Background: Obese individuals are more likely to show insulin resistance (IR). However, limited population studies on marijuana use with markers of IR have yielded mixed results. The aim of this study was to examine the association of marijuana use with IR in US adults with different body mass index (BMI) status.
Methods: Data from the 2009 to 2016 National Health and Nutrition Examination Survey (NHANES) were abstracted. Minimal lifetime marijuana use was estimated using the duration of regular exposure and frequency of use. The association of marijuana use with both fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) was determined in lean, overweight, and obese individuals separately using generalized linear models. Interview weight years of data were used to account for the unequal probability of sampling and non-response.
Results: Of all 129 509 adults aged 18 to 59 years, 50.3% were women. In current obese marijuana consumers, mean FINS in those with less than four uses per month was 52% (95% confidence interval [CI] 19%-71%) lower than in never users. In former obese consumers with eight or more uses per month and who stopped marijuana use <12 months ago, mean FINS was 47% (95% CI 18%-66%) lower than in never users. Mean FINS in those who quit marijuana 12 to 119 and 120 months and more prior the survey was 36% (95% CI 7%-57%) and 36% (95% CI 10%-54%) lower, respectively.
Conclusions: Marijuana use is associated with lower FINS and HOMA-IR in obese but not non-obese adults, even at low frequency of less than four uses per month. Former marijuana consumers with high lifetime use had significantly lower FINS levels that persisted, independent of the duration of time since last use.
背景: 肥胖者更易出现胰岛素抵抗(insulin resistance, IR)。然而, 关于大麻使用与IR标记物的有限人群研究产生了不同的结果。本研究的目的是在不同体重指数(BMI)的美国成年人当中评估吸食大麻与IR之间的关系。 方法: 提取2009-2016年全国健康与营养调查研究(NHANES)的数据。使用定期吸食的持续时间以及吸食的频率来评估最小量的终身吸食大麻持续时间。使用广义线性模型分别在消瘦、超重以及肥胖的个体当中评估吸食大麻与空腹胰岛素(both fasting insulin, FINS)以及使用稳态模型评估的胰岛素抵抗(HOMA-IR)之间的关系。使用访谈权重年数据来解释抽样与无应答的概率不均衡。 结果: 共有129 509例18-59岁的成人, 其中50.3%为女性。在当前吸食大麻的肥胖个体中, 每月吸食次数少于4次的个体平均FINS要比从未吸食者低52%(95%置信区间[CI]:19%-71%)。在每月吸食8次或以上且在<12个月前停用大麻的既往肥胖患者中, 平均FINS要比从未吸食者低47%(95% CI:18%-66%)。在调查之前12~119个月与≥120个月就停止吸食大麻的个体平均FINS比从未吸食者分别低36%(95% CI:7%-57%)与36%(95% CI:10%-54%)。 结论: 与非肥胖的成年人相比, 肥胖的成年人吸食大麻后可导致FINS以及HOMA-IR降低, 即使他们每月吸食大麻的频率少于4次时也是如此。过去曾长期大量吸食大麻的个体的FINS水平显著降低, 并且与最后一次吸食后停吸的时间无关。.
Keywords: body mass index; insulin resistance; lifetime marijuana use; 体重指数; 终生吸食大麻; 胰岛素抵抗.
© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.