Liver Injury and Khat Leaves: A Common Toxic Effect

Background:The evidence of hepatotoxic effects of khat is often based on limited numbers of case reports and animal studies.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.