Advances in Health Sciences Research (AHSR), volume 14
1st International Conference on Inter-Professional Health Collaboration (ICIHC 2018)
Lower Uric Acid Levels in Subjects
Consuming Coffee compared to Not
Consuming Coffee
Raden Sunita Yose Anggraeni Krisyanella
Jurusan Teknologi Laboratorium Medis Jurusan Teknologi Laboratorium Medis Jurusan Teknologi Laboratorium Medis
Politeknik Kesehatan Kementerian Politeknik Kesehatan Kementerian Politeknik Kesehatan Kementerian
Kesehatan Bengkulu Kesehatan Bengkulu Kesehatan Bengkulu
Bengkulu, Indonesia Bengkulu, Indonesia Bengkulu, Indonesia
radensunita19@gmail.com yosedwianggraini@gmail.com ellaunand@gmail.com
Abstract—Uric acid as the nitrogen compounds that although there is no purine intake, uric acid is
produced from catabolism purine from both diet still formed in substantial amounts. Excessive
and endogenous nucleic acids (DNA increase in uric acid is also caused by the excess
deoxyribonucleic acid). One of the factors that can formation of uric acid in the body or obstruction of
increase uric acid levels is the factor of excessive
uric acid removal by the body. Increased levels of
purine intake. The habit of consuming coffee can
reduce levels of uric acid because the content of uric acid in the blood are called hyperuricemia [1].
polyphenol compounds in coffee such as chlorogenic Hyperuricemia is caused by two things,
acid can inhibit the activity of the enzyme xanthine because of the formation of excessive uric acid or
oxidase, thereby reducing levels of uric acid. The due to a decrease in uric acid secretion. The
purpose of study was to determine differences in kidneys work to regulate the stability of uric acid
uric acid levels between subjects who consumed levels in the body where some of the remaining
coffee and did not consume coffee in the Eastern uric acids are removed through urine. Excessive
Puskesmas area in 2018. This study included an uric acid and the kidney is no longer able to
analytical study with research design cross-sectional.
regulate its stability so that uric acid will
The number of study subjects was 46 subjects aged
45-54 years. Spectrophotometer Rayto measured the accumulate in the tissues and joints. High uric acid
level of uric acid in the blood, data on the history of levels will cause severe pain, especially in the joint
gout and consumption habits were obtained using an area. Hyperuricemia that is not treated causes
observation sheet. Data analysis used test Mann- excessive uric acid in the blood, causing a buildup
Whitney. There were differences in uric acid levels of uric acid crystals. Uric acid crystals will damage
between subjects who consumed coffee and did not the coronary endothelium (inner lining of blood
consume coffee in the East Rim Health Center area vessels). If the crystal is in the joint fluid, it will
in 2018, the uric acid level of subjects who consumed cause Gout [2].
coffee was lower than subjects who did not consume
The prevalence of joint disease based on a
coffee (CI 95% 6.20, 7.80 ; p =0.001). Uric acid levels
of subjects who consume coffee are lower than diagnosis of health workers in Indonesia is 11.9%
subjects who do not consume coffee, and coffee can and based on diagnosis or symptoms 24.7%. The
be used as a non-pharmacological alternative prevalence based on the diagnosis of health
treatment and prevention of Gout. workers was highest in Bali (19.3%), followed by
Aceh (18.3%), West Java (17.5%), and Papua
Keywords: Uric acid levels, coffee, coffee consumption (15.4%). The prevalence of joint disease based on
the diagnosis of health workers or symptoms was
I. INTRODUCTION highest in East Nusa Tenggara (33.1%), followed
by West Java (32.1%), and Bali (30%). Based on
Uric acid is the final product of purine data from the Bengkulu City Health Office, the
metabolism that comes from metabolism in the number of arthritis in the city of Bengkulu is quite
body or factors endogenous (genetic) and comes high and is included in the ten diseases that suffer
from outside the body or factors exogenous (food most from the people of Bengkulu City [3].
sources). Every living thing produces uric acid as a Gout disease as a disease of purine metabolic
result of cell metabolic processes that function to disorders characterized by hyperuricemia and
maintain survival. Uric acid is excreted in the repeated attacks of acute synovitis. The incidence
kidneys (70%) and gastrointestinal tract (30%). The of Gout is 1-2%, especially in the age of 40 years
level of uric acid in the blood depends on the and 20 times more often in men than in women.
balance of production and excretion. Purine Gout is indeed many men who are caused by age,
turnover occurs continuously along with the diet, decreased kidney function, and other health
synthesis and decomposition of RNA and DNA so problems, but after 50 years of age, women are also
Copyright © 2019, the Authors. Published by Atlantis Press. 103
This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
Advances in Health Sciences Research (AHSR), volume 14
at high risk of developing Gout due to reduced (6) Serum piped 20 µL into cuvette 3 (sample); (7)
estrogen, so uric acid is difficult to pass through The cuvettes are homogenized respectively; (8)
urination. This disorder is related to the Incubated at room temperature (37oC) for 5
accumulation of monosodium monohydrate urate minutes; (9) Read on a 500 nm spectrophotometer
crystals and at a later stage joint cartilage and all used devices are cleaned.
degeneration. The limit of serum uric acid
saturation in men is 7.0 mg / dL and in women 5.7 III. RESULTS
mg/dL. According to previous research, increasing
uric acid levels in the blood are often related to Table I. shows the frequency distribution of uric
geographical location, cultural patterns of local acid levels of people who consume coffee and do
people, both those living in coastal areas and not consume coffee. The number of respondents in
highland areas, have high protein and fat eating this study was 46 subjects with arthritis in the East
habits, and habits of consuming alcoholic Rim City Health Center area of Bengkulu.
beverages [4].
TABLE I. DISTRIBUTION OF FREQUENCY OF URIC
ACID LEVELS BASED ON GENDER
CHARACTERISTICS
II. METHODS
V AU levels AU levels not
This study uses study design cross-sectional - Coffee consumption Coffee consumption
involving subjects collected according to the n n
inclusion and exclusion criteria to be determined as Normal High Normal High
research subjects. Inclusion criteria or
characteristics that need to be fulfilled by each F % F % F % F %
member of the population that can be taken as a P 8 57.14 6 42, 85 14 2 11.1 16 88.88 18
sample in this study, namely (1) Having arthritis,
(2) Not taking gout medicine; (3) Having the habit L
8 88.88 1 11.11 9 1 20 4 80 5
of drinking black coffee (Robusta) which is
dissolved in 3 cups of hot water per day; (4) V: Variable, L: Male, P: Female
Respondents aged between 45-54 years. Of the
population, 223 people met the inclusion criteria Based on Table I shows the results of the
frequency distribution of female uric acid levels
and taken 20% so that the number of samples in
this study was 46 samples. that consumed mostly normal coffee as many as
Uric Acid levels were analyzed by eight people (57.14%), and the frequency
spectrophotometer (Rayto®), The tools used in this distribution of male uric acid levels consumed
study were cuvette, blue and yellow tip, 1000 µL almost all normal coffee is eight people (88.88%).
and 20 µL micropipette, beaker glass (Pyrex®), red The results of the normality test analysis of data
obtained from 46 respondents using the
lid vacutainer tube, centrifuge, centrifuge tube,
tissue, 3 mL syringe, tourniquet, cotton, plaster, Kolmogorov-Smirnov and Shapiro-Wilk tests were
handscoon, mask. Sampling is done, namely (1) not normally distributed seen from p-value <0.05,
Tourniquet mounted on the patient's arm (3 fingers so no unpaired t-test was performed and an
above the elbow fold); (2) The patient's arm is unpaired alternative t-test, the test Mann-Whitney.
Table 2. shows the results there are differences
placed on the bearing; (3) The area of veins to be
removed is cleaned with 70% alcohol cotton; (4) 2 in uric acid levels between people who consumed
mL of venous blood is sucked using a syringe; (5) coffee and did not consume coffee in the East Rim
The venous blood is inserted into the red lid Health Center in 2018 (CI 95% 6.20, 7.80; p
vacutainer tube. The principle of checking uric acid =0.001).
levels is uric acid was oxidized by Uricase to TABLE II. DIFFERENCES IN URIC ACID LEVELS OF
become Allatoin and H2O2 in the presence of SUBJECTS WHO CONSUMED COFFEE AND
Peroxidase to produce chromogens colored DID NOT CONSUME COFFEE
measured with a wavelength of 500 nm which is
proportional to the level of uric acid in the sample. Median (Min-Max) p
Normal value of male uric acid 2.5-7.0 mg / dL,
Coffee consumption 6.20 (4-8)
female 1.5-6.0 mg / dL. Work procedures (1) Tools 0.001
and materials to be used are prepared; (2) Making No coffee consumption 7.80 (5-15)
serum from venous blood that has been taken is
centrifuge for 15 minutes at a speed of 3000 rpm;
(3) dilution of the working reagent was carried out IV. DISCUSSION
by mixing reagent 1: reagent 2 (4: 1); (4) Work Research on differences in levels uric acid
reagents are piped 1000 µL into 3 cuvettes; cuvette people who consume coffee and do not consume
1 (blank); kuvet 2 (standard); kuvet 3 (sample); (5) coffee in the Bengkulu City Lingkar Timur Health
Reagent 3 is piped 20 µL into kuvet 2 (standard);
104
Advances in Health Sciences Research (AHSR), volume 14
Center area was carried out on 23 respondents protein derivatives called xanthine purines. These
consuming coffee and 23 not consuming coffee. compounds in normal body conditions do have
The method used spectrophotometry Rayto. some properties, among others, are analgesic drugs
The results of this study indicate that coffee that can reduce uric acid levels, reduce pain and
can reduce uric acid levels in the blood through the reduce fever [7]. Allopurinol is a chemical
chlorogenic acid contained in it. Chlorogenic acid structure analogous to hypoxanthine, allopurinol as
has the effect of inhibiting the enzyme activity of an analog substrate for the enzyme xanthine
xanthine oxidase. The main content of coffee other oxidase. The function of allopurinol as an analog
than caffeine is a compound of polyphenols, the substrate will occupy the active side of the enzyme
most polyphenol content in coffee is a chlorogenic xanthine oxidase, which is usually occupied by
acid which has the effect of inhibiting the enzyme hypoxanthine. Allopurinol inhibits enzyme activity
xanthine oxidase thereby reducing serum uric acid irreversibly by reducing the formation of xanthine
levels [5]. The content of chlorogenic acid in oxidase which inhibits the formation of uric acid.
coffee also has a diuretic effect that accelerates the The workings of polyphenols (chlorogenic acid) in
excretion of uric acid in the urine, thereby reducing a coffee can inhibit the formation of uric acid
serum uric acid levels. Chlorogenic acid is one of similar to the way allopurinol works. Chlorogenic
the potent antioxidants from phenolic compounds acid which is one of the potent antioxidants from
capable of inhibiting the activity of the enzyme phenolic compounds was able to inhibit xanthine
xanthine oxidase to reduce serum uric acid levels oxidase activity [8].
[6]. Whereas according to the results of the study.
Consuming coffee can reduce the incidence of Antioxidants will capture free radicals and prevent
various types of diseases including diabetes chain reactions from free radicals. Uric acid is one
mellitus, cardiovascular, cancer, and reduce levels of the secondary antioxidants inside the body. It
of uric acid because coffee contains polyphenol means that at normal levels, uric acid will be able
compounds which are antioxidants around 200-550 to ward off free radicals that are in the body, but in
mg of coffee. When the body consumes coffee with excessive amounts will harm the body. The coffee
the content of polyphenol compounds, the body content that has been identified as an antioxidant is
will get these antioxidants while still considering chlorogenic acid and is a significant contributor of
the process of processing and serving coffee. antioxidants [7]. That the intake of high intake of
Coffee content (polyphenols) that has been coffee is not a risk factor with a decrease in uric
identified as an antioxidant is chlorogenic acid, a acid levels, this study refers to the results of a study
compound that is formed during roasting. that showed that there was a decrease in uric acid
Chlorogenic acid acts to inhibit the activity of levels after treatment in the group that obtained it
xanthine oxidase so that uric acid levels decrease. coffee solution 0.72 mL/ day and 2.16 mL/ day.
Polyphenols (chlorogenic acid) are also diuretic, so Phenol compounds have biological activities as
uric acid will dissolve and be wasted with urine [7]. potent antioxidants in vitro so they can protect
Polyphenol (compound chlorogenic acid DNA, lipids, and proteins by fighting damaging
coffee) can inhibit the action of enzymes xanthine free radicals in vivo, to reduce the risk the
oxidase because the mechanism of inhibition is occurrence of chronic diseases. Polyphenol
likely due to the similarity of the chemical structure compounds are also diuretics, so uric acid will
of polyphenol compounds with derivatives xanthin dissolve and be wasted with urine [10].
derived from caffeine degradation and the body's Coffee is one drink that is very popular with
metabolism. So that the biological activity of the people of Indonesia and in other countries in
polyphenols can inhibit xanthine oxidase, like the the world. Studies that examine the effects of
way allopurinol works in reducing uric acid levels coffee consumption on a variety of certain medical
by using the inhibitory pathway of the enzyme conditions. The positive effects of consuming
xanthine oxidase [8]. coffee include reducing the risk of Alzheimer's
The habit of consuming coffee can reduce the disease, Parkinson's, type 2 diabetes mellitus, liver
risk of gout due to the inhibition of the enzyme cirrhosis, and reducing blood uric acid. The results
xanthine oxidase which is a catalyst for the change of a study in Japan showed that drinkers of 3
of hypoxanthine to xanthine and from xanthin back glasses or more coffee per day had lower uric acid
in the catalyst by the enzyme xanthine oxidase to levels compared to drinkers of 1 cup or less coffee
uric acid [2]. If the work of the enzyme xanthin per day. Research in Canada shows that uric acid
oxidase is inhibited, the formation of uric acid in levels decrease with increasing consumption of
the body will decrease. The work inhibitory robusta black coffee every day. Based on previous
mechanism of the enzyme is xanthine oxidase research, uric acid levels of mice with high doses
almost the same as the work of blood uric acid- of coffee decreased when compared with the group
lowering drugs (Allopurinol). One of the with low doses of coffee [5]. Taxonomically,
ingredients in coffee is that caffeine a crystal- coffee includes the Rubiaceae family, genus coffee.
shaped compound. The main constituents are There are two species, namely Coffea arabica
105
Advances in Health Sciences Research (AHSR), volume 14
(arabica) and Coffea canephora (robusta). Coffee is Menggunakan Spektrofotometri Uv-Vis. Universitas
Tanjungpura, 5(2), 838–841.
an alternative beverage choice that is very popular
with Indonesian and other countries. The hobby of
consuming coffee has been done for generations
since the days of our ancestors, even in every
banquet of both formal and non-formal events,
coffee offers are rarely forgotten.
In some studies, coffee can reduce uric acid
levels in the blood. The glucose concentration in
plasma will decrease by the presence of
chlorogenic acid in coffee. One of the ingredients
in coffee, caffeine, is a crystalline compound. The
main constituent is a protein derivative called
purine xanthine. These compounds in normal body
conditions do have several benefits, including
analgesic drugs that can reduce uric acid levels,
reduce pain and reduce fever [10]. Coffee is one of
the results of plantation commodities that have high
economic value among other plantation crops and
play an essential role as a source of foreign
exchange. Some of the compounds in coffee are
polyphenols (chlorogenic acid) and caffeine. These
compounds in normal body conditions do have
some properties, including analgesic drugs that can
reduce pain and reduce fever [11].
V. CONCLUSION
From the results of this study concluded that
uric acid levels of people who consume coffee are
lower than those who do not consume coffee.
REFERENCES
[1] Kanbara, A. et al. Urine Alkalization facilitates uric Acid
Excretion, Nutritional Journal 2010, 9: 45 doi 10.1186 /
1475-289145.
[2] Dahlia, M. 2010. Effect of Drinking Coffee against
Diabetes and Gout in Men in Semarang City. Health
Journal of Indonesian Islamic University. 12-14.
[3] RISKESDAS. (2013). Basic Health Research. Health
Research and Development Agency. RI Ministry of Health.
[4] Anticipated. (2013). Ervi Diantari, Aryu Candra *). Effect
of Purine and Liquid Intake on Female Uric Acid Levels of
50-60 Years in Gajah Mungkur District, Semarang.
Diponegoro University, 2, 44–49.
[5] Koto et al. (2014). Research Article Effect of Instant Oral
Coffee on Uric Acid Levels on Wistar Rats. UNAND.
[6] Dahlia, M. 2010. Effect of Drinking Coffee against
Diabetes and Gout in Men in Semarang City. Health
Journal of Indonesian Islamic University. 12-14.
[7] Lelyana, Rosa. (2008). Effect of Coffee on Blood Uric Acid
Level Experimental Study on Rattus Norwegicus Rat Galur
Wistar. Post Graduate Program in Master of Biomedical
Sciences. Semarang: Diponegoro University.
[8] Arwangga, Aryans. et al. (2016). Analysis of Caffeine
Content in Coffee in Sesaot Narmada Village using Uv-
Vis Spectrophotometry. Bali: Udayana University.
[9] Hermawati, Eka. (2015a). The relationship between
Caffeine Intake and Uric Acid Levels at Banjarnegara
Health Center, 1–19.
[10] Pratama, RI (2016). Effect of Coffee Consumption on
Decreasing Blood Uric Acid Levels of the Effect of Coffee
Consumption in Lowering Blood Uric Acid Level.
University of Lampung, 5.
[11] Wahyuono, S., & Widyarini, S. (2016). Mentah Dari
Perkebunan Merapi Daerah Istimewa Yogyakarta
106
