Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
PLoS One. 2013 Aug 5;8(8):e70679. doi: 10.1371/journal.pone.0070679. Print 2013.
Betel nut (Areca nut) is the fruit of the Areca catechu tree. Approximately 700 million individuals regularly chew betel nut (or betel quid) worldwide and it is a known risk factor for oral cancer and esophageal cancer. We performed a meta-analysis to assess the influence of chewing betel quid on metabolic diseases, cardiovascular disease, and all-cause mortality.
METHODOLOGY/PRINCIPAL FINDINGS: We searched Medline, Cochrane Library, Web of Science, and Science Direct for pertinent articles (including the references) published between 1951 and 2013. The adjusted relative risk (RR) and 95% confidence interval were calculated using the random effect model. Sex was used as an independent category for comparison.
Of 580 potentially relevant studies, 17 studies from Asia (5 cohort studies and 12 case-control studies) covering 388,134 subjects (range: 94 to 97,244) were selected. Seven studies (N = 121,585) showed significant dose-response relationships between betel quid consumption and the risk of events. According to pooled analysis, the adjusted RR of betel quid chewers vs. non-chewers was 1.47 (P<0.001) for obesity (N = 30,623), 1.51 (P = 0.01) for metabolic syndrome (N = 23,291), 1.47 (P<0.001) for diabetes (N = 51,412), 1.45 (P = 0.06) for hypertension (N = 89,051), 1.2 (P = 0.02) for cardiovascular disease (N = 201,488), and 1.21 (P = 0.02) for all-cause mortality (N = 179,582).
CONCLUSION/SIGNIFICANCE: Betel quid chewing is associated with an increased risk of metabolic disease, cardiovascular disease, and all-cause mortality. Thus, in addition to preventing oral cancer, stopping betel quid use could be a valuable public health measure for metabolic diseases that are showing a rapid increase in South-East Asia and the Western Pacific.
槟榔（槟榔果）是槟榔树的果实。全世界约有 7 亿人经常咀嚼槟榔（或槟榔块），它是口腔癌和食管癌的已知危险因素。我们进行了一项荟萃分析，以评估咀嚼槟榔对代谢性疾病、心血管疾病和全因死亡率的影响。
方法/主要发现：我们在 Medline、Cochrane 图书馆、Web of Science 和 Science Direct 中搜索了 1951 年至 2013 年期间发表的相关文章（包括参考文献）。使用随机效应模型计算调整后的相对风险（RR）和 95%置信区间。性别被用作比较的独立类别。
在 580 篇潜在相关研究中，选择了来自亚洲的 17 项研究（5 项队列研究和 12 项病例对照研究），涵盖了 388134 名受试者（范围：94-97244 岁）。7 项研究（N=121585）显示，槟榔咀嚼者与事件风险之间存在显著的剂量-反应关系。根据汇总分析，与非咀嚼者相比，槟榔咀嚼者的调整 RR 为 1.47（P<0.001），肥胖（N=30623），1.51（P=0.01）代谢综合征（N=23291），1.47（P<0.001）糖尿病（N=51412），1.45（P=0.06）高血压（N=89051），1.2（P=0.02）心血管疾病（N=201488），1.21（P=0.02）全因死亡率（N=179582）。
结论/意义：咀嚼槟榔与代谢性疾病、心血管疾病和全因死亡率的风险增加有关。因此，除了预防口腔癌外，停止咀嚼槟榔可能是东南亚和西太平洋地区代谢性疾病快速增加的一项有价值的公共卫生措施。
