Effect of betel chewing, tobacco smoking and alcohol consumption on oral submucous fibrosis: A case-control study in Sri Lanka

Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
Journal of Oral Pathology and Medicine (Impact Factor: 1.93). 05/2006; 35(4):197-201. DOI: 10.1111/j.1600-0714.2006.00400.x
Source: PubMed


Oral submucous fibrosis (OSMF) is a chronic, insidious, disabling potentially malignant condition of the oral mucosa seen predominantly in south and Southeast Asia. No reports are hitherto available on the aetiological factors of OSMF based on Sri Lankan patients.
A total of 74 patients with OSMF and 74 controls who consecutively attended the Oral Medicine clinic at the Dental Hospital (Teaching) Faculty of Dental Sciences, University of Peradeniya, Sri Lanka were included in the study. Binary logistic regression analyses were performed to model the influence of betel chewing, smoking and alcohol use and to determine the effects of different combinations of chewing habits on OSMF.
Betel chewing was the only significantly associated factor in the aetiology of OSMF (OR = 171.83, 95% CI: 36.35-812.25). There were no interaction effects of chewing, smoking and alcohol consumption in the causation of OSMF.
The present study has shown a strong association of betel quid chewing (including tobacco as an ingredient) with the causation of OSMF.

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    • "Our findings regarding the GSTT1 polymorphism are consistent with a meta-analysis of 19 oral cancer studies , which failed to find a significant relationship [20]. However, the genetic effect of the GSTT1-null genotype on OPMD risk was higher in 5 studies [7] [15] [18] [19] [28], lower in 2 [8] [10], and unchanged in 2 studies [14] [30]. The lack of a significant relationship between the GSTP1 genotype and OPMD in this study is consistent with 3 previous reports [27] [34] [39]. "
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    ABSTRACT: Background: This case-control study investigates the role of xenobiotic-metabolizing genes, including glutathione S-transferases (GSTs) and cytochrome P450 1A1 (CYP1A1) and 2E1 (CYP2E1), in the susceptibility to oral potentially malignant disorders (OPMDs). Methods: The genotypes of GSTM1, GSTT1, GSTP1, CYP1A1∗2C, and CYP2E1 PstI/RsaI polymorphisms were determined for 217 OPMD cases and 492 age- and sex-matched controls from a Taiwanese penitentiary. Results: Compared to the GSTM1-present genotype, the GSTM1-null genotype was significantly associated with increased risk of leukoplakia (odds ratio [OR]=1.46, 95% l [CI]=1.01–2.10). Similarly, compared to the CYP1A1∗2C A/G+G/G genotype, the CYP1A1∗2C A/A genotype was significantly associated with increased risk of leukoplakia (OR=1.64, 95% CI=1.12–2.40), particularly for smokers consuming > 13 pack-years of cigarettes (OR=2.40, 95% CI=1.40–4.11) (Interaction P=0.039). In addition, participants with 4–5 risk genotypes (OR > 1) experienced higher risks for leukoplakia than those with 0-1 risk genotypes (OR=3.19, 95% CI=1.65–6.15) (Trend test P=0.001). Conclusions: Our findings suggest that the CYP1A1∗2C A/A genotype may increase the risk of leukoplakia, especially for heavy smokers. Xenobiotic-metabolizing genes may simultaneously modulate this disease risk. These observations require further confirmation with larger samples.
    Disease markers 02/2013; 34(4). DOI:10.3233/DMA-130967 · 1.56 Impact Factor
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    • "A significant number of such malignancies develop from Oral Pre-cancers (OP) including Oral Sub-mucous Fibrosis (OSF), leukoplakia, of which the former is more common in the Indian subcontinent [4]. Although the association of OSF with malnutrition, immunological deficiencies, variations in oral habits and genetic predispositions has been reported [6] [7] [8] [9] [10] [11] [12] [13] yet understanding about its aetio-pathogenesis is still grossly inconclusive. "
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    ABSTRACT: Late-diagnosis of malignant potentiality of oral pre­ cancers like Oral Sub-mucous Fibrosis (OSF) contributes towards high mortality of oral cancer patients. Current study intends to differentiate Normal Oral Mucosa (NOM) from OSF stages in terms of expression of a prime candidate gene (p63), correlated with epithelial proliferation and maturation, for better assessment of malignant potentiality of the pre-cancer. Fifty three oral biopsies (i.e. 8 NOM, 45 OSF patients with and without dysplasia) were histopathologically evaluated by hematoxylin and eosin, whereas, p63+ nuclei were identified immunohistochemically. The differences in cellular arrangement, especially in epithelial basal layer of diseased epithelium were observed. In respect to p63 expression the percentage of nuclei positive to this molecule and their size were studied. The p63 expression was higher in dysplastic epithelium and distribution of p63+ cells and their nuclear shape features demonstrated remarkable differences between NOM and OSF stages.
    International Conference on Systems in Medicine and Biology (ICSMB), 2010; 12/2010

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