Consumo de café y riesgo cardiovascular en síndrome metabólico: revisión sistemática y metaanálisis

Abstract

Abstract Introduction: Metabolic syndrome (MetS) increases the risk of cardiovascular disease (CVD), including overall mortality. Coffee consumption has shown antioxidant and anti-inflammatory effects, but its relationship with cardiovascular risk in people with MetS remains debated. Objective: To assess the association between coffee consumption and cardiovascular risk in adults with metabolic syndrome. Method: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. PubMed, Scopus, Ovid, and Google Scholar were searched (2017–2024). Observational studies in adults with MetS reporting CVD incidence, mortality, or metabolic variables were included. Random-effects models were used to estimate standardized mean differences (SMD). Results: Nineteen studies with a total of 1,149,246 participants were analyzed. Moderate coffee consumption (1–3 cups/day) was significantly associated with lower cardiovascular risk (SMD: -0.2149, 95% CI: -0.2594 to -0.1704, p < 0.0001). The effect was strongest for metabolic equivalents. Publication bias was identified. Conclusion: Moderate coffee consumption may reduce cardiovascular risk in adults with MetS. Caution is advised, and further clinical trials are warranted. Keywords: coffee consumption, metabolic syndrome, cardiovascular riskIntroducción: El síndrome metabólico (MetS) incrementa significativamente el riesgo cardiovascular, pero la evidencia sobre el impacto del consumo de café en esta población es limitada. Objetivo: Evaluar la asociación entre el consumo de café y la incidencia de enfermedad cardiovascular, mortalidad cardiovascular y parámetros metabólicos en adultos con MetS. Método: Revisión sistemática y meta-análisis según PRISMA 2020 (PROSPERO CRD42024606335). Se buscaron estudios observacionales en PubMed, Scopus, Ovid y Google Scholar (2017–2024). Los desenlaces de incidencia y mortalidad se sintetizaron mediante hazard ratios (HR) y los metabólicos mediante diferencia de medias estandarizada (SMD). Se utilizó un modelo de efectos aleatorios; la heterogeneidad se evaluó con I² y el sesgo de publicación con la prueba de Egger. Resultados: Se incluyeron 19 estudios (1,149,246 participantes). El consumo moderado de café (1–3 tazas/día) se asoció con menor incidencia cardiovascular (HR = 0.89; IC95%: 0.87–0.91; I² = 0%), menor mortalidad cardiovascular (HR = 0.81; IC95%: 0.76–0.86; I² = 69.6%) y mejoría metabólica modesta (SMD = −0.16; IC95%: −0.21 a −0.11; I² = 45.6%). Se detectó posible sesgo de publicación. Conclusión: El consumo moderado de café se asocia con resultados cardiometabólicos favorables en adultos con MetS, aunque la evidencia es observacional y heterogénea