2017 -- Conference report inside the country
陳亮宇、吳晉祥、周杰穎、張尹凡、張智仁、盧豐華、楊宜青：吸菸與非吸菸者嚼食檳榔與肝功能之相關性研究 台灣家庭醫學醫學會106年度學術研討會會刊 P109-110.
Liang-Yu Chen, Jin-Shang Wu, Chieh-Ying Chou, Yin-Fan Chang, Chih-Jen Chang, Feng-Hua Lu, Yi-Ching Yang: The Association between Betel Nut Chewing and Hepatic Function in Subjects with or without Cigarette Smoking
Betel nut chewing and cigarette smoking are important health problems which are associated with many medical diseases such as cancer, cardiovascular disease, diabetes, metabolic syndrome, peptic ulcer, and mortality. In addition to viral hepatitis and alcoholic liver disease, betel nut and cigarette are independent risk factor of hepatocellular carcinoma. There were inconsistent results for the relationship between betel nut chewing and biochemical function of liver. Only one study considered the impact of betel nut chewing on liver function such as aspartate aminotransferase (AST)and alanine aminotransferase (ALT), but some important covariates such as diabetes and lipid profile were not considered. Furthermore, the relationship between betel nut chewing and biochemical function of liver was unknown in both smoking and non-smoking groups. Thus, the aim of this study was to evaluate the difference in the impact of betel nut chewing on liver function between subjects with and without cigarette smoking in a Taiwanese population.
A total of 12372subjects with age 18 years or more were enrolled after excluding individuals with hepatitis B, hepatitis C, hepatoma, partial or total hepatectomy, intra-heaptic duct (IHD) stone or IHD dilatation, excessive alcohol drinking (more than 200 gm/week in man or 100 gm/week in woman) or incomplete data. Betel nut chewing habit was categorized as current, previous and never use. We divided the subjects into smoking and non-smoking groups. Cigarette smoking was defined as at least one pack per month for more than half a year. Current betel nut chewing was a regular chewing for more than half a year. Previous betel nut chewing was defined as regular betel nut chewing for at least six months, but no use in the previous six months. Biochemical function of liver included AST, ALT, albumin, alkaline phosphatase (Alk-P)and total bilirubin which were examined by auto-analyzer.
The prevalence of current and previous betel nut chewing were 1.3% (n=157) and 2.6% (n=323), respectively. In subjects with current smoking group (n=1395), univariate analysis revealed that AST, ALT, and albumin were significantly different among subjects with current, previous and never betel nut chewing. On the contrary, in subjects without current smoking group (n=10977), AST, ALT, Alk-P, total bilirubin, but not albumin, were significantly different among groups. In smoking group, multiple linear regression analyses showed that current betel nut was positively associated with AST, ALT and negatively associated with albumin, while previous betel nut chewing was only negatively associated with albumin. In non-smoking group, current betel nut chewing was positively associated with AST and previous betel nut chewing was not independently related to the biochemical function of liver including AST, ALT, albumin, Alk-P and total bilirubin.
The impact of betel nut chewing on biochemical function of liver was more enhanced in smoking group than non-smoking group. Current betel nut chewing was related to liver function impairment in both smoking and non-smoking groups. In contrast, previous betel nut chewing was associated with only decreased albumin level in smoking group, but not non-smoking group.