Healthy Aging Research Centre, Chang Gung University, Taoyuan, Taiwan.
Division of Family Medicine, Taiwan Landseed Hospital, Taoyuan, Taiwan.
Soc Psychiatry Psychiatr Epidemiol. 2018 Apr;53(4):393-401. doi: 10.1007/s00127-017-1460-3. Epub 2017 Nov 15.
Forms of habitual substance use including cigarette smoking and alcohol consumption have been documented as risk factors of common mental disorders (CMDs). The effects of areca nut chewing on biophysiological tests, metabolic syndromes, and liver function have been reported previously; however, the relationship between areca nut chewing and CMDs remains unclear. This study examined the association between areca nut chewing and CMDs and explored the relationships between areca nut chewing and biophysiological indicators.
A total of 4477 community dwellers who had enrolled in a cohort study and participated in health examinations in 2 consecutive years were selected for analysis in the present study. The community cohort was established in northern Taiwan during 2006-2012. The Chinese health questionnaire (CHQ-12) was used as a self-reported screening instrument to assess the potential for developing psychotic mental disorders (CHQ-12 score ≥ 3) among the community residents. Biophysiological tests performed 1 year before CMD assessment were analyzed to examine the causal pathways between areca nut chewing and CMDs. Multiple logistic regression and stratified analyses were performed.
A total of 18.23% of the participants were diagnosed as having CMDs. Factors including areca nut chewing [odds ratio (OR) 1.828; 95% confidence interval (CI) 1.165-2.869], sex (women; OR 1.828; 95% CI 1.165-2.869), age (30-49; OR 1.302; 95% CI 1.073-1.579), and socioeconomic status (lower status; OR 1.373; 95% CI 1.084-1.738) were associated with CMDs in a multiple logistic regression model. Areca nut chewers exhibited significantly more triglycerides (220.04 vs. 124.16 mg/dL) and white blood cells (65.17 102/μL vs. 60.36 102/μL) and significantly higher diastolic blood pressure (78.83 vs. 75.84 mmHg) and glutamic oxaloacetic transaminase (30.30 vs. 25.45 U/L) than did the controls.
This study demonstrated the association between areca nut chewing and CMDs and its effects on biophysiological tests in a community-based population in Taiwan. The findings suggest the existence of mechanistic effects of areca nut chewing on CMDs exerted through multiple pathways that may interact with pre-existing biophysiological abnormalities. Lifestyle variables should be considered for the prevention and management of mental disorders in the future.
吸烟和饮酒等习惯性物质使用形式已被记录为常见精神障碍（CMD）的危险因素。先前已经报道了槟榔咀嚼对生物生理测试、代谢综合征和肝功能的影响；然而，槟榔咀嚼与 CMDs 之间的关系仍不清楚。本研究探讨了槟榔咀嚼与 CMDs 的关联，并探讨了槟榔咀嚼与生物生理指标之间的关系。
本研究共纳入了 4477 名连续两年参加队列研究并参加健康检查的社区居民。该社区队列于 2006-2012 年在台湾北部建立。使用中文版健康问卷（CHQ-12）作为一种自我报告的筛查工具，评估社区居民出现精神病性精神障碍的可能性（CHQ-12 评分≥3）。分析 CMD 评估前 1 年进行的生物生理测试，以检查槟榔咀嚼与 CMDs 之间的因果关系。进行了多因素逻辑回归和分层分析。
共有 18.23%的参与者被诊断为患有 CMDs。槟榔咀嚼（优势比 [OR] 1.828；95%置信区间 [CI] 1.165-2.869）、性别（女性；OR 1.828；95%CI 1.165-2.869）、年龄（30-49 岁；OR 1.302；95%CI 1.073-1.579）和社会经济地位（较低水平；OR 1.373；95%CI 1.084-1.738）是多因素逻辑回归模型中与 CMDs 相关的因素。与对照组相比，槟榔咀嚼者的甘油三酯（220.04 与 124.16 mg/dL）和白细胞（65.17 与 102/μL）明显更高，舒张压（78.83 与 75.84 mmHg）和谷草转氨酶（30.30 与 25.45 U/L）明显更高。
本研究在台湾的社区人群中证明了槟榔咀嚼与 CMDs 之间的关联及其对生物生理测试的影响。研究结果表明，槟榔咀嚼对 CMDs 的影响存在机制作用，可能通过多种途径相互作用，这些途径可能与预先存在的生物生理异常相互作用。在未来，应该考虑生活方式变量来预防和管理精神障碍。
