Shrestha Sanjeeb, Mishra Deebya Raj, Dhakal Niraj, Bhandari Suresh, Khanal Sagar, Lamsal Madhab
Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Indian Heart J. 2019 Nov-Dec;71(6):459-463. doi: 10.1016/j.ihj.2019.10.001. Epub 2019 Oct 22.
Tobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco.
This comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk factors such as blood pressure (BP), lipid profile, and body mass index was measured against urine cotinine level. Statistical tests used were χ test for categorical variable, independent t-test, Mann-Whitney U test, and Spearman's correlation applied for numerical variable, and multivariate regression analysis was performed as required. The level of significance was set at p < 0.05.
Mean BP, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and median cotinine level were found to be significantly higher in PMT users than in controls (p < 0.001). Urinary cotinine level was positively correlated with mean BP, TC, TG, and LDL-C in PMT users (p < 0.001). Similarly, the odds of having hypercholesterolemia and increased diastolic BP was also significantly higher in PMT users (p < 0.001).
PMT use has an adverse effect on CV risk parameters and there is a rational of cotinine measurement for screening CV risk among PMT users.
烟草消费被认为是心血管疾病（CV）发病的主要危险因素之一。然而，在我们的研究背景下，对嚼烟（一种无烟烟草）消费的影响尚未得到充分研究。我们的研究旨在找出嚼烟使用者和非使用者之间心血管危险因素的关联，并将这些参数与尿可替宁水平相关联，尿可替宁是烟草中尼古丁的降解产物。
这项比较性横断面研究在200名参与者中进行。根据尿可替宁水平，测量嚼烟使用对心血管危险因素如血压（BP）、血脂谱和体重指数的影响。使用的统计检验包括分类变量的χ检验、独立t检验、曼-惠特尼U检验以及数值变量的Spearman相关性分析，并根据需要进行多变量回归分析。显著性水平设定为p < 0.05。
发现嚼烟使用者的平均血压、总胆固醇、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和可替宁中位数水平显著高于对照组（p < 0.001）。在嚼烟使用者中，尿可替宁水平与平均血压、总胆固醇、甘油三酯和低密度脂蛋白胆固醇呈正相关（p < 0.001）。同样，嚼烟使用者患高胆固醇血症和舒张压升高的几率也显著更高（p < 0.001）。
嚼烟使用对心血管风险参数有不利影响，并且有理由通过测量可替宁来筛查嚼烟使用者的心血管风险。
