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Open access

Rungnapa Ittiwut, Pichit Siriwan, Kanya Suphapeetiporn and Vorasuk Shotelersuk



Oral clefts, including cleft lip (CL), CL with cleft palate (CL/CP), and cleft palate only (CPO), are among the most common birth defects, and if left untreated can cause significant morbidity. Causes are complex and involve both genetic and environmental factors. Several studies have demonstrated the highest prevalence of oral clefts being in Asian, white, and African populations. However, there have been very few epidemiological studies of oral clefts in Thais.


To describe the epidemiology and factors associated with oral clefts in Thais.


This retrospective case-control observational study included individuals from numerous regions in Thailand. We reviewed data regarding 784 patients with an oral cleft collected in questionnaires as part of the Thai nationwide Smart Smile and Speech Project from 2006 to 2014. Data regarding patients with oral clefts were analyzed, and compared with data regarding 187 unaffected controls.


Of 784 cases, CL/CP accounted for 59.8%, CPO 21.9%, and CL 18.3%. A family history of oral clefts was detected in all 3 types (P < 0.001). Maternal use of any drugs or herbal medicine not prescribed by physicians during pregnancy in cases of CPO (P = 0.049) and maternal consumption of alcohol during pregnancy in cases of CL/CP (P = 0.047) were significantly higher than that by mothers of controls.


CL/CP is the most common type of oral cleft. A family history of oral clefts, and maternal consumption of alcohol or nonprescribed drugs are positively associated with oral clefts in Thais.

Open access

Wichaporn Intharachuti, Rungnapa Ittiwut, Jenifer Listman, Viroj Verachai, Apiwat Mutirangura, Robert T. Malison and Rasmon Kalayasiri


Background: Inhalants are abused by adolescents worldwide, but genetic markers of inhalant use or dependence are poorly understood.

Objective: We assessed the frequency and association of a functional polymorphism in the gene encoding catechol-O-methyltransferase (COMT Val158Met) in inhalant-dependent (ID) subjects and inhalant users (IU).

Methods: Demographic and diagnostic data were collected by interviewing 456 Thai-speaking methamphetamine (MA) users by using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). COMT Val158Met (rs4680) genotyping was acquired by restriction fragment length polymorphism. Individuals with ID or IU were compared with non-ID or non-IU by using a χ2 test. After that, factors associated with ID or IU were analyzed by logistic regression. Blood samples from 217 healthy blood donors were used as controls for ID and IU in the allele frequency comparison. Deviation from Hardy-Weinberg Equilibrium Expectations (HWEE) was also tested.

Results: Out of 456 MA users, deviation from HWEE was observed in IU but not in ID, non-ID or from the total sample. The “Met” allele was significantly associated with ID (p = 0.02) and IU (p = 0.002) among MA users, but not in allele frequency comparisons when compared to the healthy control group (p > 0.1). With respect to logistic regression analysis, homo or heterozygosity for the “Met” allele, male sex, younger age, lower level of education, a major depressive episode (MDE), and alcohol dependence were associated with ID. Analyses of IU vs. non-IU yielded the same results except for age and MDE. In addition, individuals with MA-induced paranoia (MIP) were more likely to have used inhalants at least once in their lifetime compared to those without.

Conclusion: COMT 158Met, male sex, younger age, lower level of education, MDE, MIP, and alcohol dependence increased risk for inhalant use and/or dependence.