Background: The evidence of hepatotoxic effects of khat is
often based on limited numbers of case reports and animal
Aim: To evaluate the prevalence and severity of effects of khat
on the liver.
Materials and methods: A total of 214 khat users, Yemeni
people, included in the study. They were divided into two groups
according to the presence or absence of hepatic insult either
detected by elevated liver enzymes and/or abnormal hepatic
finding on abdominal ultrasonography. Full medical history, clinical
examination and calculation of body mass index (BMI) were done.
Fasting blood sugar, total lipid profile, liver enzymes were
estimated in all patients. Serum albumin, bilirubin and
prothrombin time were assessed in patients showing positive
hepatic damages (either by elevated liver enzymes and liver
ultrasound). Abdominal ultrasound scan was done for all patients.
Results: One hundred and forty-four (group I) khat users showed
a positive sign of hepatic injury either by elevated liver enzymes
in 127 patients and abnormal hepatic scan finding in 89 patients.
Four patients (3%) discovered to have liver cirrhosis. Patients
showed hepatotoxic effect of khat were significantly older in age
than participants without hepatic affection. Both subgroups with
variable BMI showed elevated ALT with no significant difference.
Liver ultrasound showed positive hepatic insult in 40% of khat
chewing patients with normal BMI, meaning that obesity is not
the responsible factor for fatty liver in the current study.
Conclusion: Hepatotoxic effect of khat is common. Confounding
issues other than khat were eliminated in the present study as
causative factors, such as alcohol consumption, coexisting
disease. Also, the effect of obesity was evaluated.
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