title: Systemic conditions associated with areca nut usage: a literature review.
abstract: OBJECTIVE
  The adverse effects of areca nut (AN) chewing habit on oral health have been reported. However, the hazards related to the habit are not restricted to the oral cavity but they can also jeopardise the systemic health. Since no review reporting the harmful effects of AN chewing on systemic health is yet available, the aim of the present study was to review the systemic conditions associated with AN usage.
  
  
  METHODS
  To address the focused question ''What are the deleterious effects of AN usage on systemic health?'', the MEDLINE PubMed databases were explored from 1966 up to and including May 2010. The eligibility criteria included: human studies, individuals using AN, use of controls, and articles published in English. Hand-searching was also performed. Unpublished data was excluded.
  
  
  RESULTS
  The review included 28 articles. Seven studies associated AN chewing with cardiovascular disorders and three studies related the habit with cerebrovascular disorders. Eight studies related AN chewing with obesity, hyperglycaemia, metabolic syndrome, and type 2 diabetes mellitus. Five studies related AN chewing with the development of hepatic disorders. Two studies associated the chewing habit with oesophageal inflammation and fibrosis. Three studies associated AN chewing with respiratory discomfort. Renal disorders were related with the chewing abuse in two studies. Two studies showed an adverse effect of AN chewing on birth outcome.
  
  
  CONCLUSIONS
  AN chewing adversely affects systemic health by damaging the vital organs.
authors.affiliation: Eng.A.B. Growth Factors and Bone Regeneration Research Centre, King Saud University, Riyadh, Saudi Arabia. fawjav@gmail.com
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
authors.forename: Fernanda O
authors.initials: FO
authors.lastname: Bello Correra
authors.forename: Milisha
authors.initials: M
authors.lastname: Chotai
authors.forename: Anwar R
authors.initials: AR
authors.lastname: Tappuni
authors.forename: Khalid
authors.initials: K
authors.lastname: Almas
mesh_terms: D001114:Areca / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D008409:Mastication; D008659:Metabolic Diseases / Q000209:etiology; D009369:Neoplasms / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011634:Public Health; D012140:Respiratory Tract Diseases / Q000209:etiology; D012307:Risk Factors