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Huang J, Wen Y, Yang T, Song H, Meyboom R, Yang X, Teng L, Duez P, Zhang L. Safety and efficacy evaluation of Simo decoction and Arecae semen in herbal medicine practice. Heliyon 2024; 10:e31373. [PMID: 38841513 PMCID: PMC11152707 DOI: 10.1016/j.heliyon.2024.e31373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/07/2024] Open
Abstract
Objective The traditional Chinese patent medicine (TCPM), Simo decoction (Simo decoction oral solution), with its primary ingredient Arecae semen (Binglang, Areca catechu L.), known for its potential carcinogenic effects, is the subject of this study. The research aims to analyze the effectiveness and potential risks of Simo decoction, particularly as a carcinogen, and to suggest a framework for evaluating the risks and benefits of other herbal medicines. Methods The study is based on post-marketing research of Simo decoction and Arecae semen. It utilized a wide range of sources, including ancient and modern literature, focusing on the efficacy and safety of Simo decoction. The research includes retrospective data on the sources, varieties, and toxicological studies of Arecae semen from databases such as Pubmed, Clinical Trials, Chinese Clinical Trial Registry, China National Knowledge Infrastructure, WHO-UMC Vigibase, and China National Center for ADR Monitoring. Results Common adverse drug reactions (ADRs) associated with Simo decoction include skin rash, nausea, vomiting, abdominal pain, and diarrhea. However, no studies exist reporting the severe ADRs, such as carcinogenic effects. Arecae semen is distributed across approximately 60 varieties in tropical Asia and Australia. According to the WHO-UMC Vigibase and the National Adverse Drug Reaction Monitoring System databases, there are currently no reports of toxicity related to Arecae semen in the International System for Classification of ADRs (ISCR) or clinical studies. Conclusion Risk-benefit analysis in TCPM presents more challenges compared to conventional drugs. The development of a practical pharmacovigilance system and risk-benefit analysis framework is crucial for marketing authorization holders, researchers, and regulatory bodies. This approach is vital for scientific supervision and ensuring the safety and efficacy of drug applications, thus protecting public health.
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Affiliation(s)
- Jukai Huang
- Department of Endocrinology, Beijing University of Chinese Medicine, Dongzhimen Hospital, PR China
| | - Yalu Wen
- Department of Respiratory Medicine, Beijing Hepingli Hospital, PR China
| | - Tianyi Yang
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30329, United States
| | - Haibo Song
- Center for Drug Reevaluation, National Medical Products Administration, Beijing, PR China
| | - Ronald Meyboom
- Department of Pharmacoepidemiology and Clinical Pharmacology, University of Utrecht, the Netherlands
| | - Xiaohui Yang
- Department of Endocrinology, Beijing University of Chinese Medicine, Dongzhimen Hospital, PR China
| | - Lida Teng
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Pierre Duez
- Unit of Therapeutic Chemistry and Pharmacognosy, Université de Mons (UMONS), Mons, Belgium
| | - Li Zhang
- Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, No. 6, District 1, Fangxingyuan, Fangzhuang, Fengtai District, Beijing, PR China
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Itaki R, Taufa S. Association between habitual betel quid chewing and risk of adverse cardiovascular outcomes: A systematic review. Trop Med Int Health 2024; 29:447-453. [PMID: 38556799 DOI: 10.1111/tmi.13988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Habitual betel quid chewing, a tobacco product, is a leading cause of oral cancer in Asia-Pacific countries where this practice is most prevalent. However, it is not well understood whether betel quid chewing is also a cause of adverse cardiovascular outcomes. To address this gap, we conducted a systematic literature review of peer-reviewed published studies evaluating the association between habitual betel quid use on the risk of adverse cardiovascular outcomes. METHODS We searched PubMed for studies assessing the correlation between betel quid chewing and cardiovascular health. We included studies if (i) they included human subjects; (ii) were peer-reviewed articles in indexed journals; and (iii) were in English. We extracted data from eligible studies and stratified them by geographical location, study designs and cardiovascular outcomes. Finally, we did a narrative synthesis of the data to identify adverse cardiovascular outcomes associated with chronic betel quid use. FINDINGS We reviewed data from 19 studies that met the inclusion criteria. Habitual betel quid chewing was associated with hypertension, atherosclerosis, inflammation and ischaemic heart disease. In addition, betel quid use was a risk factor for arrhythmias. Interestingly, betel quid use was an independent risk factor for cardiovascular disease in women. Long-term betel quid consumption was associated with higher risks for all-cause mortality and increased overall cardiovascular risk. CONCLUSIONS Habitual betel quid chewing is an important cardiovascular risk factor in populations where the practice is prevalent.
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Affiliation(s)
- Rodney Itaki
- American Samoa Government, Department of Public health, Pago Pago, American Samoa, USA
| | - Shalon Taufa
- Department of Basic Medical Sciences, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
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Lai JF, Mendez AJ, Li X, Wilkens LR, Herzog T, Franke AA. Arecoline in buccal cells reflects Areca nut dose. Drug Test Anal 2024. [PMID: 38584295 DOI: 10.1002/dta.3684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 04/09/2024]
Abstract
Areca nut (AN) is a carcinogen; its chewing cessation is, therefore, of worldwide interest. However, cessation biomarkers are lacking. We sought to establish arecoline in chewers' buccal cells (BCs) as a biomarker for AN dose. Self-reported AN doses, expressed as the average AN load ("AANL"), the product of AN amount, chewing time, and chewing frequency, were correlated by regression analysis with chewers' BC arecoline, measured by liquid chromatography mass spectrometry. We then determined whether associations differed between Class 1 chewers (who consume AN alone or with slaked lime, leaf, and/or spices) and Class 2 chewers (who consume any combination of the aforementioned ingredients plus tobacco). Among the 103 chewers, 28 Class 1 and 39 Class 2 chewers had detectable arecoline levels, which were used for analyses. A linear regression of cube-root transformed AANL on equally transformed BC arecoline levels provided the best model fit; resulting slopes and corresponding correlation coefficients were 0.86 and 0.40 (p < 0.01) for all; 1.09 and 0.51 (p < 0.01) for Class 1 chewers; 0.35 and 0.17 (p = 0.29) for Class 2 chewers; and 0.94 and 0.45 (p < 0.01), and 0.79 and 0.37 (p = 0.08), respectively, for those who included or excluded lime. Relationships between AANL and BC arecoline levels were similar between chewers who included or excluded lime (p = 0.76), but less between chewing classes (p = 0.14). This provides confidence that BC arecoline can generally act as a reliable biomarker for AN dose, useful for estimating efficacy in AN cessation studies and population-based chewing assessments.
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Affiliation(s)
- Jennifer F Lai
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | | | - Xingnan Li
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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Chuang HC, Tsai MH, Lin YT, Chou MH, Yang KL, Chien CY. Systemic and Local Effects Among Patients With Betel Quid-Related Oral Cancer. Technol Cancer Res Treat 2022; 21:15330338221146870. [PMID: 36575633 PMCID: PMC9806389 DOI: 10.1177/15330338221146870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The major predisposing factors of developing oral cancer include smoking, alcohol drinking, and betel quid chewing. Betel quid chewing could cause the abrasion and damage of oral mucosa by crude fibers, chemical insults by additive slaked lime, and arecoline from areca nut. These would lead to the local consequence of oral submucosal fibrosis, which is regarded clinically as a precancer lesion and a major cause of trismus. In addition, the components and additives in betel quid contain chemical toxins and carcinogens, which would further affect the oral mucosa and gradually develop a malignancy. Following literature review, aside from having a greater total tumor burden and more local diseases in the oral cavity and digestive tract, patients with betel quid-related oral cancer also have more systemic diseases from metabolic syndrome, hypertension, cardiovascular disease, type II diabetes mellitus, and obesity than those without this habit. In conclusion, those patients who have the history of smoking, alcohol drinking, and betel quid chewing would present much more unique clinical characteristics than those who only have a history of smoking and alcohol drinking. More attention should therefore be paid to pretreatment evaluation, treatment strategy, and posttreatment follow-up among betel quid chewers.
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Affiliation(s)
- Hui-Ching Chuang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung , Taiwan,Center for mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Hsien Tsai
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung , Taiwan
| | - Yu-Tsai Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung , Taiwan
| | - Ming-Huei Chou
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung , Taiwan,Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan,Center for General Education, Cheng-Shiu University, Kaohsiung, Taiwan
| | - Kun-Lin Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung , Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung , Taiwan,Chang Gung Molecular Medicine Research Center, Taiwan ,Institute for Translation Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan,Chih-Yen Chien, Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Dalisay F, Kawabata Y, Buente W, Pokhrel P, Benitez C, Herzog T. Social media, peer norms, and betel nut susceptibility and use: Evidence from early adolescents in Guam. FRONTIERS IN COMMUNICATION 2022; 7:960093. [PMID: 37207255 PMCID: PMC10194842 DOI: 10.3389/fcomm.2022.960093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Betel (areca) nut is an addictive psychoactive substance considered to be carcinogenic. Yet not much is known about factors that may be promoting betel nut use. To fill this void, the present study examines the roles of exposure to betel nut-related posts on social media and peer norms regarding betel nut use in explaining betel nut susceptibility and use among adolescents. We conducted a representative survey of early adolescents (N = 673) attending all public middle schools on Guam, a United States-Affiliated Pacific Island in the Western Pacific. Results showed that exposure to betel nut-related posts on social media was positively associated with peer descriptive norms regarding betel nut use. Specifically, the more frequent early adolescents were exposed to betel nut posts on social media, the more likely they were to perceive betel nut use to be more prevalent among their general peers and close friends. Additionally, early adolescents' exposure to betel nut-related posts on social media was positively associated with both their susceptibility to use betel nut and reported use. Descriptive norms regarding close friends' betel nut use was also positively associated with both susceptibility to and use of betel nut. However, descriptive norms regarding general peers' betel nut use was unrelated with either betel nut susceptibility or use. Descriptive norms regarding close friends' betel nut use mediated the relationships that exposure to betel nut posts on social media had with both betel nut susceptibility and betel nut use. Implications are discussed.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU, United States
| | - Yoshito Kawabata
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU, United States
| | - Wayne Buente
- School of Communications, University of Hawai’i at Mānoa, Honolulu, HI, United States
| | - Pallav Pokhrel
- Population Sciences in the Pacific (Cancer Prevention in the Pacific) University of Hawai’i Cancer Center, Honolulu, HI, United States
| | - Chantay Benitez
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU, United States
| | - Thaddeus Herzog
- Population Sciences in the Pacific (Cancer Prevention in the Pacific) University of Hawai’i Cancer Center, Honolulu, HI, United States
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Huang YC, Geng JH, Wu PY, Huang JC, Chen SC, Chang JM, Chen HC. Betel Nut Chewing Increases the Risk of Metabolic Syndrome and Its Components in a Large Taiwanese Population Follow-Up Study Category: Original Investigation. Nutrients 2022; 14:nu14051018. [PMID: 35267993 PMCID: PMC8912331 DOI: 10.3390/nu14051018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/17/2022] [Accepted: 02/26/2022] [Indexed: 02/01/2023] Open
Abstract
Betel nut chewing is a popular habit in Taiwan, and it is associated with adverse metabolic effects. The aim of this study was to investigate correlations between betel nut chewing with metabolic syndrome (MetS) and its components in a longitudinal study using data from the Taiwan Biobank. A total of 121,423 participants were included in the baseline study, and 27,002 received follow-up examinations after a median of 4 years. The association between betel nut chewing and MetS was analyzed using multiple logistic regression after controlling for confounders. The baseline prevalence of MetS was 22.5%. Multivariable analysis showed that a history of chewing betel nut was significantly associated with baseline MetS (odds ratio (OR) = 1.629; 95% confidence interval (CI) = 1.535 to 1.730, p < 0.001) and five components of MetS in all participants. A long history of chewing betel nut (per 1 year; OR = 1.008; 95% CI = 1.004 to 1.013, p < 0.001) was associated with baseline MetS, abdominal obesity, hypertriglyceridemia and low high-density lipoprotein (HDL) cholesterol. In addition, high cumulative dose (per 1 year × frequency × daily score; OR = 1.001; 95% CI = 1.001−1.002; p < 0.001) was significantly associated with baseline MetS. At the end of the follow-up, a history of chewing betel nut (OR = 1.352; 95% CI = 1.134 to 1.612, p = 0.001) was significantly associated with MetS and its components including abdominal obesity, hypertriglyceridemia and low HDL-cholesterol in the participants without baseline MetS. In addition, a longer history of betel nut chewing was associated with MetS (per 1 year; OR = 1.021; 95% CI = 1.008 to 1.035, p = 0.002), abdominal obesity and hypertriglyceridemia at follow-up. However, cumulative dose (p = 0.882) was not significantly associated with follow-up MetS. Chewing betel nut and a long history of betel nut chewing were associated with baseline MetS and its components. In the participants without MetS at baseline, chewing betel nut and a long history of chewing betel nut were associated with the development of MetS after 4 years of follow-up. However, a cumulative dose of betel nut chewing was not associated with follow-up MetS. Betel nut chewing cessation programs are important to reduce the incidence of MetS in Taiwan.
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Affiliation(s)
- Ya-Chin Huang
- Department of Preventive Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan;
- Department of Occupational & Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (P.-Y.W.); (J.-C.H.)
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jiun-Chi Huang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (P.-Y.W.); (J.-C.H.)
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (P.-Y.W.); (J.-C.H.)
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (S.-C.C.); (J.-M.C.); (H.-C.C.); Tel.: +886-7-8036783 (ext. 3440) (S.-C.C.); +886-7-3121101 (ext. 7351) (J.-M.C.); +886-7-3121101 (ext. 7351) (H.-C.C.); Fax: +886-7-8063346 (S.-C.C.)
| | - Jer-Ming Chang
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (S.-C.C.); (J.-M.C.); (H.-C.C.); Tel.: +886-7-8036783 (ext. 3440) (S.-C.C.); +886-7-3121101 (ext. 7351) (J.-M.C.); +886-7-3121101 (ext. 7351) (H.-C.C.); Fax: +886-7-8063346 (S.-C.C.)
| | - Hung-Chun Chen
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (S.-C.C.); (J.-M.C.); (H.-C.C.); Tel.: +886-7-8036783 (ext. 3440) (S.-C.C.); +886-7-3121101 (ext. 7351) (J.-M.C.); +886-7-3121101 (ext. 7351) (H.-C.C.); Fax: +886-7-8063346 (S.-C.C.)
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Murphy KL, Liu M, Herzog TA. The Reasons for Betel Quid Chewing Scale (RBCS) for Ex-Chewers: Assessment of Factor Structure, Reliability, Validity and Measurement Invariance across Gender in a Guamanian Sample. Subst Use Misuse 2022; 57:522-530. [PMID: 35067173 PMCID: PMC9218194 DOI: 10.1080/10826084.2021.2019781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Over 600 million people chew betel nut worldwide and the behavior is classified by the World Health Organization (WHO) as a Group 1 carcinogen. Having a reliable and valid scale of reasons for chewing betel nut that can be used consistently across gender for both chewers and ex-chewers will assist practitioners to create culturally appropriate risk reduction and cessation programs and address an important public health concern.Purpose/Objectives: We sought to: 1) examine factor structure, reliability, and validity of the Reasons for Chewing Scale (RBCS) for ex-chewers; 2) examine the influence of social-cultural factors on chewing behaviors; and 3) examine if measurement invariance (MI) of the RBCS held consistently across gender groups. METHODS A Confirmatory Factor Analysis (CFA), a multigroup CFA for testing measurement invariance (MI), and Structural Equation Modeling (SEM) were applied to the RBCS using a convenience sample of (N = 223) of ex-chewers from Guam. RESULTS The majority of the items in the RBCS were found to be moderately or strongly correlated to each other. The CFA model fit the ex-chewers' data well and the model suggested that the RBCS was found to be reliable and valid. The multi-group CFA showed this scale functions equivalently for both male and female groups.Conclusions/Importance: The RBCS is a valid and reliable measure that is invariant across gender and type of ex-chewer.
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Affiliation(s)
- Kelle L Murphy
- Center on Disability Studies, University of Hawaìi at Mānoa, Honolulu, Hawaii, USA
| | - Min Liu
- Educational Psychology, University of Hawaìi at Mānoa, Honolulu, Hawaii, USA
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Mirza MR, Sultan R, Choudhary MI, Tahir M, Larsen MR, Tariq S, Rahman SU. Label-free quantitation of the changes in salivary proteome associated with the chronic consumption of the betel nut ( Areca catechu). Mol Omics 2021; 18:123-132. [PMID: 34851339 DOI: 10.1039/d1mo00391g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Areca nut or betel nut chewing is most frequently used in Pakistan and is associated with a high risk for oral cancer. Until now, however, there has not been any research conducted on the long-term effect(s) of betel nut chewing on the saliva proteome. In the present study, initially, the changes in the saliva proteome associated with betel nut chewing were investigated. Secondly, the analysis was focused on the changes in salivary proteome with respect to prolonged usage of betel nuts. After extraction, the saliva proteins were digested into peptides and these were subsequently analyzed using mass spectrometry. Data are available via ProteomeXchange with identifier PXD029768. Label-free quantitation of saliva samples revealed a total of 12 proteins that were differentially expressed between betel nut addicts (BNAs), and the control group. The study groups were further divided into three subgroups, the BNA-1, BNA-2, and BNA-3 groups, with respect to the extent of consumption of betel nuts in terms of years. The data analysis revealed a more detailed profiling of proteins expressed after five, ten, and more than ten years of betel nut consumption. A total of 30, 17, and 22 proteins were found to be differentially expressed when divided into the BNA-1, BNA-2, and BNA-3 groups. The present study shows that the chronic usage of betel nuts leads to the expression of proteins, such as SPARC1, profilin, and SBSN, which are known to be involved in head and neck cancers.
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Affiliation(s)
- Munazza Raza Mirza
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi-75270, Pakistan.
| | - Rabia Sultan
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi-75270, Pakistan.
| | - Muhammad Iqbal Choudhary
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi-75270, Pakistan. .,H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi-75270, Pakistan.,Department of Biochemistry, Faculty of Science, King Abdul Aziz University, Jeddah-21412, Saudi Arabia
| | - Muhammad Tahir
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Martin Røssel Larsen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Saria Tariq
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi-75270, Pakistan.
| | - Saeed Ur Rahman
- Oral Biology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
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9
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Bannister BE, Parry DR, Pouliot JD. Clinically Significant Bradycardia and Hypotension Following Consumption of Betel Leaf in a Patient Treated for Chronic Atrial Fibrillation. J Pharm Pract 2021; 36:453-457. [PMID: 34570986 DOI: 10.1177/08971900211048337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE A case of new onset bradycardia and hypotension following betel leaf consumption in combination with verapamil and metoprolol in an atrial fibrillation (AF) patient. SUMMARY A 66-year-old Nigerian woman presented to the emergency department for evaluation of multiple near syncope episodes with underlying AF and slow ventricular response. After initial evaluation, the patient disclosed she had ingested several betel leaves that morning. She was admitted for observation of severe, progressive hypotension and symptomatic bradycardia. Her past medical history included AF, type 2 diabetes, asthma, obesity, hypertension and hypothyroidism. Her home medications consisted of spironolactone, metoprolol succinate, and verapamil ER. Upon admission, her home medications were held. She received IV fluids and atropine .4 mg IV as needed for symptomatic bradycardia. Approximately 18 h following admission, her vital signs stabilized and her labs returned to baseline. She remained stable and was discharged with a recommendation to continue her home medications at prescribed doses with reduced doses of verapamil and metoprolol and to follow-up with her primary care provider. CONCLUSION A patient with a history of AF developed significant hypotension and symptomatic bradycardia after betel leaf consumption resulting in an overnight critical care unit admission. The use of betel leaf is not common in the United States; however, practitioners should be cognizant of the use of complementary and alternative medications like betel leaf and incorporate this knowledge in patient evaluation. Patients consuming betel leaf or betel nut should be evaluated for cardiovascular effects as well as laboratory evaluation for organ damage.
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Affiliation(s)
- Breyanne E Bannister
- 458976Department of Pharmacy Practice, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
| | - Daniel R Parry
- 458976Department of Pharmacy Practice, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
| | - Jonathon D Pouliot
- 458976Department of Pharmacy Practice, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA.,Department of Pharmacy, Williamson Medical Center, Franklin, TN, USA
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Lin WY, Tsai BCK, Day CH, Chiu PL, Chen RJ, Chen MYC, Padma VV, Luk HN, Lee HC, Huang CY. Arecoline induces heart injure via Fas/Fas ligand apoptotic pathway in heart of Sprague-Dawley rat. ENVIRONMENTAL TOXICOLOGY 2021; 36:1567-1575. [PMID: 33929070 DOI: 10.1002/tox.23153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/21/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
Habitual chewing of areca nut increases the risk of cardiovascular disease mortality, but less report demonstrate the toxic mechanism of areca nut on heart. To investigate toxicity of areca nut on cardiomyocytes, we induced the heart injury with arecoline to evaluate the acute damage of areca nut on heart. Different concentrations of are coline (lowdosage: 5 mg/kg/day and high dosage 50 mg/kg/day) were injected into Sprague-Dawley rat via intra-peritoneal method for 21 days to create negative effects of arecoline on cardiomyocyte. Themyocardial architecture of the rat heart was observed. The arecoline-induced apoptotic proteins were analysed via western blotting. The myocardialarchitecture of heart was injured with arecoline and TUNEL stain was also shown are coline-induced cardiac apoptosis. Arecoline promoted the protein expression of both Fas dependent snd mitochondrial dependent apoptosis. In summary, arecoline induces cardiac toxicity and apoptosis by inducing both death receptor and mitochondria-dependent apoptotic pathways on heart.
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Affiliation(s)
- Wen-Yuan Lin
- The Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Bruce Chi-Kang Tsai
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | | | | | - Ray-Jade Chen
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Michael Yu-Chih Chen
- Department of Cardiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - V Vijaya Padma
- Department of Biotechnology, Bharathiar University, Coimbatore, India
| | - Hsiang-Ning Luk
- Department of Anesthesia, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Hsiang-Chen Lee
- Department of Anesthesia, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
- Center of General Education, Buddhist Tzu Chi Medical Foundation, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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Yoshikawa K, Yamada H, Matsushima M. Betel quid chewing and its associated factors in Myanmar: A quantitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 92:103047. [PMID: 33268051 DOI: 10.1016/j.drugpo.2020.103047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Betel quid is more widely consumed than tobacco in Myanmar. It brings adverse health effects regardless of whether it contains tobacco; however, Myanmar has no clear prevention strategy. This study aims to show a broader picture of the prevalence of betel quid chewing and the observable characteristics of its consumers in Myanmar by comparing it to tobacco usage. METHODS This study used the 2015-2016 Myanmar Demographic and Health Survey data. First, we identified characteristics of betel quid consumers by a logit model. Next, we focused on exploring who would be likely to become heavy users, conditioned on being a betel quid consumer by controlling for possible sample selection bias. RESULTS We found differences in characteristics for betel chewers and tobacco smokers, and for betel quid users and heavy users. CONCLUSION These results suggest that betel quid consumption should be regulated by a specific prevention strategy rather than by Myanmar's existing tobacco prevention strategy.
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Affiliation(s)
- Kanako Yoshikawa
- Osaka School of International Public Policy, Osaka University, 1-31 Machikaneyamacho, Toyonaka, Osaka 560-0043, Japan.
| | - Hiroyuki Yamada
- Faculty of Economics, Graduate School of Economics. Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345 Japan
| | - Midori Matsushima
- Faculty of Humanities and Social Sciences, Graduate School of Humanities and Social Sciences, International Public Policy, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577 Japan
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Rarau P, Guo S, Baptista SN, Pulford J, McPake B, Oldenburg B. Prevalence of non-communicable diseases and their risk factors in Papua New Guinea: A systematic review. SAGE Open Med 2020; 8:2050312120973842. [PMID: 33282301 PMCID: PMC7682215 DOI: 10.1177/2050312120973842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 10/26/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The mortality associated with non-communicable diseases has increased significantly in most countries in the World Health Organization Western Pacific Region over the last 20 years, as have the underlying risk factors. This study aimed to collate evidence on the prevalence of four major non-communicable diseases and their risk factors in Papua New Guinea in order to inform appropriate policy for their prevention and management. METHODS We performed a systematic review of Papua New Guinea-based population prevalence studies of cardiovascular diseases, type 2 diabetes mellitus, chronic respiratory diseases, and cancers, as well as non-communicable disease risk factors published before 2016. Five online databases were searched and screened against eligibility criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total of 57 articles were included in this review, most of which (n = 48) were published prior to 2000. Eleven articles reported on diabetes, six reported on chronic lung disease/asthma, two reported on cardiovascular diseases, and two reported cancer as the primary outcome, while the remaining 36 papers reported non-communicable disease risk factors. CONCLUSION This review demonstrated variations in the prevalence of non-communicable diseases (0%-19%) and their risk factors (0%-80.6%) attributed to the lifestyle and genetic diversity of the Papua New Guinea population. There is a strong suggestion that the prevalence of non-communicable diseases (particularly type 2 diabetes mellitus) and key non-communicable disease risk factors (hypertension, overweight, and obesity) has increased, but there is a lack of recent data. As such, there is an urgent need for new and up-to-date data in all areas of Papua New Guinea.
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Affiliation(s)
- Patricia Rarau
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- PNG Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Shuaijun Guo
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Shaira Nicole Baptista
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Barbara McPake
- Melbourne School of Population and Global Health, Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Noe MTN, Saw YM, Saw TN, Kyaw YP, Zin PE, Cho SM, Kariya T, Yamamoto E, Win HH, Wann T, Hamajima N. Assessment of nutritional status and risk factors for malnutrition among the elderly in Loikaw, Myanmar. Nutrition 2020; 79-80:110933. [PMID: 32847774 DOI: 10.1016/j.nut.2020.110933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Malnutrition among the elderly is an important health concern in Myanmar. The country is challenged by both an aging population and poor nutritional status. The aim of this study was to estimate the prevalence of malnutrition and elucidate its associated factors among the elderly in Loikaw, Myanmar. METHODS A cross-sectional study was conducted from July to August 2019. Using a multistage sampling method, 747 elderly individuals (313 men and 434 women) were recruited. The nutritional status of these participants was assessed using the Mini-Nutritional Assessment tool, with a face-to-face interview method. Body mass index, mid-upper arm and calf circumference, blood pressure, and random blood sugar levels were also assessed. Multinomial logistic regression analysis was performed. RESULTS The prevalence of malnutrition and at risk for malnutrition were 21.7% and 59.4%, respectively. In the multivariate model, dental problem (adjusted odds ratio [aOR], 2.18; 95% confidence interval [CI], 1.24-3.83), low level of education (aOR, 3.13; 95% CI, 1.44-6.81), aged ≥70 y (aOR, 3.55; 95% CI, 1.83-6.88), current betel chewing (aOR, 2.82; 95% CI, 1.64-4.87), and having heart disease (aOR, 8.04; 95% CI, 2.29-18.13) were positively associated with malnutrition. CONCLUSION One in five elderly study participants were malnourished and 50% were at risk for malnutrition. Malnutrition was associated with being ≥70 y of age, having a low educational level, chewing betel, having a history of heart disease, and having dental problems. These findings may alert policymakers to develop and implement effective interventions for improving nutritional status of the elderly population.
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Affiliation(s)
- May Thet Nu Noe
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Public Health, Loikaw, Kayah State, Ministry of Health and Sports, Loikaw, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Yoon Pwint Kyaw
- Department of Public Health, Taunggyi, Shan State, Ministry of Health and Sports, Taunggyi, Myanmar
| | - Poe Ei Zin
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hla Hla Win
- University of Public Health, Yangon, Myanmar
| | - Tin Wann
- Department of Public Health, Loikaw, Kayah State, Ministry of Health and Sports, Loikaw, Myanmar
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Salivary Proteomic Analysis of Betel Nut (Areca catechu) Consumers by Mass Spectrometry Revealed Primary Indication of Oral Malignancies. Int J Pept Res Ther 2020. [DOI: 10.1007/s10989-019-09909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hu Y, Zhong R, Li H, Zou Y. Effects of Betel Quid, Smoking and Alcohol on Oral Cancer Risk: A Case-Control Study in Hunan Province, China. Subst Use Misuse 2020; 55:1501-1508. [PMID: 32569534 DOI: 10.1080/10826084.2020.1750031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: The high prevalence of betel quid chewing is associated with a serious burden of oral diseases. However, there is limitertd research on the effects of betel quid, smoking, and alcohol on oral cancer in the Hunan province, China. Objectives: We investigated the relationship between oral cancer and betel quid chewing, smoking, and alcohol consumption in the betel quid endemic area of Hunan province. Methods: A paired case-control study from January 2014 to September 2015 was conducted in the Hunan province, China. We recruited 304 oral cancer patients and 304 controls as subjects, and both groups were treated in the same provincial cancer hospital. Control subjects and cancer patients were matched by sex, age (3-year groups), education level, and residential district. Conditional logistic regression analyses were used to examine the associations between oral cancer and betel quid, smoking, and alcohol consumption. Results: A significantly increased risk of oral cancer was associated with smoking, alcohol consumption, and betel quid chewing (odds ratio [OR] of 1.49, 1.56, and 5.80, respectively; p < .05). The risk of cancer was significantly elevated at high levels of intake and prolonged duration of consumption of betel quid, smoking, and alcohol. After adjusting for confounders, betel quid chewers were found to have almost 5 times increased risk for oral cancer (OR = 5.41, 95% confidence interval: 3.32-8.80, p < .001). Conclusions: There was a positive correlation between betel quid chewing and risk of oral cancer in the Hunan Province.
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Affiliation(s)
- Yina Hu
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Rui Zhong
- Department of Head and Neck Oncology, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Hongyan Li
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Yanhui Zou
- Department of Health Service Centre, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
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Abstract
Background: Chewing of betel quid, popularly known as doma khamdo, is prevalent in Bhutan and is associated with Bhutanese customs and traditions. The objective of this paper was to determine the prevalence and explore the correlates of current betel quid use in Bhutan. Materials and methods: This is a retrospective study of secondary data from the National Health Survey 2012 (NHS 2012) of Bhutan. The outcome variable of interest was current betel quid use. The self-reported demographic characteristics were obtained using a questionnaire developed following the WHO STEPwise approach to the surveillance of non-communicable diseases (STEP). Univariate and multivariate logistic regression were performed to identify correlates for betel quid use. Results: The prevalence of current betel quid use in this study was 45.0%. The correlates associated with current betel quid use were: being female; having a primary, high school or a monastic education; being professionals in the armed forces, managers, technicians, service and sales workers, and machine operators; being current smokers; alcohol consumption; and intake of drugs. Correlates associated with decreased betel quid use were: having a diploma/certificate-level and non-formal education, and living in urban areas. Conclusion: The findings indicate that betel quid was consumed by nearly half of the Bhutanese population. Bhutan should immediately initiate national prevention programs targeting these correlates of betel quid use.
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Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.,Phuentsholing General Hospital, Phuentsholing, Bhutan
| | - Tshering Jamtsho
- School of Demography, ANU College of Arts & Social Sciences, The Australian National University, Canberra, ACT, Australia
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Murphy KL, Liu M, Herzog TA. Confirmatory factor analysis and structural equation modeling of socio-cultural constructs among chamorro and non-chamorro micronesian betel nut chewers. ETHNICITY & HEALTH 2019; 24:724-735. [PMID: 28678534 PMCID: PMC6013408 DOI: 10.1080/13557858.2017.1346177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/20/2017] [Indexed: 05/17/2023]
Abstract
Objectives: Betel nut chewing is embedded within the cultures of South Asia, and Southeast Asia, and the Western Pacific. The determinants of betel nut consumption are complex. Ongoing consumption of betel nut is affected by cultural, social, and drug-specific effects (i.e. dependence). This study's first objective was to assess the psychometric properties (i.e. reliability and validity) of the socio-cultural constructs in a survey developed for betel nut chewers. The study's second objective was to investigate the influence of socio-cultural variables on betel nut chewing behaviors among Chamorro and non-Chamorro Micronesians in Guam. Design: The current study was a secondary analysis of a larger study (N = 600; n = 375 chewers and n = 225 former chewers) that examined socio-cultural factors that influence why chewers chew betel nut, along with assessing chewing behaviors, perceptions of risks, probability of changing behaviors, and methods that could be used to reduce use or quit. The socio-cultural constructs of the survey were analyzed using confirmatory factor analysis and structural equation modeling. Results: The socio-cultural factors were a sufficient fit with data and the instrument is reliable and valid, as indicated by various model fit indices (χ2 (13) = 18.49 with p = .14, TLI = .99, CFI = 1.00, SRMR = .02, RMSEA = .03 with 90% CIs [.00,.07]). Cronbach's alpha, the sign and magnitude of the factor loadings, the inter-factor correlations, and the large proportion of variance extracted for each factor, all indicate that the instrument is reliable and valid. Additionally, multivariate analyses showed that socio-cultural reasons were important contributing or chewing betel nut. Participants cited chewing because their friends and family members chewed, the behavior is embedded within their culture, and it would be considered rude and disrespectful to not chew. Conclusion: Based on the findings, this study provides important implications pertaining to creating culturally appropriate cessation programs.
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Affiliation(s)
- Kelle L Murphy
- a Department of Kinesiology and Rehabilitation Science , University of Hawai'i at Mānoa , Honolulu , HI , USA
| | - Min Liu
- b Department of Educational Psychology , University of Hawai'i at Mānoa , Honolulu , HI , USA
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Thakur N, Sharma AK, Singh H, Mehrotra R. ANDB: Development of a Database Based on a Global Survey of Literature on Areca Nut and Associated Health Effects. Subst Use Misuse 2019; 55:1513-1518. [PMID: 31347432 DOI: 10.1080/10826084.2019.1644523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Areca nut (AN), commonly known as "Supari" in India is an addictive substance and widely consumed with or without tobacco as a part of customs in many South East Asian countries. Owing to the adverse health effects of AN, public awareness and stringent government policies to prohibit AN production and regulation of products containing AN should be addressed without further delay. Lack of a research database, motivated us to develop a comprehensive online portal on global survey of published articles with reference to AN. The Areca nut database (ANDB) is a manually curated database which provides the information on global literature according to the publication year, author, population, harmful effects, and associated disease. The present study is an attempt to deliver the relevant information which would be helpful to researchers in prioritizing the research areas with respect to AN and associated health effects. The portal has been developed in MySQL and the interface has been designed using core PhP and CSS, HTML. ANDB is an online resource available to provide global literature of AN in a user-friendly manner. It can be accessed freely on http://arecanut.icmr.org.in/. To the best of our knowledge, ANDB is the first portal delivering inclusive scientific literature related to AN and its health effects. This evidence-based scientific information would be useful for policy makers to make guidelines for increasing awareness and implementing the laws for regulated use of this potentially carcinogenic substance, thereby controlling the burden of many dreaded diseases primarily oral submucous fibrosis, cardiovascular disease, and cancers.
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Affiliation(s)
- Nisha Thakur
- Division of Molecular Diagnostics, ICMR-National Institute of Cancer Prevention & Research (NICPR), I-7, Sector-39, Noida, Gautam Buddha Nagar, Uttar Pradesh, India
| | - Amitesh Kumar Sharma
- Division of Informatics, Systems Research and Management, Indian Council of Medical Research, New Delhi, India
| | - Harpreet Singh
- Division of Informatics, Systems Research and Management, Indian Council of Medical Research, New Delhi, India
| | - Ravi Mehrotra
- Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention & Research (NICPR), I-7, Sector-39, Noida, Gautam Buddha Nagar, Uttar Pradesh, India
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Chen YY, Fang WH, Wang CC, Kao TW, Chang YW, Yang HF, Wu CJ, Sun YS, Chen WL. Detrimental association between betel nut chewing and colorectal polyps in adult populations. PLoS One 2018; 13:e0206383. [PMID: 30359431 PMCID: PMC6201956 DOI: 10.1371/journal.pone.0206383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/11/2018] [Indexed: 01/01/2023] Open
Abstract
Adverse systemic effect caused by betel nut had been reported for decades. Our aim was to determine whether betel nut had detrimental impact on the development of colorectal polyps in general population. Participants who attended health examinations at the Tri-Service General Hospital (TSGH) from 2010 to 2016 were included in the study. The habit of betel nut chewing was obtained from a self-reported questionnaire. Colorectal polyps were diagnosed by colonoscopies operated by experienced physicians. A logistic regression model was used for the association between betel nut chewing with the presence of colorectal polyps. After adjustment for pertinent information such as age, gender, biochemistry data and personal history, the odd ratios (ORs) of colorectal polyps among betel nut chewers was 1.49 (95%CI: 1.14–1.94). Besides, betel nut chewers in the higher percentage body fat (PBF) group had higher risk for developing colorectal polyps with ORs of 2.07 (95%CI:1.23–3.47). Subjects with habit of betel nut chewing were associated with an increased risk of colorectal polyps in Taiwanese general population. Screening for betel nut chewing history and encouraging cessation might offer improved quality of life. A further research for this association was warranted.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yaw-Wen Chang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Yu-Shan Sun
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- * E-mail:
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Relationship of Oxidative Stress, Inflammation, and the Risk of Metabolic Syndrome in Patients with Oral Cancer. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:9303094. [PMID: 29951168 PMCID: PMC5987344 DOI: 10.1155/2018/9303094] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 12/21/2022]
Abstract
Oral cancer is the fifth leading cause of cancer death in Taiwan, and the prevalence of metabolic syndrome (MS) has also increased globally. The purpose of this study was to investigate the correlations between the components of MS and oxidative stress and inflammation in patients with oral cancer based on their areca-nut-chewing habits. Two hundred patients diagnosed with oral cancer were recruited, and metabolic parameters, oxidative stress, antioxidant enzyme activities, and inflammatory markers were measured. 63% of the subjects have concomitant MS. Subjects who had an areca-nut-chewing habit had significantly higher levels of fasting glucose (p = 0.04), oxidative stress (p = 0.02), and inflammatory markers (p = 0.02) than those who never chewed. High-density lipoprotein-cholesterol level (p = 0.03) and superoxidase dismutase activity (p = 0.02) were significantly lower in individuals who had chewed or were currently chewers. Areca-nut-chewing habit was associated with the increased risks for MS and hypertriglyceridemia; the components of MS were positively correlated with oxidative stress and inflammation. In conclusion, patients with oral cancer who had an areca-nut-chewing habit exhibited higher levels of oxidative stress and inflammation, which might be related to an increased risk of MS.
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Karim MT, Inam S, Ashraf T, Shah N, Adil SO, Shafique K. Areca Nut Chewing and the Risk of Re-hospitalization and Mortality Among Patients With Acute Coronary Syndrome in Pakistan. J Prev Med Public Health 2018; 51:71-82. [PMID: 29631348 PMCID: PMC5897234 DOI: 10.3961/jpmph.17.189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/12/2018] [Indexed: 02/05/2023] Open
Abstract
Objectives Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.
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Affiliation(s)
- Muhammad Tariq Karim
- Research Evaluation Unit, College of Physicians and Surgeons Pakistan, Karachi, Pakistan
| | - Sumera Inam
- Research Evaluation Unit, College of Physicians and Surgeons Pakistan, Karachi, Pakistan
| | - Tariq Ashraf
- Research Evaluation Unit, College of Physicians and Surgeons Pakistan, Karachi, Pakistan
| | - Nadia Shah
- Research Evaluation Unit, College of Physicians and Surgeons Pakistan, Karachi, Pakistan
| | - Syed Omair Adil
- Research Evaluation Unit, College of Physicians and Surgeons Pakistan, Karachi, Pakistan
| | - Kashif Shafique
- Research Evaluation Unit, College of Physicians and Surgeons Pakistan, Karachi, Pakistan
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Chang YC, Chang CH, Yeh YC, Chuang LM, Tu YK. Subclinical and overt hypothyroidism is associated with reduced glomerular filtration rate and proteinuria: a large cross-sectional population study. Sci Rep 2018; 8:2031. [PMID: 29391480 PMCID: PMC5795015 DOI: 10.1038/s41598-018-19693-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 01/02/2018] [Indexed: 12/28/2022] Open
Abstract
Subclinical hypothyroidism has been associated with dyslipidemia, hypertension, and increased risk of coronary artery disease. However, limited is known for its effect on renal function. Here we aimed to investigate whether subclinical hypothyroidism is associated with reduced estimated glomerular filtration rate (eGFR) and proteinuria in the general population. A cross-sectional cohort of 74,356 adults aged ≥20 year participating in voluntary health examinations without previous thyroid diseases were recruited in Taiwan. The mean eGFR of persons with euthyroidism, subclinical, and overt hypothyroidism are 87.99, 83.46, and 72.22 mL/min/1.73 m2, respectively (P-for- trend < 0.001). The proportion of proteinuria in persons with euthyroidism, subclinical and overt hypothyroidism is 1.29%, 2.2%, and 2.97%, respectively (P-for-trend: 0.001). The odds ratio of CKD for subclinical, clinical, and all hypothyroidism is 2.04 (95% confidence interval (CI): 1.67-2.50) and 7.61 (95% CI: 4.92-11.77), and 2.41 (95% CI: 2.01–2.89), respectively as compared to euthyroidism. These odd ratios remained significant after further adjustments. The odds ratios for proteinuria is 2.04 (95% CI: 1.67–2.50), 7.61 (95% CI: 4.92–11.77), and 2.41 (95% CI: 2.01–2.89) for subclinical, clinical, and total hypothyroidism, respectively, although the odds ratios were attenuated after further adjustment. Our results suggest subclinical hypothyroidism is a novel risk factor of reduced renal function but not proteinuria.
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Affiliation(s)
- Yi-Cheng Chang
- Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Institue of Biomedical Science, Academia Sinica, Taipei, Taiwan
| | - Chia Hsuin Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yi-Chun Yeh
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
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23
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Chen PH, Mahmood Q, Mariottini GL, Chiang TA, Lee KW. Adverse Health Effects of Betel Quid and the Risk of Oral and Pharyngeal Cancers. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3904098. [PMID: 29376073 PMCID: PMC5742426 DOI: 10.1155/2017/3904098] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/01/2017] [Accepted: 05/18/2017] [Indexed: 02/06/2023]
Abstract
Global reports estimate 600 million betel quid (BQ) chewers. BQ chewing has been demonstrated not only to be a risk factor for cancers of the oral cavity and pharynx and oral potentially malignant disorders (OPMD) but also to cause other cancers and adverse health effects. Herein, we summarized the international comparison data to aid in the understanding of the close relationship between the prevalence of BQ chewing, the occurrence of oral and pharyngeal cancers, and adverse health effects. Potential biomarkers of BQ carcinogens, such as areca nut, alkaloids, and 3-methylnitrosaminopropionitrile (MNPN), are closely associated with human health toxicology. Molecular mechanisms or pathways involving autophagy, hypoxia, COX-2, NF-κB activity, and stemness are known to be induced by BQ ingredients and are very closely related to the carcinogenesis of cancers of oral and pharynx. BQ abuse-related monoamine oxidase (MAO) gene was associated with the occurrence and progress of oral and pharyngeal cancers. In summary, our review article provides important insights into the potential roles of environmental BQ (specific alkaloid biomarkers and nitrosamine products MNPN) and genetic factors (MAO) and offers a basis for studies aiming to reduce or eliminate BQ-related OPMD and oral/pharyngeal cancer incidences in the future.
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Affiliation(s)
- Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, No. 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, No. 70 Lienhai Road, Kaohsiung 80424, Taiwan
| | - Qaisar Mahmood
- Department of Environmental Sciences, COMSATS Institute of Information Technology, Abbottabad, Pakistan
| | - Gian Luigi Mariottini
- Department of Earth, Environment and Life Sciences (DISTAV), University of Genova, Viale Benedetto XV 5, 16132 Genova, Italy
| | - Tai-An Chiang
- College of Human Science and Technology, Chung Hwa University of Medical Technology, No. 89, Wenhwa 1st St., Rende Shiang, Tainan 71703, Taiwan
| | - Ka-Wo Lee
- Department of Otolaryngology, Kaohsiung Medical University Hospital, No. 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
- Department of Otolaryngology, College of Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan
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24
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Betel nut chewing associated with increased risk of arterial stiffness. Drug Alcohol Depend 2017; 180:1-6. [PMID: 28850901 DOI: 10.1016/j.drugalcdep.2017.07.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/25/2017] [Accepted: 07/29/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Betel nut chewing is associated with certain cardiovascular outcomes. Subclinical atherosclerosis may be one link between betel nut chewing and cardiovascular risk. Few studies have examined the association between chewing betel nut and arterial stiffness. The aim of this study was thus to determine the relationship between betel nut chewing and arterial stiffness in a Taiwanese population. METHODS We enrolled 7540 eligible subjects in National Cheng Kung University Hospital from October 2006 to August 2009. The exclusion criteria included history of cerebrovascular events, coronary artery disease, and taking lipid-lowering drugs, antihypertensives, and hypoglycemic agents. Increased arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1400cm/s. According to their habit of betel nut use, the subjects were categorized into non-, ex-, and current chewers. RESULTS The prevalence of increased arterial stiffness was 32.7, 43.3, and 43.2% in non-, ex- and current chewers, respectively (p=0.011). Multiple logistic regression analysis revealed that ex-chewers (odds ratio [OR] 1.69, 95% confidence interval (CI)=1.08-2.65) and current chewers (OR 2.29, 95% CI=1.05-4.99) had elevated risks of increased arterial stiffness after adjustment for co-variables. CONCLUSIONS Both ex- and current betel nut chewing were associated with a higher risk of increased arterial stiffness. Stopping betel nut chewing may thus potentially be beneficial to reduce cardiovascular risk, based on the principals of preventive medicine.
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25
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Hsu WC, Tsai AC, Chen YC, Wang JY. Predicted factors for older Taiwanese to be healthy octogenarians: Results of an 18-year national cohort study. Geriatr Gerontol Int 2017; 17:2579-2585. [PMID: 28744971 DOI: 10.1111/ggi.13112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/20/2017] [Accepted: 05/09/2017] [Indexed: 11/28/2022]
Abstract
AIM To identify factors that predict the 62-69 years old Taiwanese to be healthy octogenarians. METHODS We analyzed the 1989 (baseline), and 2003 and 2007 (end-point) datasets of the Taiwan Longitudinal Survey on Aging, a national cohort study. A total of 1977 participants aged 62-69 years at baseline were tracked for 14-18 years. The outcome measure was "being healthy octogenarians", defined as participants who were aged ≥80 years, free from activities of daily living dependency, depressive symptoms or cognitive impairment, and able to provide social support. A logistic regression model was used to identify the predictors. RESULTS The results showed that higher educational level, conjugal living, absence of smoking or betel quid chewing, moderate alcohol drinking, routine physical activity, more leisure activities, no hypertension, no diabetes, sleeping well and satisfied with economic condition were the positive predictors for becoming a healthy octogenarian. CONCLUSIONS Using a multidimensional criterion, the present study identified a list of factors in predicting older Taiwanese becoming healthy octogenarians. The findings highlight the need to identify potential factors for various populations. Many of the predictors are modifiable factors. The present results would be valuable for planning effective health promotion strategies to achieve healthy aging for older adults. Geriatr Gerontol Int 2017; 17: 2579-2585.
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Affiliation(s)
- Wei-Chung Hsu
- Department of Radiation Oncology, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan
| | - Alan C Tsai
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Yu-Chia Chen
- Department of Senior Citizen Services, National Tainan Institute of Nursing, Tainan, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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26
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Rarau P, Vengiau G, Gouda H, Phuanukoonon S, Kevau IH, Bullen C, Scragg R, Riley I, Marks G, Umezaki M, Morita A, Oldenburg B, McPake B, Pulford J. Prevalence of non-communicable disease risk factors in three sites across Papua New Guinea: a cross-sectional study. BMJ Glob Health 2017; 2:e000221. [PMID: 29242751 PMCID: PMC5584489 DOI: 10.1136/bmjgh-2016-000221] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/21/2017] [Accepted: 03/13/2017] [Indexed: 12/19/2022] Open
Abstract
Papua New Guinea (PNG) is a culturally, environmentally and ethnically diverse country of 7.3 million people experiencing rapid economic development and social change. Such development is typically associated with an increase in non-communicable disease (NCD) risk factors. AIM To establish the prevalence of NCD risk factors in three different regions across PNG in order to guide appropriate prevention and control measures. METHODS A cross-sectional survey was undertaken with randomly selected adults (15-65 years), stratified by age and sex recruited from the general population of integrated Health and Demographic Surveillance Sites in West Hiri (periurban), Asaro (rural highland) and Karkar Island (rural island), PNG. A modified WHO STEPS risk factor survey was administered along with anthropometric and biochemical measures on study participants. RESULTS The prevalence of NCD risk factors was markedly different across the three sites. For example, the prevalences of current alcohol consumption at 43% (95% CI 35 to 52), stress at 46% (95% CI 40 to 52), obesity at 22% (95% CI 18 to 28), hypertension at 22% (95% CI 17 to 28), elevated levels of cholesterol at 24% (95% CI 19 to 29) and haemoglobin A1c at 34% (95% CI 29 to 41) were highest in West Hiri relative to the rural areas. However, central obesity at 90% (95% CI 86 to 93) and prehypertension at 55% (95% CI 42 to 62) were most common in Asaro whereas prevalences of smoking, physical inactivity and low high-density lipoprotein-cholesterol levels at 52% (95% CI 45 to 59), 34% (95% CI 26 to 42) and 62% (95% CI 56 to 68), respectively, were highest in Karkar Island. CONCLUSION Adult residents in the three different communities are at high risk of developing NCDs, especially the West Hiri periurban population. There is an urgent need for appropriate multisectoral preventive interventions and improved health services. Improved monitoring and control of NCD risk factors is also needed in all regions across PNG.
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Affiliation(s)
- Patricia Rarau
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
- PNG Institute of Medical Research, Goroka, Papua New Guinea
| | - Gwendalyn Vengiau
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Hebe Gouda
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Research and Education, Wacol, Queensland, Australia
| | - Suparat Phuanukoonon
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Isi H Kevau
- School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
| | - Chris Bullen
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Ian Riley
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Geoffrey Marks
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Masahiro Umezaki
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayako Morita
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Brian Oldenburg
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Barbara McPake
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Justin Pulford
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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27
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Kister MP, Borowska K, Kister KA, Wojtowicz A, Jodlowska-Jedrych B. Risks associated with betel quid chewing. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2017. [DOI: 10.1515/cipms-2017-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Betel quid is one of the most commonly used psychoactive substances in the world, especially among Asian communities, just after caffeine, nicotine and alcohol. The mixture that is chewed usually contains betel leaves, areca nut and slaked lime, nonetheless, its ingredients and the preparation manner tend to vary. Areca nut contains four main alkaloids - arecoline, arecaidyne, guvacine and guvacoline that are responsible for its psychoactive effects. The act of betel chewing might have a negative impact on an overall health and can cause pathological lesions or diseases to develop and/or progress, both directly and indirectly. Also, it may happen that the negative impact of betel chewing on one system might have indirect harmful influence on another. Still an association has been drawn between betel chewing and the presence of metabolic diseases, cancers and proteinuria, as well as cardiovascular disorders - including hypertension, chronic renal failure, diabetics type II and obesity. Likewise, it is a known risk factor in the development of oral and esophagus cancer. Moreover, a correlation between betel chewing and smoking exists in that betel chewing might theoretically hinder the abandonment of tobacco smoking. Tissues of oral cavity and the upper part of digestive system are additionally exposed to the mechanical injuries caused by the areca nut. Therefore, they tend to be the most prone to be pathologically affected by betel quid chewing.
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Affiliation(s)
- Mateusz P. Kister
- ’77 STOMATOLOGIA ’dental Cinic, Mickiewicza 77, 20-466 Lublin , Poland
| | - Katarzyna Borowska
- Department of Histology and Embryology with Experimental Cytology Unit, Medical University of Lublin, Radziwilowska 11, 20-080 Lublin , Poland
| | | | - Agnieszka Wojtowicz
- Department of Histology and Embryology with Experimental Cytology Unit, Medical University of Lublin, Radziwilowska 11, 20-080 Lublin , Poland
| | - Barbara Jodlowska-Jedrych
- Department of Histology and Embryology with Experimental Cytology Unit, Medical University of Lublin, Radziwilowska 11, 20-080 Lublin , Poland
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28
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Chen WY, Lee CY, Lin PY, Hsieh CE, Ko CJ, Lin KH, Lin CC, Ming YZ, Chen YL. Betel Nut Chewing Is Associated With Reduced Tacrolimus Concentration in Taiwanese Liver Transplant Recipients. Transplant Proc 2017; 49:326-329. [PMID: 28219593 DOI: 10.1016/j.transproceed.2016.11.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/20/2016] [Accepted: 11/16/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Studies have shown that arecoline, the major alkaloid component of betel nuts, alters the activity of enzymes in the cytochrome P450 (CYP-450) family. Tacrolimus, an immunosuppressant that protects against organ rejection in transplant recipients, not only is mainly metabolized by CYP3A enzymes but also has a narrow therapeutic range. We aimed to investigate whether dose-adjusted blood trough levels of tacrolimus differed over time between betel nut-chewing and non-betel nut-chewing liver transplant recipients. METHODS In this retrospective case-control study, 14 active betel nut-using liver recipients were matched at a 1:2 ratio to 28 non-betel nut-using liver recipients by sex, age, graft source, duration of follow-up after liver transplantation, and estimated glomerular filtration rate. Differences in liver function index, renal function index, and dose-adjusted blood trough levels of tacrolimus over an 18-month period were compared between the 2 groups by using the Generalized Estimating Equation approach. RESULTS Dose-adjusted blood trough levels of tacrolimus tended to be significantly (P = .04) lower in betel nut chewers (mean = 0.81, medium = 0.7, 95% confidence interval [CI] = 0.73 to 0.90) than in nonchewers (mean = 1.12, medium = 0.88, 95% CI = 1.03 to 1.22) during the 18-month study period. However, there was no significant difference in renal and liver function index between the 2 groups. CONCLUSION Liver transplant recipients receiving tacrolimus tend to have lower blood trough levels of the drug over time if they chew betel nuts.
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Affiliation(s)
- W-Y Chen
- Department of Pharmacy, Changhua Christian Hospital, Changhua, Taiwan
| | - C-Y Lee
- Department of Pharmacy, Changhua Christian Hospital, Changhua, Taiwan
| | - P-Y Lin
- Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan
| | - C-E Hsieh
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - C-J Ko
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - K-H Lin
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - C-C Lin
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Y-Z Ming
- Transplantation Center, Third Xiangya Hospital of Central South University, Changsha, China
| | - Y-L Chen
- Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Transplant Medicine & Surgery Research Centre, Changhua Christian Hospital, Changhua, Taiwan; Transplantation Center, Third Xiangya Hospital of Central South University, Changsha, China; School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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29
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Lucas ES, Watkins AJ. The Long-Term Effects of the Periconceptional Period on Embryo Epigenetic Profile and Phenotype; The Paternal Role and His Contribution, and How Males Can Affect Offspring's Phenotype/Epigenetic Profile. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1014:137-154. [PMID: 28864989 DOI: 10.1007/978-3-319-62414-3_8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The number of adults afflicted with heart disease, obesity and diabetes, central components of metabolic disorder, has grown rapidly in recent decades, affecting up to one quarter of the world's population. Typically, these diseases are attributed to lifestyle factors such as poor diet, lack of exercise and smoking. However, studies have now identified strong associations between patterns of growth during foetal and neonatal life and an increase predisposition towards developing heart disease, obesity and diabetes in adult life. While the connection between a mother's diet and the long-term health of her offspring has been studied in great detail, our understanding of whether offspring health might be affected by a father's diet remains limited. Greater insight into the impact that paternal nutrition has on sperm quality, epigenetic status and potential offspring programming mechanisms is needed to redress this parental-programming knowledge imbalance. Disturbances in paternal reproductive epigenetic status represents one key mechanism linking paternal diet with the programing of offspring development and adult health, as many enzymatic processes involved in epigenetic regulation use metabolic intermediates to modify DNA and histones. Here, poor paternal nutrition could result in perturbed sperm and testicular epigenetic status, impacting on post-fertilisation gene transcriptional regulation and protein expression in offspring tissues, resulting in increased incidences of metabolic disorder in adult life.
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Affiliation(s)
- Emma S Lucas
- Division of Reproductive Health, Clinical Science Research Laboratories, Warwick Medical School, University of Warwick, Coventry, CV2 2DX, UK
| | - Adam J Watkins
- Aston Research Centre for Healthy Ageing, School of Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
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30
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Sinha DN, Suliankatchi RA, Gupta PC, Thamarangsi T, Agarwal N, Parascandola M, Mehrotra R. Global burden of all-cause and cause-specific mortality due to smokeless tobacco use: systematic review and meta-analysis. Tob Control 2016; 27:35-42. [PMID: 27903956 DOI: 10.1136/tobaccocontrol-2016-053302] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/04/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To systematically review and meta-analyse the studies investigating the association between smokeless tobacco (SLT) use and all-cause mortality and cause-specific mortality outcomes among adult users of SLT and estimate the number of attributable deaths worldwide. METHODS Random-effects meta-analysis was used to estimate the pooled risk of death due to SLT use. Population attributable fractions were derived and used to calculate the number of attributable deaths. Observational studies published upto 2015 were identified through MEDLINE, IndMED, Google Scholar and other databases. Data on the prevalence of SLT use was obtained from latest reports or national surveys. Data on the disease burden were obtained from the Global Burden of Disease Study. Hospital-based or community-based case-control and cohort studies that adjusted for the smoking status were included. RESULTS 16 studies that provided estimates for mortality due to all cause, all cancer, upper aerodigestive tract (UADT) cancer, stomach cancer, cervical cancer, ischaemic heart disease (IHD) and stroke were included. A significant association was found for mortality due to all cause (1.22; 1.11-1.34), all cancer (1.31; 1.16-1.47), UADT cancer (2.17; 1.47-3.22), stomach cancer (1.33; 1.12-1.59), cervical cancer (2.07; 1.64-2.61), IHD (1.10; 1.04-1.17) and stroke (1.37; 1.24-1.51). Subgroup analysis showed major regional differences. Globally, the number of attributable deaths from all-cause mortality was 652 494 (234 008-1 081 437), of which 88% was borne by the South-East Asian region. CONCLUSIONS SLT is responsible for a large number of deaths worldwide with the South-East Asian region bearing a substantial share of the burden.
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Affiliation(s)
- Dhirendra N Sinha
- Tobacco Free Initiative Unit, World Health Organization, New Delhi, India
| | - Rizwan A Suliankatchi
- Department of Community Medicine, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Thaksaphon Thamarangsi
- Department of Noncommunicable Disease and Environmental Health, World Health Organization, New Delhi, India
| | - Naveen Agarwal
- Department of Noncommunicable Disease and Environmental Health, World Health Organization, New Delhi, India
| | - Mark Parascandola
- Tobacco Control Research Branch, Behavioral Research Program, National Cancer Institute, Bethesda, Maryland, USA
| | - Ravi Mehrotra
- Institute of Cytology and Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
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31
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Yang TY, Lin HR. Taking actions to quit chewing betel nuts and starting a new life: taxi drivers' successful experiences of quitting betel nut chewing. J Clin Nurs 2016; 26:1031-1041. [PMID: 27681205 DOI: 10.1111/jocn.13599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To understand taxi drivers' successful experiences of quitting betel nut chewing. BACKGROUND Previous studies verified that betel nut chewing significantly increases the risk of oral cancer. In Taiwan, taxi drivers work for approximately 10-13 hours per day, and 31·7-80% of them choose to chew betel nuts for their invigorating qualities, which enable them to work more hours and receive more income. DESIGN A qualitative research design was used. METHODS This study used the grounded theory method with purposive sampling to perform in-depth interviews with male taxi drivers who had successfully quit betel nut chewing for more than six months. RESULTS The interviewed participants were 25 taxi drivers aged 45-67 who had chewed betel nuts for an average of 30·9 years. A constant comparative analysis of the 25 interviews revealed six categories, namely the first experience of chewing betel nuts, a part of work and life, perceiving the impact of betel nuts, trying to change, acting to quit betel nut chewing and starting a new life. CONCLUSIONS During the cessation process, taxi drivers tended to be affected by their addiction to chewing betel nuts and the temptation of friends' invitations to chew betel nuts. However, their recognition of the physical effects of betel nut chewing and their sense of responsibility and commitment to family were the critical factors affecting their determination to quit betel nut chewing. Their willpower to not to chew betel nuts and the source of their motivation to exercise self-control also contributed to their success. RELEVANCE TO CLINICAL PRACTICE Healthcare personnel should understand the experiences and perceptions of betel nut chewers, strengthen their understanding of the effects of betel nut chewing on physical health during the cessation period and support their self-efficacy and quitting behaviours with the assistance of significant others.
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Affiliation(s)
- Tsui-Yun Yang
- Department of Nursing, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hung-Ru Lin
- School of Nursing & Dean of Academic Affairs, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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32
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Vidyasagaran AL, Siddiqi K, Kanaan M. Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis. Eur J Prev Cardiol 2016; 23:1970-1981. [DOI: 10.1177/2047487316654026] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | | | - Mona Kanaan
- Department of Health Sciences, University of York, UK
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33
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Lo FE, Lu PJ, Tsai MK, Lee JH, Wen C, Wen CP, Wai JPM, Tsao CK, Chiang PH, Lyu SY, Ma KL, Chi YC, Li CS, Liu CC, Wu X. The Role of Physical Activity in Harm Reduction among Betel Quid Chewers from a Prospective Cohort of 419,378 Individuals. PLoS One 2016; 11:e0152246. [PMID: 27044010 PMCID: PMC4820123 DOI: 10.1371/journal.pone.0152246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 03/11/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess the benefits of regular exercise in reducing harms associated with betel quid (BQ) chewing. METHODS The study cohort, 419,378 individuals, participated in a medical screening program between 1994 and 2008, with 38,324 male and 1,495 female chewers, who consumed 5-15 quids of BQ a day. Physical activity of each individual, based on "MET-hour/week", was classified as "inactive" or "active", where activity started from a daily 15 minutes/day or more of brisk walking (≥3.75 MET-hour/week). Hazard ratios for mortality and remaining years in life expectancy were calculated. RESULTS Nearly one fifth (18.7%) of men, but only 0.7% of women were chewers. Chewers had a 10-fold increase in oral cancer risk; and a 2-3-fold increase in mortality from lung, esophagus and liver cancer, cardiovascular disease, and diabetes, with doubling of all-cause mortality. More than half of chewers were physically inactive (59%). Physical activity was beneficial for chewers, with a reduction of all-cause mortality by 19%. Inactive chewers had their lifespan shortened by 6.3 years, compared to non-chewers, but being active, chewers improved their health by gaining 2.5 years. The improvement, however, fell short of offsetting the harms from chewing. CONCLUSIONS Chewers had serious health consequences, but being physically active, chewers could mitigate some of these adverse effects, and extend life expectancy by 2.5 years and reduce mortality by one fifth. Encouraging exercise, in addition to quitting chewing, remains the best advice for 1.5 million chewers in Taiwan.
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Affiliation(s)
- Feng En Lo
- Department of Leisure and Recreation Management, Asia University, Taichung, Taiwan
| | - Po Jung Lu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Min Kuang Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - June Han Lee
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Christopher Wen
- Department of Radiological Sciences, University of California at Irvine, Irvine, CA, United States of America
| | - Chi Pang Wen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- China Medical University Hospital, Taichung, Taiwan
- * E-mail:
| | - Jackson Pui Man Wai
- Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
| | | | - Po Huang Chiang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shu Yu Lyu
- Department of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ko Lu Ma
- Taoyuan Innovation Institute of Technology, Taoyuan, Taiwan
| | - Ying-Chen Chi
- Department of Education & Research, Taipei City Hospital, Taipei, Taiwan
| | - Chu-Shiu Li
- Department of Risk Management and Insurance, National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan
- Department of International Business, Asia University, Taichung, Taiwan
| | - Chwen-Chi Liu
- Department of Risk Management and Insurance, Feng Chia University, Taichung, Taiwan
| | - Xifeng Wu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
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Disparities in Ischemic Stroke Subtypes and Risk Factors between Taiwanese Aborigines and Han Chinese in Taitung, Taiwan. INT J GERONTOL 2016. [DOI: 10.1016/j.ijge.2014.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Lin WY, Peng CY, Lin CC, Davidson LE, Pi-Sunyer FX, Sung PK, Huang KC. General and Abdominal Adiposity and Risk of Death in HBV Versus Non-HBV Carriers: A 10-Year Population-based Cohort Study. Medicine (Baltimore) 2016; 95:e2162. [PMID: 26765398 PMCID: PMC4718224 DOI: 10.1097/md.0000000000002162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/31/2015] [Accepted: 11/04/2015] [Indexed: 12/13/2022] Open
Abstract
Both obesity and hepatitis B virus (HBV) infection increase the risk of death. We investigate the association between general and central obesity and all-cause mortality among adult Taiwanese HBV versus non-HBV carriers.A total of 19,850 HBV carriers and non-hepatitis C virus (HCV) carriers, aged 20 years and older at enrollment in 1998 to 1999 in Taiwan, were matched to 79,400 non-HBV and non-HCV carriers (1:4). Cox proportional-hazards models were used to estimate the relative risks for all-cause mortality during a maximum follow-up period of 10 years. Four obesity-related anthropometric indices-body mass index (BMI), waist circumference, waist-to-hip ratio, and waist-to-height ratio-were the main variables of interest.During the follow-up period, 628 and 2366 participants died among HBV and non-HBV carriers, respectively. Both underweight and general obesity were associated with an increased risk of death. The highest risk of all-cause death in relation to BMI was found in the HBV carriers with underweight (BMI <18.5 kg/m2) and non-HBV carriers with obesity (BMI ≥30 kg/m2). The lowest risks of all-cause death in relation to abdominal adiposity were found at the third quartiles of waist circumference, waist-to-hip ratio, and waist-to-height ratio among HBV carriers, but in the second quartiles among non-HBV carriers. For those with pre-existing liver disease among HBV carriers, patients with underweight have higher risk of death than those with obesity.Hepatitis B virus carriers with underweight have higher risk of death than non-HBV carriers. HBV carriers with mild abdominal obesity have the lowest risk of death, but not in the non-HBV carriers.
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Affiliation(s)
- Wen-Yuan Lin
- From the Department of Family Medicine (W-YL, C-CL); Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan (C-YP); School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan(W-YL, C-CL, C-YP); Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan (W-YL, K-CH); Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan (C-CL); MJ Health Screening Center, Taipei, Taiwan (P-KS); College of Life Sciences, Brigham Young University, Utah, USA (LED); and New York Presbyterian Hospital, Columbia University, New York, USA (FXP-S)
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Lin HC, Lin CL, Huang WY, Shangkuan WC, Kang BH, Chu YH, Lee JC, Fan HC, Kao CH. The use of adjunctive traditional Chinese medicine therapy and survival outcome in patients with head and neck cancer: a nationwide population-based cohort study. QJM 2015; 108:959-65. [PMID: 25862772 DOI: 10.1093/qjmed/hcv079] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Traditional Chinese medicine (TCM) is widely used in the treatment of patients with several types of cancer. However, no large-scale clinical studies have evaluated whether TCM is associated with better survival in patients with head and neck cancer (HNC). METHODS The Taiwan National Health Insurance Research Database was used to conduct a retrospective cohort study of patients with HNC between 2001 and 2011. The patients with HNC were separated into TCM users and non-users, and Cox regression models were applied to determine the association between the use of TCM and survival outcome. RESULTS The TCM and comparison cohorts comprised data for 2966 and 2670 patients, respectively. The mean age was 51.3 years in the TCM cohort and 51.7 years in the comparison cohort. Multivariate analysis demonstrated that the use of TCM was significantly associated with lower risk of all-cause mortality by 32% (adjusted hazard ratio, 0.68; 95% confidence interval, 0.62-0.75). Patients with longer TCM use had a lower mortality rate (P for trend < 0.001). CONCLUSIONS Our study showed that adjunctive therapy with TCM is associated with higher survival outcome. However, some limitations exist, such as the lack of information of cancer stage. In addition, causality cannot be assessed with this retrospective study. A randomized controlled trial to test the effect of adjunctive TCM therapy in HNC patients is needed.
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Affiliation(s)
- Hung-Che Lin
- From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Li Lin
- Office for Health Data, China Medical University Hospital, Taichung, Taiwan, College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Yen Huang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Chuan Shangkuan
- Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Bor-Hwang Kang
- From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yueng-Hsiang Chu
- From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jih-Chin Lee
- From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Department of Biological Science and Technology, Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan
| | - Hueng-Chuen Fan
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
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Wu F, Parvez F, Islam T, Ahmed A, Rakibuz-Zaman M, Hasan R, Argos M, Levy D, Sarwar G, Ahsan H, Chen Y. Betel quid use and mortality in Bangladesh: a cohort study. Bull World Health Organ 2015; 93:684-692. [PMID: 26600610 PMCID: PMC4645429 DOI: 10.2471/blt.14.149484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 05/24/2015] [Accepted: 05/29/2015] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To evaluate the potential effects of betel quid chewing on mortality. (A quid consists of betel nut, wrapped in betel leaves; tobacco is added to the quid by some users). METHODS Prospective data were available on 20 033 individuals aged 18-75 years, living in Araihazar, Bangladesh. Demographic and exposure data were collected at baseline using a standardized questionnaire. Cause of death was defined by verbal autopsy questionnaires administered to next of kin. We estimated hazard ratios (HR) and their 95% confidence intervals (CI) for associations between betel use and mortality from all causes and from specific causes, using Cox proportional hazards models. We adjusted for age, sex, body mass index, educational attainment and tobacco smoking history. FINDINGS There were 1072 deaths during an average of 10 years of follow-up. Participants who had ever used betel were significantly more likely to die from all causes (HR: 1.26; 95% CI: 1.09-1.44) and cancer (HR: 1.55; 95% CI: 1.09-2.22); but not cardiovascular disease (HR: 1.16; 95% CI: 0.93-1.43). These findings were robust to adjustment for potential confounders. There was a dose-response relationship between mortality from all causes and both the duration and the intensity of betel use. The population attributable fraction for betel use was 14.1% for deaths from all causes and 24.2% for cancer. CONCLUSION Betel quid use was associated with mortality from all causes and from cancer in this cohort.
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Affiliation(s)
- Fen Wu
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY 10016, United States of America (USA)
| | - Faruque Parvez
- Department of Environmental Health Sciences, Columbia University, New York, USA
| | - Tariqul Islam
- U-Chicago Research Bangladesh Ltd., Dhaka, Bangladesh
| | | | | | - Rabiul Hasan
- U-Chicago Research Bangladesh Ltd., Dhaka, Bangladesh
| | - Maria Argos
- Department of Health Studies, University of Chicago, Chicago, USA
| | - Diane Levy
- Department of Environmental Health Sciences, Columbia University, New York, USA
| | - Golam Sarwar
- U-Chicago Research Bangladesh Ltd., Dhaka, Bangladesh
| | - Habibul Ahsan
- Department of Health Studies, University of Chicago, Chicago, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY 10016, United States of America (USA)
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Tseng FY, Lin WY, Li CI, Li TC, Lin CC, Huang KC. Subclinical hypothyroidism is associated with increased risk for cancer mortality in adult Taiwanese-a 10 years population-based cohort. PLoS One 2015; 10:e0122955. [PMID: 25830770 PMCID: PMC4382195 DOI: 10.1371/journal.pone.0122955] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 02/16/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The association between subclinical hypothyroidism (SCH) and cancer mortality is seldom discussed. METHODS A total of 115,746 participants without thyroid disease history, aged 20 and above, were recruited from four nationwide health screening centers in Taiwan from 1998 to 1999. SCH was defined as a serum thyroid-stimulating hormone (TSH) level of 5.0-19.96 mIU/L with normal total thyroxine concentrations. Euthyroidism was defined as a serum TSH level of 0.47-4.9 mIU/L. Cox proportional hazards regression analyses were used to estimate the relative risks (RRs) of death from cancer for adults with SCH during a 10-year follow-up period. RESULTS Among 115,746 adults, 1,841 had SCH (1.6%) and 113,905 (98.4%) had euthyroidism. There were 1,532 cancer deaths during the 1,034,082 person-years follow-up period. Adjusted for age, gender, body mass index, diabetes, hypertension, dyslipidemia, smoking, alcohol drinking, betel nut chewing, physical activity, income, and education level, the RRs (95% confidence interval) of cancer deaths among subjects with SCH versus euthyroid subjects were 1.51 (1.06 to 2.15). Cancer site analysis revealed a significant increased risk of bone, skin and breast cancer among SCH subjects (RR 2.79, (1.01, 7.70)). The risks of total cancer deaths were more prominent in the aged (RR 1.71, (1.02 to 2.87)), in females (RR 1.69 (1.08 to 2.65)), and in heavy smokers (RR 2.24, (1.19 to 4.21)). CONCLUSIONS Subjects with SCH had a significantly increased risk for cancer mortality among adult Taiwanese. This is the first report to demonstrate the association between SCH and cancer mortality.
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Affiliation(s)
- Fen-Yu Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medicine Science, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Medical Research, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medicine Science, China Medical University, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Kuo-Chin Huang
- Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine Science, China Medical University, Taichung, Taiwan
- * E-mail:
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Hsiao CN, Ting CC, Shieh TY, Ko EC. Relationship between betel quid chewing and radiographic alveolar bone loss among Taiwanese aboriginals: a retrospective study. BMC Oral Health 2014; 14:133. [PMID: 25366525 PMCID: PMC4247196 DOI: 10.1186/1472-6831-14-133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 10/17/2014] [Indexed: 12/14/2022] Open
Abstract
Background Betel quid chewing is associated with the periodontal status; however, results of epidemiological studies are inconsistent. To the best of our knowledge, no study has reported radiographic alveolar bone loss (RABL) associated with betel quid chewing. Methods This survey was conducted in an aboriginal community in Taiwan because almost all betel quid chewers were city-dwelling cigarette smokers. In total, 114 subjects, aged 30–60 years, were included. Full-mouth intraoral RABL was retrospectively measured and adjusted for age, gender, and plaque index (PI). Multiple regression analysis was used to assess the relationship between RABL and potential risk factors. Results Age-, gender-, and PI-adjusted mean RABL was significantly higher in chewers with or without cigarette smoking than in controls. Multiple regression analysis showed that the RABL for consumption of 100,000 pieces betel quid for the chewer group was 0.40 mm. Full-mouth plotted curves for adjusted mean RABL in the maxilla were similar between the chewer and control groups, suggesting that chemical effects were not the main factors affecting the association between betel quid chewing and the periodontal status. Conclusion Betel quid chewing significantly increases RABL. The main contributory factors are age and oral hygiene; however, the major mechanism underlying this process may not be a chemical mechanism. Regular dental visits, maintenance of good oral hygiene, and reduction in the consumption of betel quid, additives, and cigarettes are highly recommended to improve the periodontal status.
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Affiliation(s)
| | | | | | - Edward Chengchuan Ko
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Furber S, Jackson J, Johnson K, Sukara R, Franco L. A qualitative study on tobacco smoking and betel quid use among Burmese refugees in Australia. J Immigr Minor Health 2014; 15:1133-6. [PMID: 23892575 DOI: 10.1007/s10903-013-9881-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Anecdotal evidence suggests that there are high rates of smoking among Burmese men in Wollongong, Australia. A qualitative study was undertaken to explore the beliefs and experiences of Burmese refugees in Wollongong on smoking to guide the development of smoking cessation interventions. Three focus groups were conducted with Burmese refugees. Ten semi-structured interviews were conducted with service providers involved with Burmese refugees. Qualitative content analysis was used to categorise responses to the questions. Participants were aware of the health effects of tobacco smoking but had little knowledge of support for quitting. Many participants chewed betel quid and were unaware of the health consequences. Service providers noted the lack of resources on smoking and betel quid use for Burmese people. Smoking cessation interventions for Burmese people should consider the co-related use of betel quid due to the possibility of inadvertently encouraging use of betel nut as an alternative to tobacco.
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Affiliation(s)
- Susan Furber
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Locked Mail Bag 9, Wollongong, NSW, 2500, Australia,
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Tseng SK, Chang MC, Hsu ML, Su CY, Chi LY, Lan WC, Jeng JH. Arecoline inhibits endothelial cell growth and migration and the attachment to mononuclear cells. J Dent Sci 2014. [DOI: 10.1016/j.jds.2012.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Lin SH, Liao YS, Huang SH, Liao WH. Relationship between betel quid chewing and risks of cardiovascular disease in older adults: a cross-sectional study in Taiwan. Drug Alcohol Depend 2014; 141:132-7. [PMID: 24934690 DOI: 10.1016/j.drugalcdep.2014.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 05/16/2014] [Accepted: 05/21/2014] [Indexed: 12/23/2022]
Abstract
BACKGROUND The association between betel quid (BQ) chewing and oral cancer is well established. However, evidence regarding the relationship between BQ chewing and cardiovascular disease (CVD) is still insufficient. METHODS This cross-sectional study included 2002 men and 1175 women aged 50 and older in a city-level health examination survey of an agricultural and fishing population in 2013. In addition to anthropometric parameters, CVD risks were estimated using high-sensitivity C-reactive protein (hs-CRP), brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index. Age, gender, smoking and alcohol drinking status were all incorporated into the multivariate logistic regression model to delineate the effect of BQ chewing on CVD risks. RESULTS Two hundred forty-one (12%) males and eight (0.7%) females were ever chewers. BQ chewing was an independent risk factor for general obesity (odds ratio [OR] 1.43, 95% confidence interval [CI] 1.07-1.91, p=0.017), central obesity (OR 2.27, 95% CI 1.53-3.37, p<0.001) and an elevated hs-CRP level (OR 1.38, 95% CI 1.03-1.85, p=0.029). Subjects who chewed more frequently had a higher systolic blood pressure (p=0.025) and baPWV (p=0.006). The waist circumference (p=0.015) and waist-to-height ratio (p=0.022) were greater in current chewers than in former chewers. CONCLUSION These findings suggest that BQ chewing is associated with obesity and a higher CVD risk as estimated by hs-CRP. Furthermore, potential beneficial effects of BQ chewing cessation on central obesity were also found.
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Affiliation(s)
- Sheng-Hsiang Lin
- Department of Internal Medicine, New Taipei City Hospital, No. 3, Section 1, New Taipei Boulevard, San-Chong District, New Taipei 24141, Taiwan; Department of Respiratory Therapy, Fu-Jen Catholic University, No. 510, Zhong-Zheng Road, Xin-Zhuang District, New Taipei 24205, Taiwan
| | - Yu-Shu Liao
- Department of Prosthodontic, Chang-Gung Memorial Hospital, No. 199, Tung-Hwa North Road, Song-Shan District, Taipei 10507, Taiwan
| | - Shih-Horng Huang
- Department of Surgery, New Taipei City Hospital, No. 3, Section 1, New Taipei Boulevard, San-Chong District, New Taipei 24141, Taiwan
| | - Wan-Hsiu Liao
- Department of Family Medicine, New Taipei City Hospital, No. 3, Section 1, New Taipei Boulevard, San-Chong District, New Taipei 24141, Taiwan; Department of Family Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhong-Zheng District, Taipei 10002, Taiwan.
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Tseng WS. Halitosis: Could it be a predictor of stroke? Med Hypotheses 2014; 82:335-7. [DOI: 10.1016/j.mehy.2013.12.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/27/2013] [Indexed: 12/21/2022]
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McClintock TR, Parvez F, Wu F, Wang W, Islam T, Ahmed A, Shaheen I, Sarwar G, Demmer RT, Desvarieux M, Ahsan H, Chen Y. Association between betel quid chewing and carotid intima-media thickness in rural Bangladesh. Int J Epidemiol 2014; 43:1174-82. [PMID: 24550247 DOI: 10.1093/ije/dyu009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Areca nut, more commonly known as betel nut, is the fourth most commonly used addictive substance in the world. Though recent evidence suggests it may play a role in the development of cardiovascular disease, no studies have investigated whether betel nut use is related to subclinical atherosclerosis. METHODS We evaluated the association between betel nut use and subclinical atherosclerosis in 1206 participants randomly sampled from the Health Effects of Arsenic Longitudinal Study (HEALS). Frequency and duration of betel nut use were assessed at baseline, and carotid IMT was measured on average 6.65 years after baseline. RESULTS A positive association was observed between duration and cumulative exposure (function of duration and frequency) of betel nut use and IMT, with above-median use for duration (7 or more years) and cumulative exposure (30 or more quid-years) corresponding to a 19.1 μm [95% confidence interval (CI): 5.3-32.8; P ≤ 0.01] and 16.8 μm (95% CI: 2.9-30.8; P < 0.05) higher IMT in an adjusted model, respectively. This association was more pronounced in men [32.8 μm (95% CI: 10.0-55.7) and 30.9 μm (95% CI: 7.4-54.2)]. There was a synergy between cigarette smoking and above-median betel use such that the joint exposure was associated with a 42.4 μm (95% CI: 21.6-63.2; P ≤ 0.01) difference in IMT. CONCLUSION Betel nut use at long duration or high cumulative exposure levels is associated with subclinical atherosclerosis as manifested through carotid IMT. This effect is especially pronounced among men and cigarette smokers.
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Affiliation(s)
- Tyler R McClintock
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Faruque Parvez
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Fen Wu
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Weijia Wang
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Tariqul Islam
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Alauddin Ahmed
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Ishrat Shaheen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Golam Sarwar
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Ryan T Demmer
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Moise Desvarieux
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USADepartments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USADepartments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, Unive
| | - Habibul Ahsan
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA, U-Chicago Research Bangladesh, Dhaka, Bangladesh, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA, INSERM, UMR-S 707, Université Pierre et Marie Curie-Paris 6, Paris, France, École des Hautes Études en Santé Publique, Paris and Rennes, France and Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
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Chao MC, Hu SL, Hsu HS, Davidson LE, Lin CH, Li CI, Liu CS, Li TC, Lin CC, Lin WY. Serum homocysteine level is positively associated with chronic kidney disease in a Taiwan Chinese population. J Nephrol 2014; 27:299-305. [PMID: 24430766 DOI: 10.1007/s40620-013-0037-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/04/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Both hyperhomocysteinemia and chronic kidney disease (CKD) increase risk of cardiovascular disease. In this study, we investigated the association between serum homocysteine level and CKD. MATERIALS AND METHODS A total of 1,581 participants were recruited from a health check-up center in a tertiary hospital in Taiwan between 2006 and 2008. Two groups were created based on serum homocysteine levels above or below 12.24 μmol/l. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease equation; we defined CKD as an eGFR below 60 ml/min/1.73 m(2). Multivariate logistic and linear regression analyses were used to estimate the associations between serum homocysteine levels and kidney function. RESULTS Subjects with elevated homocysteine levels were older and had higher body mass index, blood pressures, fasting plasma glucose, total cholesterol, triglycerides, and eGFR than those with normal serum homocysteine level. Using multiple logistic regression analyses after adjustment for age, sex, lifestyle habits (smoking, alcohol consumption, and betel nut chewing) and chronic diseases (hypertension, diabetes, dyslipidemia), the odds ratio (95 % confidence interval) of having CKD was 5.76 (2.99-11.1) among subjects with elevated serum homocysteine levels compared to subjects with normal serum homocysteine levels. The significant increase in odds ratios for CKD in progressive homocysteine levels reveals a dose-response effect. After adjustment for confounders, at multiple linear regression analyses serum homocysteine level resulted significantly and negatively correlated to eGFR. CONCLUSIONS Elevated serum homocysteine levels appear to be closely associated with CKD. Serum homocysteine levels are negatively associated with eGFR.
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Affiliation(s)
- Min-Chun Chao
- Department of Family Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 404, Taiwan
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Tai TS, Hsu CC, Pai HC, Liu WH, Hsu YH. The association between hyperuricemia and betel nut chewing in Taiwanese men: a cross-sectional study. BMC Public Health 2013; 13:1136. [PMID: 24308550 PMCID: PMC4234360 DOI: 10.1186/1471-2458-13-1136] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 11/27/2013] [Indexed: 02/07/2023] Open
Abstract
Background Studies have associated betel nut chewing with cancers, metabolic syndrome, cardiovascular disorders, chronic kidney disease, and proteinuria. This study investigated whether hyperuricemia is associated with betel nut chewing in men who participated in a health check-up program. Methods From hospital records, we identified a total of 11,991 men who participated in the health check-up program from 2003 to 2009. They were divided into hyperuricemic group and non-hyperuricemic group. Laboratory tests, medical history, and status of cigarette smoking, alcohol consumption, and betel nut chewing were compared between the 2 groups. We calculated odds ratio (OR) and 95% confidence interval (CI) of hyperuricemia in association with betel nut consumption and other factors. Results Compared with the non-hyperuricemic group, the hyperuricemic group was slightly older (59.4 vs. 58.6 years) but less prevalent with betel nut use (11.8 vs. 13.6%, p = 0.003). Multivariable logistic regression analysis showed that hyperuricemia was negatively associated with betel nut chewing (OR 0.75, 95% CI 0.66-0.84), older age (OR 0.84, 95% CI 0.77-0.93), and diabetes mellitus (OR 0.57, 95% CI 0.50-0.64). On the other hand, hyperuricemia was positively associated with body mass index (OR 1.75, 95% CI 1.62-1.90), drinking (OR 1.36, 95% CI 1.25-1.49), hypertension (OR 1.41, 95% CI 1.30-1.52), mixed hyperlipidemia (OR 1.84, 95% CI 1.33-2.54), chronic kidney disease (OR 3.28, 95% CI 2.94-3.65), and proteinuria (OR 1.22, 95% CI 1.08-1.38). Smoking, hypercholesterolemia, and hypertriglyceridemia had no significant association with hyperuricemia. Conclusion Our data suggest that betel nut chewing is negatively associated with hyperuricemia.
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Affiliation(s)
- Tsai-Sung Tai
- Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan City 736, Taiwan.
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Yinon L, Chen Y, Parvez F, Bangalore S, Islam T, Ahmed A, Rakibuz-Zaman M, Hasan R, Sarwar G, Ahsan H. A prospective study of variability in systolic blood pressure and mortality in a rural Bangladeshi population cohort. Prev Med 2013; 57:807-12. [PMID: 24051264 PMCID: PMC4314716 DOI: 10.1016/j.ypmed.2013.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 09/04/2013] [Accepted: 09/08/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Limited studies suggest that blood pressure variability over time is a risk factor of long-term cardiovascular outcomes. However, most of these were in populations with pre-existing cardiovascular diseases (CVD) and studies in general population are lacking. METHODS The study included 11,153 participants in a population-based, prospective cohort study in Araihazar, Bangladesh. Resting blood pressure was measured at baseline and every two years thereafter. Participants were followed up for an average of 6.5 years (2002-2009). RESULTS Male gender, older age, baseline systolic blood pressure (SBP), and absence of betel leaf use were independently positively associated with greater SBP variability over time. There was a significant association between SBP variability and the risk of death from overall CVD, especially from major CVD events. The positive association with the risk of death from any cause and stroke in age- and sex-adjusted models was attenuated in fully-adjusted models. In addition, the hazard ratio (HR) of stroke mortality was greater for individuals with both high baseline and high SBP variability. Similar patterns of HRs were observed for all-cause and CVD mortalities. CONCLUSION In this rural Bangladeshi population, variability in SBP contributes to the risk of death from CVD and may further potentiate the increased mortality risk associated with high SBP.
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Affiliation(s)
- Lital Yinon
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
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Peroxidase as the major protein constituent in areca nut and identification of its natural substrates. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:412851. [PMID: 24250715 PMCID: PMC3821912 DOI: 10.1155/2013/412851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 09/04/2013] [Indexed: 01/17/2023]
Abstract
Numerous reports illustrate the diverse effects of chewing the areca nut, most of which are harmful and have been shown to be associated with oral cancer. Nearly all of the studies are focused on the extract and/or low molecular weight ingredients in the areca nut. The purpose of this report is to identify the major protein component in the areca nut. After ammonium sulfate fractionation, the concentrated areca nut extract is subjected to DEAE-cellulose chromatography. A colored protein is eluted at low NaCl concentration and the apparently homogeneous eluent represents the major protein component compared to the areca nut extract. The colored protein shares partial sequence identity with the royal palm tree peroxidase and its peroxidase activity is confirmed using an established assay. In the study, the natural substrates of areca nut peroxidase are identified as catechin, epicatechin, and procyanidin B1. The two former substrates are similarly oxidized to form a 576 Da product with concomitant removal of four hydrogen atoms. Interestingly, oxidation of procyanidin B1 occurs only in the presence of catechin or epicatechin and an additional product with an 864 Da molecular mass. In addition, procyanidin B1 is identified as a peroxidase substrate for the first time.
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Benyshek DC. The “early life” origins of obesity-related health disorders: New discoveries regarding the intergenerational transmission of developmentally programmed traits in the global cardiometabolic health crisis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 152 Suppl 57:79-93. [DOI: 10.1002/ajpa.22393] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 09/17/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Daniel C. Benyshek
- Department of Anthropology, University of Nevada; Las Vegas Las Vegas, NV 89154-5003
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Liu YM, Chen SLS, Yen AMF, Chen HH. Individual risk prediction model for incident cardiovascular disease: a Bayesian clinical reasoning approach. Int J Cardiol 2013; 167:2008-12. [PMID: 22658349 DOI: 10.1016/j.ijcard.2012.05.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 04/27/2012] [Accepted: 05/05/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND A Bayesian clinical reasoning model was developed to predict an individual risk for cardiovascular disease (CVD) for desk-top reference. METHODS Three Bayesian models were constructed to estimate the CVD risk by sequentially incorporating demographic features (basic), six metabolic syndrome components (metabolic score) and conventional risk factors (enhanced model). By considering clinical weights (regression coefficients) of each model as normal distribution, individual risk can be predicted making allowance for uncertainty of clinical weights. A community-based cohort that enrolled 64,489 participants free of CVD at baseline and followed up over five years to ascertain newly diagnosed CVD cases during the period through 2000 to 2004 was used for the illustration of the three proposed models (full empirical data are available from website http://homepage.ntu.edu.tw/~chenlin/CVD_prediction_data.rar). RESULTS The proposed models can be applied to predicting the CVD risk with any combination of risk factors. For a 47-year-old man, the five-year risk for CVD with the basic model was 11.2% (95% CI: 7.8%-15.6%). His metabolic syndrome score, leading to 1.488 of likelihood ratio, enhanced the risk for CVD up to 15.8% (95% CI: 11.0%-21.5%) and put him in highest deciles. As with the habit of smoking over 2 packs per-day and family history of CVD, yielding the likelihood ratios of 1.62 and 1.47, respectively, the risk was further raised to 30.9% (95% CI: 20.7%-39.8%). CONCLUSIONS We demonstrate how to make individual risk prediction for CVD by incorporating routine information with a sequential Bayesian clinical reasoning approach.
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Affiliation(s)
- Yi-Ming Liu
- Division of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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