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Ajou University School of Medicine, Department of Physical Medicine and Rehabilitation1, Korea University, College of Medicine, Department of Preventive Medicine2, Hanyang University Hospital for Rheumatic Diseases, Department of Internal Medicine3 |
OBJECTIVE: Traditionally, serum uric acid (UA) has been related to gouty arthropathy. Hyperuricemia is
associated with a variety of medical conditions, such as hypertension, insulin resistance, and cardiovascular
and renal diseases, as well as gout. Study results on the effects of coffee consumption on serum UA have
been conflicting. The aim of this study is to analyze the literature regarding the effect of coffee
consumption on serum UA.
METHODS: We searched MEDLINE, EMBASE, the Cochrane library, and KoreaMed for all articles published
before January 2015. Studies were included in our systematic review if they met all of the following three
inclusion criteria: (1) original studies with the aim of evaluating the association between coffee consumption and serum UA level or coffee consumption and risk of gout; (2) studies providing quantitative data on
coffee consumption and serum UA level; and (3) human study. Coffee consumption and serum UA level
were identified with/without the risk of gout.
RESULTS: Nine studies published between 1999 and 2014 were included, containing a total of 175,310
subjects. Meta-analysis demonstrated that coffee has a significantly lowering effect on serum UA, where
there are gender differences in the amount of coffee required to lower serum UA. Men showed significantly
lower serum UA level with coffee intake of 1–3 cups/day than with <1 cup/day (3 studies, 7,794 subjects,
-0.12 mg/dl [95% CI: -0.17 to -0.08], I2 = 41%; p < 0.00001). Women showed significant reduction in serum UA with coffee intake of 4–6 cups/day compared to <1 cup/day (1 study, 3,428 subjects, -0.11 mg/dl
[95% CI: -0.20 to -0.02]; p = 0.02). Therefore, women (4–6 cups/day) need more coffee to lower serum UA
than men (1-3 cups/day). Meta-analysis showed that coffee intake of 1 cup/day or more was significantly
associated with reduction of the risk of gout, with a negative correlation with the amount of daily intake,
where coffee intake ≥4 cups/day reduced the multivariate risk ratio to 0.50.
CONCLUSIONS: This is the first systematic review on the effects of coffee consumption on serum UA. Based on our study, moderate coffee intake might be advocated for primary prevention of hyperuricemia and gout in both genders. The mechanism by which serum UA is lowered by coffee remains still unknown. Since
coffee is a complex beverage containing over 1,000 compounds, it is difficult to identify a single mechanism. Chlorogenic acid, one of the major polyphenols in coffee is known to have an inhibitory effect on xanthine
oxidase. Therefore, it is plausible that various other polyphenols in coffee have inhibitory effects on xanthine oxidase similar to chlorogenic acid. Further prospective studies should be conducted to verify the effect of
coffee on serum UA. |
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Meta-analysis of the effect of coffee intake on serum uric acid for men. Men showed significantly lower serum UA level with coffee intake of 1–3 cups/day than with <1 cup/day .
Meta-analysis of the effect of coffee intake on serum uric acid for women. Women showed significant reduction in serum UA with coffee intake of 4–6 cups/day compared to <1 cup/day.
Meta-analysis of the effect of coffee intake on risk of gout. Coffee intake of 1 cup/day or more showed significant reduction of the risk of gout for both gender, with negative correlation with the amount of daily coffee intake.
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