Effect of Moringa Oleifera Leaf Decoction on Uric Acid in Gout Older Adults

Rinco Siregar; Flora Sijabat; Agus Hartati Hulu

doi:10.25077/njk.v22i2.472

Authors

Rinco Siregar Faculty of Pharmacy and Health Science, Universitas Sari Mutiara Indonesia, Medan, North Sumatra, Indonesia
Flora Sijabat Faculty of Pharmacy and Health Science, Universitas Sari Mutiara Indonesia, Medan, North Sumatra, Indonesia
Agus Hartati Hulu Faculty of Pharmacy and Health Science, Universitas Sari Mutiara Indonesia, Medan, North Sumatra, Indonesia

DOI:

https://doi.org/10.25077/njk.v22i2.472

Keywords:

Aged, Gout Arthritis, Gout Therapy, Moringa Oleifera Leaf Therapy, Uric Acid

Abstract

Gout is a chronic inflammatory joint disorder characterized by uric acid crystal deposition, which frequently affects elderly individuals due to age-related decline in kidney function and purine metabolism. Non-pharmacological interventions such as herbal therapy: Moringa oleifera leaves contain flavonoids, saponins, and antioxidants that are believed to reduce uric acid levels. This study aimed to examine the effect of Moringa oleifera leaf decoction consumption on uric acid levels in older adults with gout arthritis. A quasi-experimental design with a pretest-posttest control group was conducted involving 58 older adult’s participants with hyperuricemia (>7 mg/dL), selected through purposive sampling. Participants were allocated to the intervention or control group based on the order of enrolment, with 29 participants in each group. The intervention group consumed Moringa oleifera leaf decoction daily for four weeks, whereas the control group received standard care. Uric acid levels were measured at baseline before the intervention and after four weeks of intervention using the EasyTouch GCU Meter. Capillary blood samples were obtained by fingertip puncture, and the measurement was performed once at each assessment time point. The single reading displayed by the device was recorded as the participant’s uric acid value. The same measurement procedure was applied at baseline and post-intervention. Data were analyzed using Wilcoxon and Mann–Whitney tests. The intervention group showed a significant reduction in mean uric acid levels, from 7.96 ± 0.42 mg/dL to 6.84 ± 0.48 mg/dL (p < 0.001), whereas no significant change was observed in the control group (7.92 ± 0.43 mg/dL to 7.98 ± 0.45 mg/dL, p = 0.270). Between-group comparison demonstrated no significant difference at baseline (p = 0.579) but a significant difference after the intervention (p < 0.001), with a large effect size (r = 0.81). Regular consumption of Moringa oleifera leaf decoction plays a beneficial role in controlling uric acid levels among older adults with gout arthritis. This intervention is recommended as a safe, accessible, and cost-effective complementary therapy in community health practice.

References

Adonteng-Kissi, B., Moyle, W., & Grealish, L. (2020). Informal care of older adults with chronic lifelimiting illness in Africa: An integrative review. International Social Work. https://doi.org/10.1177/0020872819901164.

Age, S. P. (2021). Pengaruh Pemberian Rebusan Daun Kelor Terhadap Penurunan Kadar Glukosa Darah Diabetes Melitus [The Effect of Moringa Leaf Decoction on the Reduction of Blood Glucose Levels in Diabetes Mellitus]. Journal Health & Science : Gorontalo Journal Health and Science Community, 5(2), 252–257. https://doi.org/10.35971/gojhes.v5i2.10383.

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Lawrence Erlbaum Associates USA. https://utstat.toronto.edu/~brunner/oldclass/378f16/readings/CohenPower.pdf

Dalbeth, N., Gosling, A. L., Gaffo, A., & Abhishek, A. (2021). Gout. The Lancet, 397(10287), 1843–1855. https://doi.org/10.1016/S0140-6736(21)00569-9.

Etri, Y., & Nofia, V. R. (2023). Pengaruh Pemberian Rebusan Daun Kelor Terhadap Tekanan Darah Pada Penderita Hipertensi [The Effect of Moringa Oleifera Leaf Decoction on Blood Pressure in Hypertensive Patients]. Jurnal Ilmu Kesehatan, 3(1), 24–29.

Fitzgerald, J. D., Dalbeth, N., Mikuls, T., Brignardello-petersen, R., Guyatt, G., Gelber, A. C., Harrold, L. R., Khanna, D., King, C., Levy, G., Libbey, C., Mount, D., Pillinger, M. H., Rosenthal, A., Singh, J. A., Sims, J. E., Smith, B. J., Wenger, N. S., Bae, S. S., … Sehra, S. T. (2020). 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis & Reumatology, 72(6), 879–895. https://doi.org/10.1002/art.41247.

Global Clinical Trila Landscape. (2024). Rheumatoid Arthritis – Global Clinical Trial Lansdscape. Novotech Health Holding. https://www.clinicaltrialsarena.com/wp-content/uploads/sites/22/2024/03/Novotech-Rheumatoid-Arthritis.

Gopalakrishnan, L., Doriya, K., & Kumar, D. S. (2016). Moringa oleifera: A review on nutritive importance and its medicinal application. Food Science and Human Wellness, 5(2), 49–56. https://doi.org/10.1016/j.fshw.2016.04.001.

Indonesian Basic Health Research (Riskesdas). (2018). Laporan Riskesdas 2018 Nasional [Indonesian Basic Health Research National Report]. In Lembaga Penerbit Balitbangkes (p. 156).

Indonesian Rheumatology Association. (2024). Pedoman Diagnosis dan Tatalaksana Hiperurisemia & Artritis Gout [Guidelines for the Diagnosis and Management of Hyperuricemia & Gout Arthritis].

Irmawati, R., Pailan, E. T., & Baharuddin, B. (2023). Risk Factor Analysis of Gout Arthritis. Jurnal Ilmiah Kesehatan Sandi Husada, 12(1), 157–162. https://doi.org/10.35816/jiskh.v12i1.919.

Jami, S. R., Fatimah-Muis, S., Syauqy, A., Tjahjono, K., & Anjani, G. (2022). Effect of Moringa (Moringa oleifera) Leaf Flour Supplementation on Total Antioxidant Content of Sprague Dawley Rat Serum Given High-Fat Diet. Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition), 10(2), 141–149. https://doi.org/10.14710/jgi.10.2.141-149.

Lee, J. H., Yang, J. A., Shin, K., Lee, G. H., Lee, W. W., Lee, E. Y., Song, Y. W., Lee, E. B., & Park, J. K. (2017). Elderly patients exhibit stronger inflammatory responses during gout attacks. Journal of Korean Medical Science, 32(12), 1967–1973. https://doi.org/10.3346/jkms.2017.32.12.1967.

Li, Y., Chen, Z., Xu, B., Wu, G., Yuan, Q., Xue, X., Wu, Y., Huang, Y., & Mo, S. (2024). Global, regional, and national burden of gout in elderly 1990–2021: an analysis for the global burden of disease study 2021. BMC Public Health, 24(1). https://doi.org/10.1186/s12889-024-20799-w.

Lin, F., Zhang, H., Huang, F., Chen, H., Lin, C., & Zhu, P. (2016). Influence of changes in serum uric acid levels on renal function in elderly patients with hypertension: A retrospective cohort study with 3.5-year follow-up Public health, nutrition and epidemiology. BMC Geriatrics, 16(1), 1–8. https://doi.org/10.1186/s12877-016-0209-2.

Luo, X., Zhou, L., Wang, S., Yuan, J., Chang, Z., Hu, Q., Chen, Y., Liu, Y., Huang, Y., Wang, B., Gao, Y., Wang, Z., Cui, Y., Liu, Y., & Zhang, L. (2022). The Therapeutic Effect and the Potential Mechanism of Flavonoids and Phenolics of Moringa oleifera Lam. Leaves against Hyperuricemia Mice. Molecules, 27(23). https://doi.org/10.3390/molecules27238237.

Mauliku, N., Dermawan, F. H., Yuliana, H., Murtiani, F., & Norma, N. (2019). The effect of Moringa Oleifera leaf extract capsules on increasing hemoglobin levels in teenage girls. Indonesian Journal of Global Health Research, 2(4), 303–310. https://doi.org/10.37287/ijghr.v2i4.250.

Pareek, A., Pant, M., Gupta, M. M., Kashania, P., Ratan, Y., Jain, V., Pareek, A., & Chuturgoon, A. A. (2023). Moringa oleifera: An Updated Comprehensive Review of Its Pharmacological Activities, Ethnomedicinal, Phytopharmaceutical Formulation, Clinical, Phytochemical, and Toxicological Aspects. International Journal of Molecular Sciences, 24(3). https://doi.org/10.3390/ijms24032098.

Rahmawati, R., & Candra K, A. (2015). Pengaruh Pemberian Seduhan Daun Kelor (Moringa Oleifera) Terhadap Kadar Asam Urat Tikus Putih [The Effect of Moringa Leaf Decoction on Uric Acid Levels in White Rats]. Journal of Nutrition College, 4(2), 593–598.

Saputra, A., Puspita Sari, R., & Solihati. (2023). The Effect of Moringa Leaf Detection on Decreasing Blood Sugar Levels in Diabetes Mellitus Patients in Pangarengan, 2022. Nusantara Hasana Journal, 2(8), 67–73.

Sueni, Haniarti, & Ayu Dwi Putri Rusman. (2021). Analisis Penyebab Faktor Resiko Terhadap Peningkatan Penderita Gout Di Wilayah Kerja Puskesmas Suppa Kabupaten Pinrang [Analysis of Risk Factors Contributing to the Increase of Gout Cases in the Working Area of Suppa Community Health Center]. Jurnal Ilmiah Manusia Dan Kesehatan, 4(1), 1–9. https://doi.org/10.31850/makes.v4i1.315.

Sulthoh, M., & Rohmah, H. N. F. (2023). Pengaruh Ekstrak Daun Kelor Terhadap Produksi Asi Pada Ibu Menyusui Di Puskemas Bahagia Tahun 2021[The Effect of Moringa Oleifera Leaf Extract on Breast Milk Production among Breastfeeding Mothers at Bahagia Public Health Center in 2021]. Cakrawala Medika: Journal of Health Sciences, 1(1), 11–19. https://doi.org/10.59981/k8gcbb33.

Tian, Y., Lin, L., Zhao, M., Peng, A., & Zhao, K. (2021). Xanthine oxidase inhibitory activity and antihyperuricemic effect of Moringa oleifera Lam. leaf hydrolysate rich in phenolics and peptides. Journal of Ethnopharmacology, 270(August 2020), 113808. https://doi.org/10.1016/j.jep.2021.113808.

Tumwikirize, W. A., Ogwal-Okeng, J. W., Vernby, A., Anokbonggo, W. W., Gustafsson, L. L., & Lundborg, S. C. (2011). Adverse drug reactions in patients admitted on Internal Medicine wards in a district and Regional Hospital in Uganda. African Health Sciences, 11(1), 72–78.

Widiyanto, A., Pradana, A. K., Hidayatullah, F., Atmojo, T. J., Putra, S. N., & Fajriah, S. A. (2020). The Effectiveness of Warm Compress of Moringa Leaves Against Uric Acid Pain in the Elderly in Kenteng, Nogosari, Boyolali. Journal of Health Research, 3(2), 103–113. https://jurnal.stikesmus.ac.id/index.php/avicenna/article/view/422.

Worku, B., & Tolossa, N. (2024). A Review on the Neuroprotective Effect of Moringa oleifera. Oxidative Medicine and Cellular Longevity, 2024, 7694516. https://doi.org/10.1155/2024/7694516.