Prevalence and determinants of biochemical dysfunction of the liver in Atayal Aboriginal community of Taiwan: Is betel nut chewing a risk factor?

Lin, Ching Feng; Shiau, Tun Jen; Ko, Ying Chin; Chen, Ping Ho; Wang, Jung‐Der

doi:10.1186/1471-230x-8-13

Cited by 34 publications

(19 citation statements)

References 35 publications

(36 reference statements)

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“…It is known that persistent hepatic inflammation is a hallmark of habitual BQ chewing (Sarma et al, 1992;Gupta and Warnakulasuriya, 2002;Lin et al, 2008) and/or chronic HBV/HCV infection (Bouchard and Navas-Martin, 2011;El-Serag, 2012). Our results indicated that habitual BQ chewing do increase risk for HCC (Table 2) and hepatic fibrosis regardless of chronic hepatitis B or hepatitis C (Table 4 and Table 5).…”

Section: Discussionmentioning

confidence: 54%

“…Persistent hepatic inflammation is a hallmark of habitual BQ chewing (Sarma et al, 1992;Lin et al, 2008;Angadi and Rao, 2011) and/or chronic HBV/HCV infection (Bouchard and Navas-Martin, 2011;El-Serag, 2012). Hepatic fibrosis, or cirrhosis, is a common end-stage condition of many chronic liver diseases (Bouchard and Navas-Martin, 2011;Luedde and Schwabe, 2011;El-Serag, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Impact of Chronic Hepatitis B and Hepatitis C on Adverse Hepatic Fibrosis in Hepatocellular Carcinoma Related to Betel Quid Chewing

Jeng

Tsai²,

Tsai³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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The pathogenesis of hepatocellular carcinoma (HCC) related to habitual betel quid (BQ) chewing is unclear. Risk of HCCis increased with adverse hepatic fibrosis. This study aimed to assess the impact of chronic viral hepatitis on adverse hepatic fibrosis in HCC related to BQ chewing. This hospital-based case-control study enrolled 200 pairs of age-and gender-matched patients with HCC and unrelated healthy controls. Serologic hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV), α-fetoprotein (AFP), and surrogate markers for significant hepatic fibrosis were measured. Information on substance-use habits was obtained with a questionnaire. By analysis of surrogate markers for hepatic fibrosis, the prevalence of significant hepatic fibrosis in patients chewing BQ was between 45.8% and 91.7%, whereas that for patients without BQ chewing was between 18.4% and 57.9%. The difference was significant (P <0.05 for each surrogate marker). Multivariate analysis indicated that cirrhosis with Child-Pugh C (odds ratio (OR) = 3.28; 95% confidence interval (CI), 1.29-8.37), thrombocytopenia (OR = 3.92, 95% CI, 1.77-8.68), AFP >400 mg/L (OR = 2.21, 95% CI, 1.05-4.66) and male gender (OR = 4.06, 95% CI, 1.29-12.77) were independent factors associated with habitual BQ chewing. In conclusion, adverse hepatic fibrosis and severe liver damage play important roles in the pathogenesis of BQrelated HCC, which could be aggravated by chronic hepatitis B and hepatitis C. BQ-cessation programs and prevention of chronic HBV/HCV infection are needed to prevent HCC related to BQ chewing.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Impact of Chronic Hepatitis B and Hepatitis C on Adverse Hepatic Fibrosis in Hepatocellular Carcinoma Related to Betel Quid Chewing

Jeng

Tsai²,

Tsai³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Therefore, the Atayal tribe is Taiwan's second largest Indigenous group after the Amis. The Taiwan Atayal people have preserved their own languages (Huang 2008;Tsai and Wu 2012), customs (Chang et al 2008), diets (Lin et al 2008), and social organizations (Tang and Tang 2010).…”

Section: Research On Taiwanese Indigenous Peoplesmentioning

confidence: 99%

Atayal’s identification of sustainability: traditional ecological knowledge and indigenous science of a hunting culture

Fang

Lee

2015

Sustain Sci

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The history of Taiwan's Indigenous peoples is not well developed in written form, but has been passed down in oral form based on memories from the collective consciousness. However, tracing the cultural roots of Indigenous peoples' concepts of traditional ecological knowledge (TEK) and science is necessary to more deeply engage with Indigenous epistemologies. The main purpose of this narrative inquiry is to explore traditional concepts of the Indigenous Atayal aborigines of gaga (moral rules) and utux (faith) from a hunting culture, which has constructed their sustainability. This study was performed using qualitative social sciences. We listened to and collected stories by local tribes that live at elevations of 300-1300 m in northern Taiwan, and then conducted an analysis based on a joint construction of cultural meanings from rightsholders such as Atayal officers, tribe leaders, and local hunters. Using concepts from TEK, we determined how these concepts of gaga and utux became established in the lives of the Atayal people, and how Indigenous Atayal hunters have devoted their skills to maintaining the culture which sustains their resilient landscapes and ecosystems. Through the special cultural connotations of hunting knowledge and specifications, the hunting behavior of Taiwan's Atayal can shape a harmonic balance with ecological systems, and facilitate learning about competition and rules of survival in the natural environment.

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“…A large community study in Taiwan from 2003 to 2004 illustrated that the prevalence of elevated ALT in an adult population was 11.4%, and non-alcoholic fatty liver disease (NAFLD) seemed to be the most common cause of elevated ALT [9]. Moreover, there were 16.5% adults with abnormal ALT levels in an Atayal indigenous community [10]. Previous cross-sectional studies have reported a positive association between serum ALT level and MetS [11,12].…”

Section: Introductionmentioning

confidence: 99%

The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study

Chen

Lin

Yeh

et al. 2020

Preprint

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Background: Metabolic syndrome (MetS), a prevalent health condition in Taiwan, places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. Nevertheless, only limited studies about MetS have been conducted among indigenous peoples in Taiwan; these studies identified a high prevalence of MetS among an indigenous population, which encouraged us to investigate further. Thus, our study aims to determine the prevalence of MetS among the indigenous Taiwanese population and to explore the relationship between MetS and associated risk factors, especially serum alanine transaminase (ALT). Methods: This is an observational, population-based, cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2015. A total of 454 participants, 47.36% male and 52.64% female, were eligible for analysis. The participants underwent anthropometric assessment and measurements of blood pressure, serum triglyceride levels, fasting plasma glucose levels, serum HDL-C levels and serum ALT levels. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. Results: A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years old. People with MetS had a significantly higher ALT level (average 31.21±25.00 U/L vs. 23.29±15.98 U/L, p<0.001) than those without MetS. In addition, the chi-square comparison showed that participants with abnormal ALT levels (>36 U/L) had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p=0.001) than those with normal ALT levels (≤36 U/L). The adjusted odds ratio (OR) of abnormal ALT levels for MetS was 2.58 (95% CI=1.23-5.44, p=0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI=0.58-0.68, p<0.001), which showed that the ALT level was positively associated with MetS. Conclusions: The overall prevalence of MetS was 61.01% in the highland indigenous population in Taiwan, which suggests an unignorable health problem that should actively be addressed. Furthermore, these findings indicated that higher serum ALT levels (>36 U/L) were associated with an increased risk of MetS.

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Prevalence and determinants of biochemical dysfunction of the liver in Atayal Aboriginal community of Taiwan: Is betel nut chewing a risk factor?

Abstract: Background: We address the independent and interactive roles of habitual betel quid chewing and other known risk factors for biochemical dysfunction and cirrhosis of the liver.

Cited by 34 publications

References 35 publications

Impact of Chronic Hepatitis B and Hepatitis C on Adverse Hepatic Fibrosis in Hepatocellular Carcinoma Related to Betel Quid Chewing

Impact of Chronic Hepatitis B and Hepatitis C on Adverse Hepatic Fibrosis in Hepatocellular Carcinoma Related to Betel Quid Chewing

Atayal’s identification of sustainability: traditional ecological knowledge and indigenous science of a hunting culture

The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study

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