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Tekle Y, Hiware S, Shameem A, Atlaw D. Impact of khat leaves on glycosylated haemoglobin and lipid profile in healthy individuals in Dire Dawa, Ethiopia. SAGE Open Med 2022; 10:20503121221094451. [PMID: 35492886 PMCID: PMC9047809 DOI: 10.1177/20503121221094451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The objective of this study is to determine the effect of Catha edulis leaves
on glycosylated haemoglobin and lipid profiles in healthy individuals in
Dire Dawa, Ethiopia. Method: A cross-sectional study was conducted to evaluate the effect of khat leaves
on the glycated haemoglobin and lipid profile in the Dire Dawa population.
For the study, 100 male subjects (aged ⩾20–⩽40 years) were recruited and
divided into two groups, each consisting of 50 subjects: the first group was
khat chewing people while the other group was non-khat chewing individuals.
Blood samples were collected and tested to evaluate the glycated haemoglobin
and lipid profiles. Results: The mean glycated haemoglobin value of khat chewers was 5.33% and for
non-chewers, it was 5.48%, respectively. Since p value is
less than the significance value, the t-test supports the
reduction in glycated haemoglobin values in khat chewers. The mean values of
total cholesterol, and triglycerides in khat chewers are 175.2 and 172.92,
and for non-chewers they are 168.7 and 164.56, respectively. Conclusion: From this study, we concluded that Catha edulis leaves have a significant
effect on glycosylated haemoglobin levels. Mean glycated haemoglobin values
of long-term healthy khat chewers are comparatively less than healthy
non-chewers. Long-term khat chewing increases total cholesterol levels and
triglycerides levels but there is no significant effect on the high-density
lipoprotein and low-density lipoprotein levels.
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Affiliation(s)
- Yared Tekle
- Department of Anatomy, School of Medicine, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Sanket Hiware
- Department of Anatomy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahammed Shameem
- Department of Anatomy, School of Medicine, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Daniel Atlaw
- Department of Anatomy, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
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Al-Duais MA, Al-Awthan YS. Khat Chewing and Lipid Profile in Human and Experimental Animals. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6001885. [PMID: 34977243 PMCID: PMC8719995 DOI: 10.1155/2021/6001885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Catha edulis, also known as khat or qat, is a plant that grows in East Africa and southern Arabia. Several millions of people chew the leaves and twigs of khat plant for their central stimulating amphetamine-like effects. Khat chewing is becoming more common in Europe and the United States, owing to worldwide migration. OBJECTIVE This review examines the khat ingredients, global prevalence, and legal status as well as its effects on lipid profile. Methodology. A literature search was performed using PubMed, Scopus, and Google Scholar to collect information within articles published up to April 2021 with the goal of identifying relevant studies. The proposed mechanisms of cathinone effects on total cholesterol and triglyceride were also discussed. CONCLUSION The khat chewing habit is considered as a serious economic and health issue that needs specialized programs to assist those people to quit or reducing this habit.
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Affiliation(s)
- Mohammed A. Al-Duais
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
- Biochemistry Unit, Chemistry Department, Faculty of Science, Ibb University, Ibb, Yemen
| | - Yahya S. Al-Awthan
- Department of Biology, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
- Department of Biology, Faculty of Science, Ibb University, Ibb, Yemen
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Mengistu Y, Dedefo G, Arkew M, Asefa G, Jebessa G, Atnafu A, Ataro Z, Kinde S. Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study. Nutr Metab Insights 2021; 14:11786388211035220. [PMID: 34376995 PMCID: PMC8320567 DOI: 10.1177/11786388211035220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat's effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.
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Affiliation(s)
- Yordanos Mengistu
- Department of Medical Laboratory, School of Allied Health Sciences, Health Science College, Addis Ababa University, Ethiopia
| | - Gobena Dedefo
- Department of Medical Laboratory, School of Allied Health Sciences, Health Science College, Addis Ababa University, Ethiopia
| | - Mesay Arkew
- Department of Medical Laboratory, College of Health and Medical Science, Haramaya University, Ethiopia
| | - Gebeyehu Asefa
- Armauer Hanson Research institute, Addis Ababa, Ethiopia
| | - Gutema Jebessa
- Armauer Hanson Research institute, Addis Ababa, Ethiopia
| | - Abay Atnafu
- Armauer Hanson Research institute, Addis Ababa, Ethiopia
| | - Zerihun Ataro
- Department of Medical Laboratory, College of Health and Medical Science, Haramaya University, Ethiopia
| | - Samuel Kinde
- Department of Medical Laboratory, School of Allied Health Sciences, Health Science College, Addis Ababa University, Ethiopia
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Alsalahi A, Alshawsh MA, Chik Z, Mohamed Z. Effect of Catha edulis (khat) on pancreatic functions in streptozotocin-induced diabetes in male Sprague-Dawley rats. Exp Anim 2018; 67:517-526. [PMID: 29973470 PMCID: PMC6219881 DOI: 10.1538/expanim.18-0057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
People consume Catha edulis (khat) for its euphoric effect, and type 1
diabetics have claimed that khat could reduce elevated levels of blood sugar. However,
khat has been suggested to provoke diabetes mellitus through destruction of pancreatic
β-cells. This study investigated the effect of an ethanolic khat extract on pancreatic
functions in type 1 diabetes (T1DM)-induced male Sprague-Dawley rats and to assess its
in vitro cytotoxicity in rat pancreatic β-cells (RIN-14B). T1DM was
induced in a total of 20 rats with a single intraperitoneal injection of 75 mg/kg of
streptozotocin. The rats were distributed into four groups (n=5): the diabetic control, 8
IU insulin-treated, 200 mg/kg khat-treated, and 400 mg/kg khat-treated groups. Another 5
rats were included as a nondiabetic control. Body weight, fasting blood sugar, and caloric
intake were recorded weekly. Four weeks after treatment, the rats were sacrificed, and
blood was collected for insulin, lipid profile, total protein, amylase, and lipase
analysis, while pancreases were harvested for histopathology. In vitro,
khat exerted moderate cytotoxicity against RIN-14B cells after 24 and 48 h but
demonstrated greater inhibition against RIN-14B cells after 72 h. Neither 200 mg/kg nor
400 mg/kg of khat produced any significant reduction in blood sugar; however, 200 mg/kg
khat extract provoked more destruction of pancreatic β-cells as compared with the diabetic
control. Ultimately, neither 200 mg/kg nor 400 mg/kg of khat extract could produce a
hypoglycemic effect in T1DM-induced rats. However, 200 mg/kg of khat caused greater
destruction of pancreatic β-cells, implying that khat may cause a direct cytotoxic effect
on pancreatic β-cells in vitro.
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Affiliation(s)
- Abdulsamad Alsalahi
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammed A Alshawsh
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zamri Chik
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zahurin Mohamed
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Alsalahi A, Alshawsh MA, Mohamed R, Alyousefi NA, Alshagga MA, Shwter AN, Al-Maqtari A, Ahmed RH, Mohamed Z. Conflicting reports on the role of the glycemic effect of Catha edulis (Khat): A systematic review and meta-analysis. JOURNAL OF ETHNOPHARMACOLOGY 2016; 186:30-43. [PMID: 27025406 DOI: 10.1016/j.jep.2016.03.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/03/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditionally, the leaves of Catha edulis Forsskal (Khat) are consumed by the people of Yemen primarily for its recreational effect, and secondarily, for achieving certain tasks. Additionally, Yemeni diabetics chew such leaves in the belief that this can control their elevated blood glucose level. AIMS This review focuses on outlining the findings of studies that have been conducted to display the glycemic effect of Catha edulis, while trying to balance it with findings of the association of its chewing with the development of type 2 diabetes mellitus (DM). MATERIALS AND METHODS The search strategy adopted was based on a comprehensive research in Medline, PubMed, Web of Science, JSTOR, Scopus and Cochrane for articles, proceeding abstracts and theses to identify complete reports written in the English language about the glycemic effect of Catha edulis in humans and animals from 1976 to 2016. In addition, bibliographies were also reviewed to find additional reports not otherwise published. Thirty seven records were identified of which, 25 eligible studies were included in the meta-analysis using blood glucose as an outcome measurement. Studies were divided into four subgroups according to the experimental model, namely; non-diabetic animals, diabetic animals, non-diabetic humans and diabetic humans. The pooled mean difference (MD) of blood glucose between experimental and control were calculated using random effects model of the weighted mean difference of blood glucose with 95% confidence interval (CI). Heterogeneity between studies was tested using I(2) statistic and a value of P<0.05 was considered to indicate statistical significance. RESULTS The scientific reports in the literature prevailed that the glycemic effect of Catha edulis were greatly conflicting with the majority of studies indicating that Catha edulis has a mild hypoglycemic effect. However, the meta-analysis indicted that the overall result showed an insignificant reduction in blood glucose (MD=-9.70, 95% CI: -22.17 to 2.76, P=0.13, with high heterogeneity between subgroups, I(2)=88.2%, P<0.0001). In addition, pooled mean difference of blood glucose of non-diabetic animals, diabetic animals and non-diabetic humans showed an insignificant reduction in blood glucose (MD=-18.55, 95% CI: -39.55 to 2.50, P<0.08, MD=-52.13%, 95% CI: -108.24 to 3.99, P=0.07 and MD=-2.71%, 95% CI: -19.19 to -13.77, P=0.75) respectively. Conversely, a significant elevation in the pooled mean difference of blood glucose in diabetic humans was indicated (MD=67.18, 95% CI: 36.93-97.43, P<0.0001). The conflict shown in the glycemic effect of Catha edulis is thought to be cultivar-related, while demographic and epidemiological reports suggested that chewing Catha edulis might be a predisposing factor contributing to the development of type 2 DM. CONCLUSION It was difficult to draw a meaningful conclusion from both the systematic and the meta-analysis with respect to the glycemic effect of Catha edulis since the meta-analysis results were insignificant with high heterogeneity among subgroups and are greatly conflicting. The variation is most likely due to unadjusted experimental factors or is related to Catha edulis itself, such as the differences in the phytochemical composition. Therefore, it is highly recommended that further studies of the glycemic effect of the cultivar of Catha edulis being studied should come with the identification and quantification of phytochemical content so that a meaningful assessment can be made with regard to its hypoglycemic properties. In addition, well-controlled clinical studies should be conducted to confirm whether or not chewing Catha edulis is associated with the development of type 2 DM, since this would be a source of concern seeing that the plant is widely consumed in certain populations.
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Affiliation(s)
- Abdulsamad Alsalahi
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammed A Alshawsh
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Rosmawati Mohamed
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Naelah A Alyousefi
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mustafa Ahmed Alshagga
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Abdrabuh N Shwter
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ali Al-Maqtari
- Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603 Kuala Lumpur, Malaysia
| | - Radwan H Ahmed
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zahurin Mohamed
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Al-Sharafi BA, Gunaid AA. Effect of Habitual Khat Chewing on Glycemic Control, Body Mass Index, and Age at Diagnosis of Diabetes in Patients with Type 2 Diabetes Mellitus in Yemen. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2015; 8:47-53. [PMID: 26064075 PMCID: PMC4455697 DOI: 10.4137/cmed.s26045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/11/2015] [Accepted: 05/13/2015] [Indexed: 11/12/2022]
Abstract
Khat chewing is common in Yemen. We conducted this study to see if it affected diabetes control in patients with type 2 diabetes mellitus (DM). We studied 1540 patients with type 2 DM attending an endocrinology clinic in Sana’a, Yemen, of which 997 were khat chewers (KC) and 543 were non-khat chewers (NKC). The patients answered a questionnaire regarding khat chewing. Hemoglobin A1c (HbA1c) and body mass index (BMI) were measured. KC had a higher mean HbA1c of 9.8 (95% confidence interval (95% CI) 9.6–10) than the NKC, with a mean of 9.1 (95% CI 8.9–9.4) (adjusted odds ratios (AOR) 1.74, P < 0.001) after multivariate regression analysis. KC also had a lower mean BMI, 26.9 (95% CI 26.6–27.2), than the NKC, mean BMI 27.6 (95% CI 27.1–28) (P < 0.01). The mean age at diagnosis of DM among the KC group was 43.3 (10.1) and among the NKC group was 45.9 (11.8) (AOR 1.4 P < 0.008) after multivariate regression analysis. KC patients had a higher mean HbA1c, a lower BMI, and a younger age at diagnosis of type 2 DM when compared with NKC.
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Affiliation(s)
| | - Abdallah A Gunaid
- Department of Medicine, Sana'a University Medical School, Sana'a, Yemen
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Lemieux AM, Li B, al'Absi M. Khat use and appetite: an overview and comparison of amphetamine, khat and cathinone. JOURNAL OF ETHNOPHARMACOLOGY 2015; 160:78-85. [PMID: 25435289 PMCID: PMC4281284 DOI: 10.1016/j.jep.2014.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/31/2014] [Accepted: 11/02/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE To understand the role of khat (Catha edulis) use on the aberrations in appetite and weight which are common comorbidities for khat and other amphetamine users. MATERIALS AND METHODS We provide a comprehensive overview and conceptual summary of the historical cultural use of khat as a natural stimulant and describe the similarities and differences between cathinone (the main psychoactive constituent of khat) and amphetamine highlighting the limited literature on the neurophysiology of appetite and subsequent weight effects of khat. RESULTS Animal and some human studies indicate that khat produces appetite suppression, although little is known about mechanisms of this effect. Both direct and indirect effects of khat stem from multiple factors including behavioral, chemical and neurophysiological effects on appetite and metabolism. Classic and newly identified appetite hormones have not been explored sufficiently in the study of appetite and khat use. Unique methodological challenges and opportunities are encountered when examining effects of khat and cathinone including khat-specific medical comorbidities, unique route of administration, differential patterns of behavioral effects relative to amphetamines and the nascent state of our understanding of the neurobiology of this drug. CONCLUSION A considerable amount of work remains in the study of the appetite effects of khat chewing and outline a program of research that could inform our understanding of this natural amphetamine׳s appetite effects and help prepare health care workers for the unique health effects of this drug.
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Affiliation(s)
- Andrine M Lemieux
- University of Minnesota Medical School Duluth Campus, Duluth, MN, USA
| | - Bingshuo Li
- University of Minnesota Medical School Duluth Campus, Duluth, MN, USA; Werner Reichardt Centre for Integrative Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Mustafa al'Absi
- University of Minnesota Medical School Duluth Campus, Duluth, MN, USA.
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Alsanusy R, El-Setouhy M. Why would khat chewers quit? An in-depth, qualitative study on Saudi Khat quitters. Subst Abus 2014; 34:389-95. [PMID: 24159910 PMCID: PMC3827665 DOI: 10.1080/08897077.2013.783526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Khat chewing, which has many adverse health and social consequences, is highly prevalent and socially accepted in the Jazan region of the Kingdom of Saudi Arabia. Methods: A qualitative study was conducted with 47 adult male former khat users regarding their khat initiation, continuance, and cessation, the amounts of khat they had used, and the health and social consequences of their use and cessation of use. Results: Participants noted a desire to show maturity, ease of availability of khat, and peer pressure as reasons for initiating khat chewing. Many noted long leisure times with little to do as a reason for continuing use. Negative consequences of khat use were seen in economic, health, familial, and sexual areas of their lives. After quitting khat use, participants saw improvements in all of these areas. Conclusions: A comprehensive community development program (CCDP) tackling, among other issues, the normalization of khat use, substantial leisure times with few positive activities, and misinformation about the “benefits” of khat use, as well as developing peer and family training programs to help prevent or stop khat use, would be useful to reduce khat chewing in this community.
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Affiliation(s)
- Rashad Alsanusy
- a Substance Abuse Research Center (SARC) , Jazan University , Jazan , Kingdom of Saudi Arabia
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Toxicological Features of Catha edulis (Khat) on Livers and Kidneys of Male and Female Sprague-Dawley Rats: A Subchronic Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:829401. [PMID: 23259000 PMCID: PMC3522130 DOI: 10.1155/2012/829401] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/15/2012] [Accepted: 10/22/2012] [Indexed: 11/18/2022]
Abstract
Hepato- and nephrotoxicity of Khat consumption (Catha edulis Forskal) have been evoked. Therefore, this study was conducted to evaluate such possible hepatorenal toxicity in female and male Sprague-Dawley rats (SD rats) focusing primarily on liver and kidney. In addition, female and male rats were investigated separately. Accordingly, forty-eight SD-rats (100–120 g) were distributed randomly into four groups of males and female (n = 12). Normal controls (NCs) received distilled water, whereas test groups received 500 mg/kg (low dose (LD)), 1000 mg/kg (medium dose (MD)), or 2000 mg/kg (high dose (HD)) of crude extract of Catha edulis orally for 4 weeks. Then, physical, biochemical, hematological, and histological parameters were analyzed. Results in Khat-fed rats showed hepatic enlargement, abnormal findings in serum aspartate aminotransferase (AST), and alkaline phosphatase (ALP) of male and female SD-rats and serum albumin (A) and serum creatinine (Cr) of female as compared to controls. In addition, histopathological abnormalities confirmed hepatic and renal toxicities of Khat that were related to heavy Khat consumption. In summary, Khat could be associated with hepatic hypertrophy and hepatotoxicity in male and female SD-rats and nephrotoxicity only in female SD-rats.
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