University of Hawaii Cancer Center, Honolulu, Hawaii, USA.
University of Guam Cancer Research Center, Mangilao, Guam, USA.
Drug Test Anal. 2023 Jan;15(1):58-65. doi: 10.1002/dta.3364. Epub 2022 Oct 2.
The Betel Nut Intervention Trial (BENIT) is the first known randomized controlled intervention trial designed to help minority Pacific Islanders in Guam and Saipan quit chewing the carcinogenic Areca catechu nut (AN). We report the BENIT's saliva bioverification results against the self-reported chewing status ("quitter" or "chewer") at day 22 follow-up.
AN-specific (arecoline, arecaidine, guvacoline, and guvacine) and tobacco-specific (nicotine, cotinine, and hydroxycotinine) alkaloids were analyzed in saliva from 176 BENIT participants by an established and sensitive liquid chromatography mass spectrometry-based assay.
The combined four AN alkaloid levels decreased from baseline in quitters (n = 50) and chewers (n = 108) by 32% and 9%, respectively. In quitters, decreases were significant for arecoline (p = 0.044)-the most prominent AN alkaloid, along with arecaidine (p = 0.042) and nicotine (p = 0.011). In chewers, decreases were significant only for hydroxycotinine (p = 0.004). Similar results were obtained when quitters and chewers were stratified by treatment arm.
Salivary AN alkaloid levels generally agreed with self-reported chewing status, which suggests the former can be used to verify the latter.
Our results can help to objectively evaluate compliance and program effectiveness in AN cessation programs.
槟榔干预试验（BENIT）是首个旨在帮助关岛和塞班岛的太平洋岛裔少数族裔戒除致癌槟榔果（AN）咀嚼习惯的随机对照干预试验。我们报告了 BENIT 在第 22 天随访时唾液生物验证结果与自我报告咀嚼状态（“戒烟者”或“咀嚼者”）的一致性。
采用一种成熟且灵敏的基于液相色谱-质谱联用的检测方法，对 176 名 BENIT 参与者的唾液进行了槟榔碱（arecoline）、槟榔次碱（arecaidine）、古柯叶碱（guvacoline）和古柯叶宁（guvacine）等 AN 特异性生物碱以及尼古丁（nicotine）、可替宁（cotinine）和 3-羟基可替宁（hydroxycotinine）等烟草特异性生物碱的分析。
在戒烟者（n=50）和咀嚼者（n=108）中，联合四种 AN 生物碱水平分别从基线下降了 32%和 9%。在戒烟者中，最主要的 AN 生物碱槟榔碱（arecoline）以及槟榔次碱（arecaidine）和尼古丁（nicotine）水平下降具有统计学意义（p=0.044、0.042 和 0.011）。在咀嚼者中，只有 3-羟基可替宁（hydroxycotinine）水平下降具有统计学意义（p=0.004）。在按治疗组分层的戒烟者和咀嚼者中，也得到了类似的结果。
唾液 AN 生物碱水平通常与自我报告的咀嚼状态一致，这表明前者可用于验证后者。
我们的结果可以帮助客观评估 AN 戒除计划中的依从性和项目效果。
