day were 1.00(reference), 0.99(0.69-1.44), 1.36(1.01-1.83), and 1.64(1.14-2.34), respectively. Corresponding ORs(95% CIs) for individuals with the rapid * 1A/* 1A genotype were 1.00, 0.75(0.51-1.12), 0.78(0.56-1.09), and 0.99(0.66-1.48)(P=.04 for gene × coffee interaction). For individuals younger than the median age of 59 years, the ORs(95% CIs) associated with consuming less than 1, 1, 2 to 3, or 4 or more cups of coffee per day were 1.00, 1.24(0.71-2.18), 1.67(1.08-2.60), and 2.33(1.39-3.89), respectively, among carriers of the * 1F allele. The corresponding ORs(95% CIs) for those with the * 1A/* 1A genotype were 1.00, 0.48(0.26-0.87), 0.57(0.35-0.95), and 0.83(0.46-1.51). Conclusion: Intake of coffee was associated with an increased risk of nonfatal MI only among individuals with slow caffeine metabolism, suggesting that caffeine plays a role in this association.展开更多
文摘Context: The association between coffee intake and risk of myocardial infarction(MI) remains controversial. Coffee is a major source of caffeine, which is metabolized by the polymorphic cytochrome P450 1A2(CYP1A2) enzyme. Individuals who are homozygous for the CYP1A2* 1A allele are “ rapid” caffeine metabolizers, whereas carriers of the variant CYP1A2* 1F are “ slow” caffeine metabolizers. Objective: To determine whether CYP1A2 genotype modifies the association between coffee consumption and risk of acute nonfatal MI. Design, Setting, and Participants: Cases(n=2014) with a first acute nonfatal MI and population-based controls(n=2014) living in Costa Rica between 1994 and 2004, matched for age, sex, and area of residence, were genotyped by restriction fragment-length polymorphism polymerase chain reaction. A food frequency questionnaire was used to assess the intake of caffeinated coffee. Main Outcome Measure: Relative risk of nonfatal MI associated with coffee intake, calculated using unconditional logistic regression. Results: Fifty-five percent of cases(n=1114) and 54% of controls(n=1082) were carriers of the slow * 1F allele. For carriers of the slow * 1F allele, the multivariate-adjusted odds ratios(ORs) and 95% confidence intervals(CIs) of nonfatal MI associated with consuming less than 1, 1, 2 to 3, and 4 or more cups of coffee per day were 1.00(reference), 0.99(0.69-1.44), 1.36(1.01-1.83), and 1.64(1.14-2.34), respectively. Corresponding ORs(95% CIs) for individuals with the rapid * 1A/* 1A genotype were 1.00, 0.75(0.51-1.12), 0.78(0.56-1.09), and 0.99(0.66-1.48)(P=.04 for gene × coffee interaction). For individuals younger than the median age of 59 years, the ORs(95% CIs) associated with consuming less than 1, 1, 2 to 3, or 4 or more cups of coffee per day were 1.00, 1.24(0.71-2.18), 1.67(1.08-2.60), and 2.33(1.39-3.89), respectively, among carriers of the * 1F allele. The corresponding ORs(95% CIs) for those with the * 1A/* 1A genotype were 1.00, 0.48(0.26-0.87), 0.57(0.35-0.95), and 0.83(0.46-1.51). Conclusion: Intake of coffee was associated with an increased risk of nonfatal MI only among individuals with slow caffeine metabolism, suggesting that caffeine plays a role in this association.
