Patil Varsha R, Sanjai Karpagaselvi
Department of Oral Pathology and Microbiology, Vydehi Institute of Dental Sciences and Research Centre, Bangalore, IND.
Cureus. 2025 Jun 2;17(6):e85229. doi: 10.7759/cureus.85229. eCollection 2025 Jun.
Background The widespread use of smokeless tobacco, particularly in India, is a major public health concern, contributing to increased oral cancer cases. Tobacco pouch keratosis, an early sign of oral mucosal damage, is commonly observed in regular smokeless tobacco users. This study examines the impact of smokeless tobacco on salivary antioxidant systems, comparing individuals with and without tobacco pouch keratosis to healthy controls. Materials and methods A total of 63 participants were divided into three groups: smokeless tobacco users without oral lesions (group 1, n=23), users with tobacco pouch keratosis (group 2, n=20), and healthy controls (group 3, n=20). Salivary parameters, including flow rate, pH, and total antioxidant capacity (measured by the ferric reducing antioxidant power [FRAP] assay), were analyzed. A descriptive analysis was conducted for both continuous and categorical variables. For inferential statistics, the Mann-Whitney U test was used to compare the duration and frequency of tobacco use. A one-way ANOVA, followed by Tukey's post-hoc test, was applied to compare the mean salivary flow rate and salivary pH levels. Spearman's correlation test was employed to assess the relationship between total antioxidant levels and various parameters. The level of statistical significance was set at < 0.05. Results The mean duration of tobacco use was 6.30 years in group 1 and 18.10 years in group 2 (p=0.001). The mean salivary flow rates were 0.272 ± 0.137 mL/min (group 1), 0.159 ± 0.094 mL/min (group 2), and 0.277 ± 0.192 mL/min (group 3), with a p-value of 0.02. The mean pH levels were 6.999 ± 0.322 (group 1), 6.650 ± 0.355 (group 2), and 6.943 ± 0.360 (group 3), with a value of 0.004. Group 3 had significantly higher total salivary antioxidant levels (=0.001). Conclusions Smokeless tobacco use, particularly in individuals with tobacco pouch keratosis, is associated with reduced salivary flow rate, lower (more acidic) pH, and decreased total antioxidant levels. There is a strong negative correlation between salivary antioxidant levels and the duration and frequency of smokeless tobacco use.
背景 无烟烟草的广泛使用，尤其是在印度，是一个重大的公共卫生问题，导致口腔癌病例增加。烟草袋角化病是口腔黏膜损伤的早期迹象，在经常使用无烟烟草的人群中很常见。本研究通过比较有无烟草袋角化病的个体与健康对照，考察无烟烟草对唾液抗氧化系统的影响。
材料与方法 总共63名参与者被分为三组：无口腔病变的无烟烟草使用者（第1组，n = 23）、有烟草袋角化病的使用者（第2组，n = 20）和健康对照（第3组，n = 20）。分析了唾液参数，包括流速、pH值和总抗氧化能力（通过铁还原抗氧化能力[FRAP]测定法测量）。对连续变量和分类变量均进行了描述性分析。对于推断性统计，采用曼-惠特尼U检验比较烟草使用的持续时间和频率。应用单向方差分析，随后进行Tukey事后检验，以比较唾液平均流速和唾液pH值水平。采用斯皮尔曼相关性检验评估总抗氧化水平与各种参数之间的关系。统计学显著性水平设定为<0.05。
结果 第1组烟草使用的平均持续时间为6.30年，第2组为18.10年（p = 0.001）。唾液平均流速分别为0.272±0.137 mL/分钟（第1组）、0.159±0.094 mL/分钟（第2组）和0.277±0.192 mL/分钟（第3组），p值为0.02。平均pH值分别为6.999±0.322（第1组）、6.650±0.355（第2组）和6.943±0.360（第3组），p值为0.004。第3组的唾液总抗氧化水平显著更高（p = 0.001）。
结论 使用无烟烟草，尤其是有烟草袋角化病的个体，与唾液流速降低、pH值降低（更酸性）和总抗氧化水平降低有关。唾液抗氧化水平与无烟烟草使用的持续时间和频率之间存在很强的负相关性。
