父親嚼食檳榔是否會導致子女之代謝症候群提早發病？—以親子關係家族研究探討之

Does Paternal Exposure to Betel Quids Lead to Early Onset of Metabolic Syndrome? —A Population-based Parent-offspring Family Study

李奕瑋(Yi-Wei Lee)

指導教授 ： 陳秀熙

國立臺灣大學/公共衛生學院/預防醫學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.02242

摘要

研究背景：
嚼檳榔以及代謝症候群兩者在台灣的盛行率都相當高。然而，未如諸多遺傳與環境因素已被證實在代謝症候群的發生上扮演重要角色，嚼食檳榔是否可透過遺傳而影響代謝症候群發生的相關議題，卻無人類流行病學研究可引證。有鑑於此，本研究旨在分析父親的嚼檳榔史是否會顯著影響其子女罹患代謝症候群的機會。
材料與方法：
本研究之樣本來自一社區為基礎之複合式篩檢計畫，針對其中可追溯得親子關係者來進行分析。代謝症候群之罹病定義採NCEPATPIII的標準（其中腹部肥胖採用亞太區定義）。共溯得5092對親子關係，總數11583位民眾，其檳榔史、代謝症候群之判定資料與相關危險因子之記錄，以存活分析模式（Cox proportional hazards regression model）來探討嚼食檳榔可能之遺傳作用。
研究結果:
出生於父親嚼檳榔期間者，其代謝症候群的診斷年齡顯著低於父親未曾嚼食者（P<0.001），在校正過本人的嚼檳榔史和其他危險因子後，仍然有2.14倍的罹病風險（95%CI:1.25-3.66，P<0.01）。對於父、母都沒有代謝症候群病史且本人無嚼食習慣者，在校正了運動、蔬菜攝取習慣等因素後，其父親之嚼食檳榔仍會造成2.53倍的罹病風險（95%CI:1.03-6.24，P=0.04）。此外嚼食檳榔的劑量效應，無論是以每日用量、嚼食年數，或食用總量來看都有達到顯著的相關（三者皆得P<0.0001）。
結論:
本研究顯示檳榔可對子代罹患代謝症候群的情形造成影響，是故戒嚼檳榔對於代謝症候群的預防可能有相當之重要性。

關鍵字

檳榔 ； 家族研究 ； 代謝症候群

並列摘要

Background: Prevalence rates of betel nut chewing and metabolic syndrome (MS) are both high in Taiwan. As genetic factors and environmental factors play important roles in the development of MS, however, the impact of betel quids via inheritance on MS is poorly understood in human being study. The aim of this study was to elucidate whether paternal exposure to betel quids can significantly affect the risk for MS.
Materials and methods: Attendants of a population-based screening program with retrievable parentage relationship were included for this analysis. MS cases were defined according to the modified NCEP ATP III criteria. A total of 5092 pairs of parent-progeny relationship amounting to 11583 subjects with information concerning betel quid chewing, relevant risk factors and MS, were analyzed with Cox proportional hazards regression model.
Results: Offspring with paternal exposure of betel quids were significantly younger in diagnosed age of MS (P < 0.001) with an OR of 2.14 (95% CI:1.25-3.66, P < 0.01), adjusted for individual betel-chewing and other risk factors. After controlling for exercise and intake of vegetable, the effect of paternal exposure on the risk for MS in progeny in the absence of parental MS and without personal chewing history, was still significant (OR=2.53; 95% CI: 1.03-6.24, P=0.04). Besides, testing for trends showed significant dose-response effect according to quantity (P<0.0001), duration (P<0.0001), and intensity (P<0.0001) of betel quid chewing.
Conclusion: The present study corroborates the impact of betel quids on the risk of MS in offspring, which may have a significant implication for the prevention of MS.

並列關鍵字

family study ； betel quid ； metabolic syndrome

參考文獻

8. Chu NS (1993) Cardiovascular responses to betel chewing. Journal of the Formosan Medical Association 92:835-837.

2. Boucher BJ, Ewen SWB, Stowers JM (1994) Betel nut (Areca catechu) consumption and the induction of glucose intolerance in adult CD1 mice and in their F1 and F2 offspring. Diabetologia 37;49-55.

3. Boucher BJ, Mannan M (2002) Metabolic effects of the consumption of Areca catechu. Add Bio 7;103-110.

4. Byun SJ, Kim HS, Jeon SM, Park YB, Choi MS (2001) Supplementation of Areca catechu L. extract alters triglyceride absorption and cholesterol metabolism in rats. Annals of Nutrition & Metabolism 45:279-284.

5. Chen JW, Shaw JH (1996) A study on betel quid chewing behavior among Kaohsiung residents aged 15 years and above. J Oral Pathol Med 25;140-143.