Diabetes, Metabolic Syndrome and Obesity (Sep 2021)
Metabolic Syndrome Associated with Tobacco and Caffeine Products Use Among Refugee Adolescents: Risk of Dyslipidemia
Abstract
Basma Damiri,1 Omar Khatib,2 Zaher Nazzal,3 Diala Sanduka,2 Siwar Igbaria,2 Ammar Thabaleh,2 Ahmad Farhoud,2 Lubna Saudi,3 Souad Belkebir,3 Rayyan Al Ali,4 Mohammed Alili,2 Mahmoud Hamdan,5 Omar A Safarini,2 Omar Younis2 1Medicine & Health Science Faculty, Drug, and Toxicology Division, An-Najah National University, Nablus, 00970, Palestine; 2Medicine & Health Science Faculty, Department of Medicine, An-Najah National University, Nablus, 00970, Palestine; 3Medicine & Health Science Faculty, Family and Community Medicine, An-Najah National University, Nablus, 00970, Palestine; 4Medicine & Health Sciences Faculty, Forensic Medicine Institute, An-Najah National University, Nablus, 00970, Palestine; 5Medicine & Health Science Faculty, Graduate School, Clinical Laboratory Science Program, An-Najah National University, Nablus, 00970, PalestineCorrespondence: Basma DamiriFaculty of Medicine and Health Sciences, Drug and Toxicology Division, An-Najah National University, P.O. Box 7, Nablus, 00970, PalestineTel +972592234270Email [email protected]: Due to their stressful lives, Palestinian refugees are prone to use cognitive enhancers (CE) and psychostimulant substances (PS). Recognising health problems associated with CE/PS use can indicate how preventive programs should be directed towards adolescents. Unfortunately, research has not thoroughly investigated the health problems related to tobacco and caffeine products, the most socially acceptable CE/PS among Palestinian refugee adolescents.Methodology: In 2021, schoolchildren from five Palestinian refugee camps (N=271) aged 12-< 16 years agreed to give blood samples and to be interviewed to address the association between metabolic syndrome (MetS) and tobacco smoking, coffee, energy drinks (ED), black tea, and chocolate consumption. MetS was diagnosed based on International Diabetic Federation Criteria. To address the association, we used binary logistic regression models adjusted to age, gender, BMI, and central obesity.Results: The prevalence of MetS was [17 (6.3%)]; (7.4%) in males, (5.1%) in females. The prevalence of substance use was as follows: ED [163 (48.9%)], coffee [255 (76.6%)], black tea [295 (89.1%)], cigarette [35 (10.5%)], waterpipe [59 (17.7%)], and chocolate [309 (93.6%)], with male predominance. Cigarette smokers have increased central obesity (p-value=0.024), and decreased HDL-cholesterol (p-value=0.015) than non-smokers. Similar results were observed for waterpipe smokers besides the increased levels of triglycerides (p-value=0.01). ED consumers have increased central obesity (p-value=0.03) and fast blood sugar (p-value=0.003) than non-consumers. Chocolate consumers have decreased central obesity (p-value=0.008) and increased HDL levels (p-value=0.04) than non-consumers. ED consumers were significantly at higher risk of MetS (OR=9.97, p-value=0.019) than non-consumers and chocolate consumers were at lower risk of MetS (OR=0.14, p-value=0.046) than non-consumers. Waterpipe smokers were at a higher risk of having increased plasma triglycerides than non-consumers (OR=3.4, p-value=0.03).Conclusion: The high prevalence of ED consumption and waterpipe smoking in Palestinian refugee adolescents is problematic. Their use was associated with higher odds of MetS, dyslipidemia, and central obesity, which justifies greater attention.Keywords: refugee adolescents, metabolic syndrome, tobacco smoking, cognitive enhancers and psychostimulants, dyslipidemia, UNRWA