Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
BMC Public Health. 2012 Mar 7;12:162. doi: 10.1186/1471-2458-12-162.
Areca nut chewing has been reported to be associated with obesity, metabolic syndrome, hypertension, and cardiovascular mortality in previous studies. The aim of this study was to examine whether chewing areca nut increases the risk of coronary artery disease (CAD) in Taiwanese men.
This study is a hospital-based case-control study. The case patients were male patients diagnosed in Taiwan between 1996 and 2009 as having a positive Treadmill exercise test or a positive finding on the Thallium-201 single-photon emission computed tomography myocardial perfusion imaging. The case patients were further evaluated by coronary angiography to confirm their CAD. Obstructive CAD was defined as a ≥ 50% decrease in the luminal diameter of one major coronary artery. The patients who did not fulfill the above criteria of obstructive CAD were excluded.The potential controls were males who visited the same hospital for health check-ups and had a normal electrocardiogram but no history of ischemic heart disease or CAD during the time period that the case patients were diagnosed. The eligible controls were randomly selected and frequency-matched with the case patients based on age. Multiple logistic regression analyses were used to estimate the odds ratio of areca nut chewing and the risk of obstructive CAD.
A total of 293 obstructive CAD patients and 720 healthy controls, all men, were analyzed. Subjects who chewed areca nut had a 3.5-fold increased risk (95% CI = 2.0-6.2) of having obstructive CAD than those without, after adjusting for other significant covariates. The dose-response relationship of chewing areca nut and the risk of obstructive CAD was also noted. After adjusting for other covariates, the 2-way additive interactions for obstructive CAD risk were also significant between areca nut use and cigarette smoking, hypertension and dyslipidemia.
Long-term areca nut chewing was an independent risk factor of obstructive CAD in Taiwanese men. Interactive effects between chewing areca nut and cigarette smoking, hypertension, and dyslipidemia were also observed for CAD risk. Further exploration of their underlying mechanisms is necessary.
之前的研究表明，咀嚼槟榔与肥胖、代谢综合征、高血压和心血管死亡率有关。本研究旨在探讨咀嚼槟榔是否会增加台湾男性患冠状动脉疾病（CAD）的风险。
这是一项基于医院的病例对照研究。病例组患者为 1996 年至 2009 年间在台湾被诊断为跑步机运动试验阳性或铊-201 单光子发射计算机断层心肌灌注成像阳性的男性患者。进一步通过冠状动脉造影评估病例组患者以确认其 CAD。阻塞性 CAD 定义为主要冠状动脉之一的管腔直径减少≥50%。不符合上述阻塞性 CAD 标准的患者被排除在外。对照组为同期因健康检查而就诊的男性，心电图正常，无缺血性心脏病或 CAD 病史。符合条件的对照组随机选择，并根据年龄与病例组进行频数匹配。采用多因素 logistic 回归分析来估计咀嚼槟榔与阻塞性 CAD 风险的比值比。
共分析了 293 例阻塞性 CAD 患者和 720 名健康对照者（均为男性）。校正其他显著协变量后，咀嚼槟榔者患阻塞性 CAD 的风险是不咀嚼者的 3.5 倍（95%CI=2.0-6.2）。还观察到咀嚼槟榔与阻塞性 CAD 风险之间的剂量-反应关系。校正其他协变量后，在 CAD 风险方面，咀嚼槟榔与吸烟、高血压和血脂异常之间也存在着双向相加交互作用。
长期咀嚼槟榔是台湾男性患阻塞性 CAD 的独立危险因素。还观察到咀嚼槟榔与吸烟、高血压和血脂异常之间存在交互作用，进一步探讨其潜在机制是必要的。
