Liver function tests as a measure of hepatotoxicity in areca nut chewers

Abstract

Background: Areca nut has been listed as a carcinogenic agent in humans and is linked to cancers of oral cavity, gastrointestinal tract, and hepatobiliary system. Liver function tests (LFTs), the estimation of enzymes specific to the hepatic system, give an assessment of its cellular integrity, and functionality. Aim and Objectives: This study aimed to evaluate the state of the liver in patients consuming areca nut and its products over a period. Materials and Methods: LFTs were carried out on 10 nonareca nut chewers and thirty patients with a history of areca nut, quid or a combination of tobacco and areca nut chewing, extending from 6 months to 30 years. The LFTs included estimation of aspartate transaminase (AST), alanine transaminase, alkaline phosphatase (ALP), direct bilirubin, albumin, and total protein content. A comparative analysis was done for each biochemical marker with duration, form (betel nut alone, quid, and betel nut with tobacco), and frequency of chewing areca nut. Results: A mild increment in AST was seen in 33.3% cases. Statistically significant association (P < 0.05) was observed between the control and cases for AST, ALP, and total protein content. A significant positive Pearson's correlation (+0.417) was obtained for a form of areca nut chewing (areca nut and tobacco) and AST. A significant negative Pearson's correlation (−0.05) was observed between total protein content and form of chewing (areca nut and tobacco). Conclusion: The results of the study seem to indicate that even long-term chewing of areca nut is not hepatotoxic. Minor alterations in LFTs were well within limits.