Abstract
Data on risk of metabolic syndrome among various forms of tobacco consumption in Myanmar tobacco users are currently limited. The present study aimed to determine and compare nicotine metabolites serum cotinine, oxidative stress marker serum F2-isoprostane in adult male tobacco users, and to find out relationships between these parameters and risk of metabolic syndrome. This cross-sectional study was done in 30 to 45 years old males: 84 cigarette smokers, 84 cheroot smokers and 84 betel quid with tobacco chewers. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III definition. Serum cotinine concentration of cigarette smokers was significantly higher than that of cheroot smokers (p=0.026), however, no significant difference was seen between cigarette smokers and betel quid with tobacco chewers (p=1.000), and between cheroot smokers and betel quid with tobacco chewers (p=0.248). Serum F2-isoprostane concentration was significantly higher (p=0.001) in cigarette smokers than cheroot smokers and betel quid with tobacco chewers, but no significant difference was observed between cheroot smokers and betel quid with tobacco chewers (p=1.000). Compared with betel quid with tobacco chewers, cigarette smokers had 5.2 times (95% CI, 2.3-11.4) (p<0.001) and cheroot smokers had 1.4 times (95% CI, 0.62-3.3) (p=0.402) higher risk of having metabolic syndrome. There was a significant association between the presence of metabolic syndrome and high serum cotinine as well as high serum F2-isoprostane. A significant correlation between serum cotinine and serum F2-isoprostane was found in betel quid with tobacco chewers, but not in cigarette smokers and cheroot smokers. The present study showed that both nicotine and oxidative stress take part in the pathogenesis of metabolic syndrome. Cigarette smoking has the highest risk of having metabolic syndrome, however, cheroot smoking as well as betel quid with tobacco chewing is related to metabolic syndrome as well.
Highlights
Tobacco is regarded as the most addictive substance in the world [1]
Current cigarette smokers who smoke at least 7 cigarettes per day for a year without betel quid chewing and cheroot smoking were regarded as CS, current cheroot smokers who smoke at least 5 cheroots per day for a year without betel quid chewing and cigarette smoking as CH, and current betel quid with tobacco chewers who chew at least 10 betel quids per day for a year without smoking as BQTC
Serum cotinine and F2-isoprostane levels of the CS were highest among the study groups, and risk of having metabolic syndrome was utmost in them
Summary
Tobacco is regarded as the most addictive substance in the world [1]. About 79.8% of Myanmar males are tobacco users [2]. This is the highest percentage among South-East Asia countries [3]. There are two main forms of tobacco use: smoking and smokeless tobacco use. Cigarette smoking is the most common form of smoked tobacco use but some people prefer cheroot, a kind of smoked tobacco made traditionally by hands. Among various forms of smokeless tobacco use in Myanmar, betel quid chewing is the most popular one, and is very common in people who want to give up smoking
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