Tung T-H, Chiu Y-H, Chen L-S, Wu H-M, Boucher B J, Chen T H-H
Department of Medicine Research and Education, Cheng Hsin Rehabilitation Center, Taipei, Taiwan.
Diabetologia. 2004 Oct;47(10):1776-81. doi: 10.1007/s00125-004-1532-2. Epub 2004 Oct 27.
AIMS/HYPOTHESIS: The aim of this study was to assess whether the diabetogenicity of areca nut (Areca catechu or 'betel-nut'), which has previously been demonstrated experimentally in mice, independently contributes to the risk of hyperglycaemia or type 2 diabetes in men in Taiwan, where the habit has become established relatively recently.
We used data from a population-based cross-sectional survey and a multiple-disease-screening programme that tested for hyperglycaemia, type 2 diabetes and risk factors related to type 2 diabetes. Data on habitual areca nut chewing were available for 14,816 men. Multiple logistic regression models were used to determine whether areca nut chewing was an independent risk factor for type 2 diabetes.
Compared with non-chewers, areca nut chewers had higher age-adjusted prevalence rates for hyperglycaemia (11.4% vs 8.7%) and type 2 diabetes (10.3% vs 7.8%). Areca nut chewing independently increased the risk of hyperglycaemia (adjusted odds ratio [OR] 1.19, 95% CI 0.97-1.45) and type 2 diabetes (adjusted OR 1.29, 95% CI 1.04-1.60). The independent effects of duration of chewing were dose-dependent for type 2 diabetes (adjusted OR 1.32 for the duration of 10-19 years and 1.41 for the duration of > or =20 years), as were the effects of increased rates of areca nut chewing (adjusted OR 1.14 for <10 pieces/day, 1.30 for 10-19 pieces/day and 2.02 for > or =20 pieces/day); similar findings were noted for hyperglycaemia.
CONCLUSIONS/INTERPRETATION: The habit of chewing areca nut independently contributes to the risk of both hyperglycaemia and type 2 diabetes in Taiwanese men. This association is dose-dependent with respect to the duration of areca nut use and the quantity of areca nut chewed per day.
目的/假设：本研究旨在评估槟榔（槟榔或“槟榔果”）的致糖尿病性（此前已在小鼠实验中得到证实）是否独立导致台湾男性高血糖或2型糖尿病风险增加，在台湾，嚼槟榔的习惯是相对近期才形成的。
我们使用了基于人群的横断面调查和多病筛查项目的数据，该项目检测了高血糖、2型糖尿病及与2型糖尿病相关的危险因素。共有14816名男性提供了嚼槟榔习惯的数据。采用多元逻辑回归模型确定嚼槟榔是否为2型糖尿病的独立危险因素。
与不嚼槟榔者相比，嚼槟榔者经年龄调整后的高血糖患病率（11.4%对8.7%）和2型糖尿病患病率（10.3%对7.8%）更高。嚼槟榔独立增加了高血糖风险（调整优势比[OR]为1.19，95%置信区间为0.97 - 1.45）和2型糖尿病风险（调整OR为1.29，95%置信区间为1.04 - 1.60）。嚼槟榔持续时间对2型糖尿病的独立影响呈剂量依赖性（10 - 19年的调整OR为1.32，≥20年的调整OR为1.41），嚼槟榔频率增加的影响也呈剂量依赖性（每天<10片的调整OR为1.14，10 - 19片的调整OR为1.30，≥20片的调整OR为2.02）；高血糖方面也有类似发现。
结论/解读：嚼槟榔的习惯独立增加了台湾男性高血糖和2型糖尿病的风险。这种关联在槟榔使用持续时间和每日嚼槟榔量方面呈剂量依赖性。
