In a series of 50 consecutive cases with oral or oropharyngeal malignancies, aryl hydrocarbon hydroxylase (AHH) inducibility and smoking habits were studied. 82% of the patients were smokers. The AHH levels were divided into high, intermediate and low groups and were correlated to a healthy control material also divided into the groups mentioned. A significant overrepresentation of patients with a high AHH level (p < 0.0005) as well as an underrepresentation of low AHH levels (p < 0.01) was found. Smokers with a high AHH level run a sixfold risk of developing cancer in this area and develop it earlier in life than people with low or intermediate AHH levels. Recurrences or secondary malignancies in the upper digestive tract or airways were substantially higher in the high AHH level group as compared to the other. A high AHH inducibility level thus is of both pathogenetic as well as prognostic importance in oral and/or oropharyngeal cancer.
Oral glucose tolerance test (OGTT) results were compared between 4,667 middle-aged males attending a preventive medical screening and intervention program in Malmö and the subjects in this sample who reported a history of previous operation for gastric or duodenal ulcer (n = 158, or 3.4%). 76% of the operated subjects were smokers in comparison with 50% in the general cohort of males of the same age. The glucose and insulin responses in the OGTT in both the smoking and non-smoking operated cases showed higher early peak values and a subsequent rapid drop of the levels with lower 120-min values of both glucose and insulin compared to the average screening cohort. This type of response to an oral glucose load had previously been well known in the acute and immediate postoperative stages of gastric and duodenal resection, but it had not been shown before that it seems to be a permanent effect and may chronically influence the results of OGTTs in the population. Gastro-duodenal surgery should be included among the factors which may significantly affect the chronic results and thereby also the clinical interpretation of the OGTTs in the population.
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