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Corroon J, Grant I, Allison MA, Bradley R. Associations Between Monthly Cannabis Use and Myocardial Infarction in Middle-Aged Adults: NHANES 2009 to 2018. Am J Cardiol 2023; 204:226-233. [PMID: 37556891 PMCID: PMC10998689 DOI: 10.1016/j.amjcard.2023.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023]
Abstract
Mechanistic research suggests using Cannabis sativa L. (cannabis or marijuana) may increase the risk of cardiometabolic disease, but observational studies investigating associations between cannabis use and myocardial infarction (MI) have reported inconsistent results. Cross-sectional National Health and Nutrition Examination Survey data from five 2-year cycles between 2009 and 2018 and representing 9,769 middle-aged adults (35 to 59 years old) were analyzed. Multivariable logistic regression models accounting for sampling weights and adjusting for cardiovascular risk factors were used to assess associations between a history of monthly cannabis use before MI and a subsequent MI. A quarter of respondents (n = 2,220) reported a history of monthly use >1 year before an MI. A history of MI was reported by 2.1% of all respondents and 3.2.% of those who reported a history of monthly use. In fully adjusted multivariable models, and compared with never use, a history of monthly cannabis use preceding an MI was not associated with an MI (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.35 to 1.71). However, when stratified by recent use, the odds of MI were threefold greater (OR 2.98, 95% CI 1.08 to 8.60) when no use was reported within the past month than when use was reported within the past month. Duration of monthly use was also not significantly associated with MI, including monthly use >10 years (OR 0.78, 95% CI 0.30 to 2.01). In conclusion, in a representative sample of middle-aged US adults, a history of monthly cannabis use >1 year before an MI was not associated with a subsequent physician-diagnosed MI, except for threefold greater odds when cannabis was not used within the past month.
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Affiliation(s)
- Jamie Corroon
- Department of Family Medicine, University of California San Diego, San Diego, California.
| | - Igor Grant
- Center for Medicinal Cannabis Research, Department of Psychiatry, University of California San Diego, San Diego, California
| | - Matthew A Allison
- Department of Family Medicine, University of California San Diego, San Diego, California
| | - Ryan Bradley
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California
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2
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Lisano JK, Kisiolek J, Flores V, Smoak P, Pullen NA, Stewart LK. Chronic cannabis use is associated with altered monocyte phenotype, immune response, and depression in physically active individuals. Can J Physiol Pharmacol 2023; 101:316-326. [PMID: 36867857 DOI: 10.1139/cjpp-2022-0451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Introduction: This study evaluated depression, monocyte phenotype, and immune function in physically active cannabis users. Methods: Participants (N = 23) were classified as either cannabis users (CU, n = 11) or non-users (NU, n = 12). White blood cells isolated from blood were analyzed for co-expression of cluster of differentiation 14 and 16 using flow cytometry. Lipopolysaccharide (LPS) was cultured with whole blood and assessed for interleukin-6 and tumor necrosis factor-α (TNF-α) release. Results: The percentage of white blood cells classified as monocytes was not different between groups; however, CU had a significantly greater percentage of monocytes classified as intermediate (p = 0.02). When standardized per milliliter of blood, CU had significantly greater numbers of total monocytes (p = 0.01), classical monocytes (p = 0.02), and intermediate monocytes (p = 0.01). Intermediate monocytes per milliliter of blood were positively correlated to the number of times CU used cannabis per day (r = 0.864, p < 0.01) and Beck Depression Inventory-II (BDI-II) score (r = 0.475, p = 0.03), which was significantly greater in CU (5.1 ± 4.8) compared with NU (0.8 ± 1.0; p < 0.01). CU released significantly less TNF-α per monocyte in response to LPS. Conclusions: CU had altered monocyte phenotypes and functions compared with NU. Elevations in intermediate monocytes were positively correlated with measures of cannabis use and BDI-II score.
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Affiliation(s)
- Jonathon K Lisano
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO, USA
| | - Jacob Kisiolek
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO, USA
| | - Victoria Flores
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO, USA
| | - Peter Smoak
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO, USA
| | - Nicholas A Pullen
- School of Biological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Laura K Stewart
- Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO, USA
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3
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Shah S, Schwenk ES, Sondekoppam RV, Clarke H, Zakowski M, Rzasa-Lynn RS, Yeung B, Nicholson K, Schwartz G, Hooten WM, Wallace M, Viscusi ER, Narouze S. ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids. Reg Anesth Pain Med 2023; 48:97-117. [PMID: 36596580 DOI: 10.1136/rapm-2022-104013] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear. METHODS In November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids. A consensus recommendation required ≥75% agreement. RESULTS Nine questions were selected, with 100% consensus achieved on third-round voting. Topics addressed included perioperative screening, postponement of elective surgery, concomitant use of opioid and cannabis perioperatively, implications for parturients, adjustment in anesthetic and analgesics intraoperatively, postoperative monitoring, cannabis use disorder, and postoperative concerns. Surgical patients using cannabinoids are at potential increased risk for negative perioperative outcomes. CONCLUSIONS Specific clinical recommendations for perioperative management of cannabis and cannabinoids were successfully created.
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Affiliation(s)
- Shalini Shah
- Dept of Anesthesiology & Perioperative Care, UC Irvine Health, Orange, California, USA
| | - Eric S Schwenk
- Anesthesiology and Perioperative Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Hance Clarke
- Anesthesiology and Pain Medicine, Univ Toronto, Toronto, Ontario, Canada
| | - Mark Zakowski
- Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - Brent Yeung
- Anesthesiology and Perioperative Care, University of California Irvine, Irvine, California, USA
| | | | - Gary Schwartz
- AABP Integrative Pain Care, Melville, New York, USA.,Anesthesiology, Maimonides Medical Center, Brooklyn, New York, USA
| | | | - Mark Wallace
- Anesthesiology, Division of Pain Medicine, University of California San Diego, La Jolla, California, USA
| | - Eugene R Viscusi
- Anesthesiology and Perioperative Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Samer Narouze
- Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, Ohio, USA
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4
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Lisano JK, Flores VA, Kisiolek JN, Stewart LK. Regular Use of Cannabis in Female Athletes Is Associated With a Reduction in Early Anaerobic Power Production. J Strength Cond Res 2023; 37:616-622. [PMID: 36820704 DOI: 10.1519/jsc.0000000000004297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
ABSTRACT Lisano, JK, Flores, VA, Kisiolek, JN, and Stewart, LK. Regular use of cannabis in female athletes is associated with a reduction in early anaerobic power production. J Strength Cond Res 37(3): 616-622, 2023-Despite a growing number of claims related to the ability of cannabis use to affect health and performance, there is limited research available, especially in female athletes. This cross-sectional study aimed to determine whether chronic cannabis use in physically active female athletes is related to altered health and performance. Healthy, physically active, female cannabis users (CU: n = 12) and noncannabis users (NU: n = 12) with an average age of 23.8 ± 3.7 years and 19.3 ± 4.2% body fat completed athletic performance and health assessments. Significance was set at alpha = 0.05. The age of onset of regular cannabis use was 20.1 ± 2.8 years in CU with an average duration of cannabis use of 5.8 ± 3.1 years. There were no differences between groups with respect to body size, body composition, pulmonary function, cardiorespiratory function, or muscular strength. Cannabis users produced significantly less power in the first 2 stages of the Wingate assessment, but CU experienced significantly less anaerobic fatigue. Although body composition and cardiovascular fitness were comparable, average C-reactive protein concentration classified CU with higher risk for cardiovascular disease (CVD). Athletes and coaches who rely heavily on anaerobic performance should consider these findings because they indicate that regular cannabis use may affect early power production and CVD risk.
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Affiliation(s)
- Jonathon K Lisano
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorado
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5
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Schrock JM, McDade TW, D'Aquila RT, Mustanski B. Does body mass index explain the apparent anti-inflammatory effects of cannabis use? Results From a cohort study of sexual and gender minority youth. Drug Alcohol Depend 2022; 233:109344. [PMID: 35182843 PMCID: PMC8988174 DOI: 10.1016/j.drugalcdep.2022.109344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/28/2022] [Accepted: 01/29/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cannabis use has been linked to lower systemic inflammation, but the pathways connecting cannabis use and systemic inflammation are unclear. Here we investigate whether body mass index (BMI) accounts for the association between cannabis use and systemic inflammation in a cohort of sexual and gender minority youth assigned male at birth (n = 712). METHODS Substance use was assessed across six biannual visits. Cannabis use was measured using the Cannabis Use Disorders Identification Test-Revised (CUDIT-R) and urine screening for tetrahydrocannabinol (THC). At the final visit, BMI was measured, and a plasma sample was collected to measure biomarkers of systemic inflammation: C-reactive protein (CRP), interleukin-6, interleukin-1β, and tumor necrosis factor-α. Inflammatory markers were log2-transformed. Age, gender, race/ethnicity, education, HIV status, cigarette use, alcohol use, and polydrug use were included as covariates. RESULTS In models including all covariates except BMI, greater cumulative CUDIT-R score was associated with lower CRP (β = -0.14; 95% CI: -0.22,-0.05) and lower interleukin-6 (β = -0.12; 95% CI: -0.21,-0.04). These associations were attenuated when BMI was added to the model. Mediation analyses revealed an indirect effect of cumulative CUDIT-R score on CRP (β = -0.08; 95% CI: -0.12,-0.05) and interleukin-6 (β = -0.08; 95% CI: -0.12,-0.05), mediated by BMI. Models using urine THC or self-reported frequency to operationalize cannabis use produced similar results. We found no clear evidence that HIV status moderates these associations. CONCLUSIONS These results suggest that BMI may partially account for the apparent anti-inflammatory effects of cannabis use. Research on the mechanisms linking cannabis use, adiposity, and inflammation may uncover promising intervention targets.
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Affiliation(s)
- Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL 60611, USA; Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA.
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Richard T D'Aquila
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Arkes Suite 2330, Chicago, IL 60611, USA.
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, 21st Floor, Chicago, IL 60611, USA.
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6
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Romeo B, Lestra V, Martelli C, Benyamina A, Hamdani N. Cannabis Cessation, Inflammatory Markers and Schizophrenia. J Dual Diagn 2022; 18:33-41. [PMID: 34985404 DOI: 10.1080/15504263.2021.2013697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective A dysbalance of the immune system in schizophrenia has been largely described but few studies have investigated the impact of cannabis use on inflammatory markers in patients with schizophrenia. The objective of our study was to investigate the impact of cannabis use on high-sensitivity C-reactive protein (hsCRP), fibrinogen levels and leucocytic formula in patients with schizophrenia. Methods: Thirty-eight acutely ill inpatients with schizophrenia were included. Patient hsCRP, fibrinogen levels, leukocytic formula and urinary cannabis were measured at baseline and after four weeks of treatment. Results: After four weeks of cannabis cessation (as confirmed by urinary tests), we found an increase of hsCRP level (p = .016) and lymphocytes (p = .03) in consumers patients whereas no difference was observed in non-consumers patients. As compared to non-consumers patients with schizophrenia, consumers had lower levels of hsCRP (p = .045). Finally, a negative correlation was found between the PANSS score evolution (between baseline and 4 weeks) and baseline hsCRP level. Conclusions: In our study, cannabis cessation raises inflammatory markers though improving clinical symptoms. The investigation and the understanding of interactions between cannabis use and inflammatory markers in patients with schizophrenia is of importance and could in the future be a new target for treatment of psychiatric symptoms linked to inflammation.
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Affiliation(s)
- Bruno Romeo
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif, France.,Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche 4872 PSYCOMADD Université Paris Sud - AP-HP - Université Paris Saclay, Villejuif, France
| | - Valentine Lestra
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif, France
| | - Catherine Martelli
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif, France.,Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche 4872 PSYCOMADD Université Paris Sud - AP-HP - Université Paris Saclay, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale U1299, Research unit, NeuroImaging and Psychiatry, Paris Sud University- Paris Saclay University, Paris Descartes University, Digiteo Labs, Gif-sur- Yvette, France
| | - Amine Benyamina
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif, France.,Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche 4872 PSYCOMADD Université Paris Sud - AP-HP - Université Paris Saclay, Villejuif, France
| | - Nora Hamdani
- Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche 4872 PSYCOMADD Université Paris Sud - AP-HP - Université Paris Saclay, Villejuif, France.,Cédiapsy, Paris, France
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7
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Montoya-Alatriste CA, Alarcon-Aguilar FJ. Cannabis and cannabinoids as an alternative remedy in metabolic syndrome. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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8
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Morcuende A, Navarrete F, Nieto E, Manzanares J, Femenía T. Inflammatory Biomarkers in Addictive Disorders. Biomolecules 2021; 11:biom11121824. [PMID: 34944470 PMCID: PMC8699452 DOI: 10.3390/biom11121824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 12/21/2022] Open
Abstract
Substance use disorders are a group of diseases that are associated with social, professional, and family impairment and that represent a high socio-economic impact on the health systems of countries around the world. These disorders present a very complex diagnosis and treatment regimen due to the lack of suitable biomarkers supporting the correct diagnosis and classification and the difficulty of selecting effective therapies. Over the last few years, several studies have pointed out that these addictive disorders are associated with systemic and central nervous system inflammation, which could play a relevant role in the onset and progression of these diseases. Therefore, identifying different immune system components as biomarkers of such addictive disorders could be a crucial step to promote appropriate diagnosis and treatment. Thus, this work aims to provide an overview of the immune system alterations that may be biomarkers of various addictive disorders.
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Affiliation(s)
- Alvaro Morcuende
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Elena Nieto
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Teresa Femenía
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-965-919-553
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9
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Shuster DL, Pastino G, Cerneus D. Framework for the Design of Cannabis-Mediated Phase I Drug-Drug Interaction Studies. Curr Rev Clin Exp Pharmacol 2021; 17:18-25. [PMID: 34455952 DOI: 10.2174/2772432816666210813123716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/22/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022]
Abstract
Cannabis has become legal in much of the United States similarly to many other countries, for either recreational or medical use. The use of cannabis products is rapidly increasing while the body of knowledge of its myriad of effects still lags. In vitro and clinical data show that cannabis' main constituents, delta-9-tetrahydrocannabinol and cannabidiol, can affect the pharmacokinetics (PK), safety and pharmacodynamics (PD) of other drugs. Within the context of clinical drug development, the widespread and frequent use of cannabis products has essentially created another special population; that is, the cannabis user. We propose that all clinical drug development programs include a Phase 1 study to assess the drug-drug interaction potential of cannabis as a precipitant on the PK, safety and if applicable, the PD of all new molecular entities (NMEs) in a combination of healthy adult subjects as well as frequent and infrequent cannabis users. This data should be required to inform drug labeling and aid health care providers in treating any patient, as cannabis has quickly become another common concomitant medication and cannabis users, a new special population.
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Affiliation(s)
| | - Gina Pastino
- PRA Health Sciences, Millcreek, UT. United States
| | - Dirk Cerneus
- PRA Health Sciences, Millcreek, UT. United States
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10
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Ong LQ, Bellettiere J, Alvarado C, Chavez P, Berardi V. Cannabis use, sedentary behavior, and physical activity in a nationally representative sample of US adults. Harm Reduct J 2021; 18:48. [PMID: 33926458 PMCID: PMC8086340 DOI: 10.1186/s12954-021-00496-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 04/20/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Prior research examining the relationship between cannabis use, sedentary behavior, and physical activity has generated conflicting findings, potentially due to biases in the self-reported measures used to assess physical activity. This study aimed to more precisely explore the relationship between cannabis use and sedentary behavior/physical activity using objective measures. METHODS Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey. A total of 2,092 participants (ages 20-59; 48.8% female) had accelerometer-measured sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Participants were classified as light, moderate, frequent, or non-current cannabis users depending on how often they used cannabis in the previous 30 days. Multivariable linear regression estimated minutes in sedentary behavior/physical activity by cannabis use status. Logistic regression modeled self-reported moderate-to-vigorous physical activity in relation to current cannabis use. RESULTS Fully adjusted regression models indicated that current cannabis users' accelerometer-measured sedentary behavior did not significantly differ from non-current users. Frequent cannabis users engaged in more physical activity than non-current users. Light cannabis users had greater odds of self-reporting physical activity compared to non-current users. CONCLUSIONS This study is the first to evaluate the relationship between cannabis use and accelerometer-measured sedentary behavior and physical activity. Such objective measures should be used in other cohorts to replicate our findings that cannabis use is associated with greater physical activity and not associated with sedentary behavior in order to fully assess the potential public health impact of increases in cannabis use.
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Affiliation(s)
- Lydia Q Ong
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, 9500 Gillman Drive, San Diego, CA, 92093, USA.
| | - Citlali Alvarado
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Paul Chavez
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, 9500 Gillman Drive, San Diego, CA, 92093, USA
| | - Vincent Berardi
- Department of Psychology, Chapman University, 1 University Drive, Orange, CA, 92866, USA.
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11
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Diaz AA, Colangelo LA, Okajima Y, Yen A, Sala MA, Dransfield MT, Tino G, Ross JC, San José Estépar R, Washko GR, Kalhan R. Association between Cardiorespiratory Fitness and Bronchiectasis at CT: A Long-term Population-based Study of Healthy Young Adults Aged 18-30 Years in the CARDIA Study. Radiology 2021; 300:190-196. [PMID: 33904771 DOI: 10.1148/radiol.2021203874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Protective factors against the risk of bronchiectasis are unknown. A high level of cardiorespiratory fitness is associated with a lower risk of chronic obstructive pulmonary disease. But whether fitness relates to bronchiectasis remains, to the knowledge of the authors, unknown. Purpose To examine the association between cardiorespiratory fitness and bronchiectasis. Materials and Methods This was a secondary analysis of a prospective observational study: the Coronary Artery Risk Development in Young Adults cohort (from 1985-1986 [year 0] to 2015-2016 [year 30]). During a 30-year period, healthy participants (age at enrollment 18-30 years) underwent treadmill exercise testing at year 0 and year 20 visits. Cardiorespiratory fitness was determined according to the treadmill exercise duration. The 20-year difference in cardiorespiratory fitness was used as the fitness measurement. At year 25, chest CT was performed to assess bronchiectasis and was used as the primary outcome. Multivariable logistic models were performed to determine the association between cardiorespiratory fitness changes and bronchiectasis. Results Of 2177 selected participants (at year 0: mean age, 25 years ± 4 [standard deviation]; 1224 women), 209 (9.6%) had bronchiectasis at year 25. After adjusting for age, race-sex group, study site, body mass index, pack-years smoked, history of tuberculosis, pneumonia, asthma and myocardial infarction, peak lung function, and cardiorespiratory fitness at baseline, preservation of cardiorespiratory fitness was associated with lower odds of bronchiectasis at CT at year 25 (per 1-minute-longer treadmill duration from year 0 to year 20: odds ratio [OR], 0.88; 95% CI: 0.80, 0.98; P = .02). A consistent strong association was found when cough and phlegm were included in bronchiectasis (OR, 0.72; 95% CI: 0.59, 0.87; P < .001). Conclusion In a long-term follow-up, the preservation of cardiorespiratory fitness was associated with lower odds of bronchiectasis at CT. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Stojanovska in this issue.
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Affiliation(s)
- Alejandro A Diaz
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Laura A Colangelo
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Yuka Okajima
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Andrew Yen
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Marc A Sala
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Mark T Dransfield
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Gregory Tino
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - James C Ross
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Raúl San José Estépar
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - George R Washko
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
| | - Ravi Kalhan
- From the Division of Pulmonary and Critical Care Medicine (A.A.D., Y.O., G.R.W.) and Department of Radiology (J.C.R., R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (L.A.C., R.K.); Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.A.S., R.K.); Department of Radiology, University of California, San Diego, San Diego, Calif (A.Y.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Ala (M.T.D.); and Department of Medicine, Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (G.T.)
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12
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Fuster D, García-Calvo X, Bolao F, Zuluaga P, Rocamora G, Hernández-Rubio A, Sanvisens A, Tor J, Muga R. Cannabis use is associated with monocyte activation (sCD163) in patients admitted for alcohol use disorder treatment. Drug Alcohol Depend 2020; 216:108231. [PMID: 32818911 DOI: 10.1016/j.drugalcdep.2020.108231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/20/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The effect of concomitant cocaine and cannabis use on monocyte activation and inflammation in patients with alcohol use disorder (AUD) is unknown. METHODS To analyze the impact of cocaine and cannabis use on levels of markers of monocyte activation (sCD163 and sCD14) and systemic inflammation (interleukin-6 [IL-6]) in AUD patients admitted for hospital treatment between 2013 and 2018. Clinical and laboratory parameters were obtained upon admission. IL-6, sCD163, and sCD14 were measured in frozen plasma samples. We performed logistic regression to detect associations between cocaine and cannabis use and markers of monocyte activation and inflammation in the highest quartile. RESULTS A total of 289 patients (77.5 % male) were included (median age = 50 years). The median alcohol intake upon admission was 142 g/day. The median duration of AUD was 20 years. Of the 289 patients with AUD, 76 % were active smokers, 23.1 % and 22.1 % concomitantly used cocaine and cannabis, respectively The median levels of IL-6, sCD163, and sCD14 were 4.37 pg/mL, 759 ng/mL, and 1.68 × 106 pg/mL, respectively. We did not detect associations between cocaine use and inflammation or monocyte activation. Cannabis use was associated with a higher odds of having sCD163 levels in the highest quartile (adjusted odds ratio = 2.34, 95 % confidence interval = 1.07-5.15, p = 0.03). Cannabis use was not associated with inflammation. CONCLUSION In this series of AUD patients the concomitant use of cannabis use was associated with sCD163 levels that were in the highest quartile, consistent with monocyte activation.
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Affiliation(s)
- Daniel Fuster
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain.
| | - Xavier García-Calvo
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
| | - Ferran Bolao
- Department of Internal Medicine, Hospital Universitari Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08907, Spain
| | - Paola Zuluaga
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
| | - Gemma Rocamora
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
| | - Anna Hernández-Rubio
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
| | - Arantza Sanvisens
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
| | - Jordi Tor
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
| | - Robert Muga
- Department of Internal Medicine, Addiction Unit Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Badalona, 08916, Spain
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13
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Okafor CN, Li M, Paltzer J. Self-reported cannabis use and biomarkers of inflammation among adults in the United States. Brain Behav Immun Health 2020; 7:100109. [PMID: 33615280 PMCID: PMC7894624 DOI: 10.1016/j.bbih.2020.100109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/15/2020] [Accepted: 07/19/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cannabis is among the most frequently used substance in United States (U.S.). Studies evaluating the association between cannabis use and inflammation in humans have been few and have not explored potential sex-dependent effects. OBJECTIVE To examine the relationship between self-reported cannabis use and high-sensitivity C-reactive protein (hsCRP), Interleukin 6 (IL-6) and fibrinogen. METHODS We used Wave 1 of the Population Assessment of Tobacco and Health (PATH) - a nationally representative sample of adults in the U.S. Weighted linear regression models were used to determine associations of self-reported cannabis use with natural log-transformed hs-CRP, IL-6 and fibrinogen adjusting for sociodemographic and psychosocial factors. RESULTS Self-reported cannabis use, particularly cannabis use within the past 30 days, was associated with lower levels of each biomarker of systemic inflammation, although findings were imprecise. Specifically, in multivariable models, the associations between respondents who self-reported cannabis use in the past 30 days compared to never use was imprecise for hs-CRP (β= -0.15, 95% confidence interval (CI): -0.32, 0.00), IL-6 (β= - 0.02, 95% CI: -0.10, 0.05) and fibrinogen (β= - 0.01, 95% CI: -0.04, 0.02). We did not find that these associations differed significantly by sex. DISCUSSIONS Data from this nationally representative study suggest potential anti-inflammatory effects of recent cannabis use. Additional studies that biologically measure the THC and CBD concentrations of the cannabis used and employ prospective and or experimental study designs investigate cannabis and inflammation associations are needed.
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Affiliation(s)
- Chukwuemeka N. Okafor
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, One Bear Place #97343, Waco, TX, 76798, USA
| | - Michael Li
- Department of Family Medicine, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA
| | - Jason Paltzer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, One Bear Place #97343, Waco, TX, 76798, USA
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Alshaarawy O. Total and differential white blood cell count in cannabis users: results from the cross-sectional National Health and Nutrition Examination Survey, 2005-2016. J Cannabis Res 2019; 1. [PMID: 33225221 PMCID: PMC7678768 DOI: 10.1186/s42238-019-0007-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Elevated white blood cell (WBC) count in tobacco cigarette smokers compared to non-smokers has been well documented, but little is known on circulating WBC counts and cannabis use. Methods The National Health and Nutrition Examination Survey (2005–2016) is designed to be nationally representative of United States non-institutionalized population. The current study includes adult participants 20–59 years of age (n = 16,430) who underwent a detailed examination in the mobile examination center (MEC). Cannabis use was measured using Audio Computer-Assisted Self-Interview. Cannabis use was classified into never, former, occasional (1–7 days of the past 30 days), and heavy (> 7 days of the past 30 days). WBC count was measured using the Coulter Counter method. Results Total WBC count was higher among heavy cannabis users when compared to never users (β = 189; 95% confidence interval: 74, 304, p = 0.001). Among circulating WBC types, modest differences were observed for neutrophil count. Neither former nor occasional cannabis use was associated with total or differential WBC counts. Conclusions A modest association between heavy cannabis use and WBC count was detected. Additional research is needed to understand the immune related effects of different modes of cannabis use and to elucidate the role of proinflammatory chemicals generated from smoking cannabis. Electronic supplementary material The online version of this article (10.1186/s42238-019-0007-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Omayma Alshaarawy
- Department of Family Medicine, Michigan State University, East Lansing, MI 48824
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Alshaarawy O. Total and differential white blood cell count in cannabis users: results from the cross-sectional National Health and Nutrition Examination Survey, 2005-2016. J Cannabis Res 2019. [PMID: 33225221 DOI: 10.26828/cannabis.2019.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Elevated white blood cell (WBC) count in tobacco cigarette smokers compared to non-smokers has been well documented, but little is known on circulating WBC counts and cannabis use. METHODS The National Health and Nutrition Examination Survey (2005-2016) is designed to be nationally representative of United States non-institutionalized population. The current study includes adult participants 20-59 years of age (n= 16,430) who underwent a detailed examination in the mobile examination center (MEC). Cannabis use was measured using Audio Computer-Assisted Self-Interview. Cannabis use was classified into never, former, occasional (1-7 days of the past 30 days), and heavy (>7 days of the past 30 days). WBC count was measured using the Coulter Counter method. RESULTS Total WBC count was higher among heavy cannabis users when compared to never users (β = 189; 95% confidence interval: 74, 304, p = 0.001). Among circulating WBC types, modest differences were observed for neutrophil count. Neither former nor occasional cannabis use was associated with total or differential WBC counts. CONCLUSIONS A modest association between heavy cannabis use and WBC count was detected. Additional research is needed to understand the immune related effects of different modes of cannabis use and to elucidate the role of proinflammatory chemicals generated from smoking cannabis.
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Affiliation(s)
- Omayma Alshaarawy
- Department of Family Medicine, Michigan State University, East Lansing, MI 48824
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