Effect of Chronic Consumption of Smokeless Tobacco (Snuff) on Liver Enzymes of Males in Maiduguri, Northeast Nigeria

Abstract

Smokeless tobacco snuff consumption is as dangerous as cigarette smoking. It is now considered a significant source of morbidity and mortality owing to the effect of the numerous chemical constituents. Thus, this study was designed to investigate the effect of chronic consumption of Smokeless Tobacco (Snuff) on Liver Enzymes of males in Maiduguri and its environs, Northeast Nigeria. In this study we recruited 109 individuals who were smokeless tobacco snuffers and 97 healthy controls. It was a prospective case control study performed in adult males (30-50 years and 23 – 48 years for case and control respectively) with mean age of the case and control subjects of 37.12 ± 10.21and 33.64 ± 3.29 respectively. Serum Alanine amino transferase (ALT), Serum Aspartate amino transferase (AST) and serum Alkaline phosphatase (ALP) were estimated using kinetic methods by Cobas C311(Roche/Hitachi) chemistry auto analyzer. The estimated Serum AST, ALT, and ALP, levels were compared using un-paired student's t test between the two groups. Also, the liver enzyme levels were evaluated based on the duration of the smokeless tobacco consumption and correlation was determined. The age range of the study subjects was between 30 and 50 years and the mean age of the Case and control subjects were 37.12 ± 10.21and 33.64 ± 3.29 respectively. The mean(average) of the duration of tobacco snuff intake was 10.52 ± 7.02 years. The mean Serum level of AST, ALT, and ALP of tobacco snuffers were found to be higher (15.45 ± 3.32, 22.00 ± 5.10 and 22.00 ± 5.10 respectively) as compared to controls (10.42 ± 2.36, 8.88 ± 3.14 and 31.14 ± 4.60 for AST, ALT and ALP respectively) and the differences were statistically significant at p< 0.05. Also, the serum levels of the liver enzymes (AST, ALT, and ALP) were evaluated according to duration of snuff intake and the liver enzymes were found to be higher in people who uses the tobacco snuff for 11-20 years. However, the duration of the snuff intake was correlated with the serum levels of the liver enzymes. There was strong correlation between duration of snuff intake and serum levels of AST and ALT (r=0.648 and r=0.741 respectively) and the relationship were statistically significant at p<0.05. But the serum level of ALP was weekly correlated with the duration of snuff intake and the relationship was not statistically significant at p>0.05. From the results of the current study and the literature reviewed it is evident that tobacco snuff may likely be one of the causes of several liver diseases. Therefore, our study might be helpful in creating awareness on the hazards of using smokeless tobacco products (Snuff), among our population who are using smokeless tobacco.