Abstract
Background and AimThe association of betel nut with liver cirrhosis among alcohol drinkers has been clearly shown. However, very few studies have shown such an association among non-alcohol drinkers. The aim of this study was to assess the relationship between betel nut chewing and cirrhosis among non-alcohol drinkers.Materials and MethodsThis study retrospectively analyzed data retrieved from the 2012 Adult Preventive Medical Services and the National Health Insurance Research Datasets in Taiwan. Participants’ information included physical examination and lifestyle, alongside laboratory tests. Betel nut chewers were grouped into three categories: never, occasional and frequent. Diseases were diagnosed using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Initially, 1573024 adults aged 40 years and above who engaged in the free adult preventive medical services in 2012 were recruited. However, only 1065246 of them were included in the analysis. Chi-square test and logistic regression were used for the analyses.ResultsAfter multivariable adjustments, there were significant relationships between cirrhosis and betel nut chewing in both sexes (P-trend < 0.0001). The risk of cirrhosis was greater in females than males. The odds ratios of cirrhosis in occasional and frequent female chewers were respectively 2.91; 95% C.I: 1.75–4.83 and 3.06; 95% C.I: 1.69–5. However, they were respectively 1.76; 95% C.I: 1.47–2.10 and 2.32; 95% C.I: 1.90–2.85 in occasional and frequent male chewers.ConclusionsThis study demonstrated significant relationships between betel nut chewing and cirrhosis in both male and female non-alcohol drinkers. The risk of cirrhosis was greater in female than male chewers.
Highlights
Liver cirrhosis is the 6th disease-related principal cause of death in Taiwan [1]
After multivariable adjustments, there were significant relationships between cirrhosis and betel nut chewing in both sexes (P-trend < 0.0001)
This study demonstrated significant relationships between betel nut chewing and cirrhosis in both male and female non-alcohol drinkers
Summary
Liver cirrhosis is the 6th disease-related principal cause of death in Taiwan [1]. Advanced fibrotic changes in a chronically damaged liver could lead to cirrhosis [2, 3]. The betel nuts chewed in Taiwan are wrapped in piper betel leaves [4]. They are not mixed with tobacco [18, 19]. The association of betel nut chewing with liver cirrhosis among alcohol drinkers has been clearly shown [4,5,6,7]. The aim of our study was to assess the association between betel nut chewing and cirrhosis among male and female non-alcohol drinkers. The association of betel nut with liver cirrhosis among alcohol drinkers has been clearly shown. The aim of this study was to assess the relationship between betel nut chewing and cirrhosis among non-alcohol drinkers
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