1
|
Baral A, Liu J, Garcia-Davis S, Diggs BNA, Ayala L, Aka A, Agrawal YS, Messiah SE, Vidot DC. Prevalence of Metabolic Syndrome Among Emerging Adult Cannabis Users by Race/Ethnicity: Analysis of the 2009-2018 National Health and Nutrition Examination Surveys. AMERICAN JOURNAL OF MEDICINE OPEN 2024; 11:100069. [PMID: 39034940 PMCID: PMC11256325 DOI: 10.1016/j.ajmo.2024.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 03/02/2024] [Accepted: 03/24/2024] [Indexed: 07/23/2024]
Abstract
Background Association between cannabis use and metabolic syndrome (MetS) has been documented; yet variation by race/ethnicity is understudied. We examined cannabis use and MetS by race/ethnicity among emerging adults (18-25 years old), the age group with the highest prevalence of cannabis use. Methods Data from 18- to 25-year-olds who completed the National Health and Nutrition Examination Survey (2009-2018) were analyzed. Current cannabis use was defined as ≥1 day of use in the last 30 days. MetS was defined using standardized guidelines as ≥3 of the following: elevated fasting glucose, triglycerides, systolic (SBP) and/or diastolic blood pressure (DPB), waist circumference, and/or low high-density lipoprotein (HDL) cholesterol. Logistic regression was used to examine the association between current cannabis use (CCU) and MetS, adjusting for covariates. Results Of 3974 respondents, 48.8% were female, mean age 21.1 years (SD = 2.4), 56.7% non-Hispanic white, 20.4% Hispanic, and 14.0% non-Hispanic black (NHB). Hispanics had the highest MetS prevalence (7.9%) and lowest CCU prevalence (23.5%). NHB had highest CCU prevalence (33.4%, P < .0001) and lowest MetS prevalence (4.8%, P = .2543). CCUs had a higher mean SBP (P = .020) and Hispanics (P = .002) than never users. Conversely, NHB CCUs exhibited lower mean SBP than NHB never users (P = .008). CCUs had 42% reduced odds of MetS than never users (AOR: 0.58, 95% CI: 0.35-0.95). Among NHB, CCUs had 78% lower likelihood of having MetS than never users (AOR: 0.22, 95% CI: 0.06-0.81). Conclusions Cannabis use impacts MetS and blood pressure differently by race/ethnicity. Current cannabis use was associated with lower odds of MetS overall and among NHB. Further research is warranted to investigate how administration routes, dosages, and usage duration affect MetS.
Collapse
Affiliation(s)
- Amrit Baral
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
- University of Miami School of Nursing and Health Studies, Miami, FL
| | - Jingxin Liu
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
| | - Sandra Garcia-Davis
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
| | - Bria-Necole A. Diggs
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
- University of Miami School of Nursing and Health Studies, Miami, FL
| | - Lizelh Ayala
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
| | - Anurag Aka
- University of Miami School of Nursing and Health Studies, Miami, FL
| | - Yash S. Agrawal
- University of Miami School of Nursing and Health Studies, Miami, FL
| | - Sarah E. Messiah
- University of Texas Health Science Center at Houston, School of Public Health, Houston, TX
- Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Houston, TX
| | - Denise C. Vidot
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL
- University of Miami School of Nursing and Health Studies, Miami, FL
| |
Collapse
|
2
|
Du R, Tang XY, Yang C, Gao WH, Gao SJ, Xiang HJ, Yang L. Marijuana use is inversely associated with liver steatosis detected by transient elastography in the general United States population in NHANES 2017-2018: A cross-sectional study. PLoS One 2023; 18:e0284859. [PMID: 37200309 DOI: 10.1371/journal.pone.0284859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/09/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The impact of marijuana on the general population is largely unknown. The present study aimed to assess the association between marijuana use and liver steatosis and fibrosis in the general United States population utilizing data from the National Health and Nutrition Examination Survey (NHANES). METHODS This cross-sectional study was performed with data from the 2017-2018 cycle of NHANES. The target population comprised adults in the NHANES database with reliable vibration controlled transient elastography (VCTE) results. The median values of the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were used to evaluate liver steatosis and fibrosis, respectively. After adjusting for relevant confounders, a logistic regression analysis was used to assess the association between marijuana use and liver steatosis and fibrosis. RESULTS A total of 2622 participants were included in this study. The proportions of never marijuana users, past users, and current users were 45.9%, 35.0%, and 19.1%, respectively. Compared to never marijuana users, past and current users had a lower prevalence of liver steatosis (P = 0.184 and P = 0.048, respectively). In the alcohol intake-adjusted model, current marijuana use was an independent predictor of a low prevalence of liver steatosis in people with non-heavy alcohol intake. The association between marijuana use and liver fibrosis was not significant in univariate and multivariate regression. CONCLUSION In this nationally representative sample, current marijuana use is inversely associated with steatosis. The pathophysiology is unclear and needs further study. No significant association was established between marijuana use and liver fibrosis, irrespective of past or current use.
Collapse
Affiliation(s)
- Rui Du
- Department of Ultrasound, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| | - Xiao-Yan Tang
- Department of Cardiology, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| | - Cheng Yang
- Department of Radiology, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| | - Wen-Hong Gao
- Department of Ultrasound, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| | - Shun-Ji Gao
- Department of Ultrasound, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| | - Hui-Juan Xiang
- Department of Ultrasound, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| | - Li Yang
- Department of Ultrasound, General Hospital of Central Theater Command, Wuchangqu, Wuhan, Hubei, China
| |
Collapse
|
3
|
Phytocannabinoids-A Green Approach toward Non-Alcoholic Fatty Liver Disease Treatment. J Clin Med 2021; 10:jcm10030393. [PMID: 33498537 PMCID: PMC7864168 DOI: 10.3390/jcm10030393] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most frequent chronic liver disease in adults in developed countries, with a global prevalence as high as one billion. The pathogenesis of NAFLD is a multifactorial and multi-step process. Nowadays, a growing body of research suggests the considerable role of the endocannabinoid system (ECS) as a complex cell-signaling system in NAFLD development. Although increased endocannabinoid tone in the liver highly contributes to NAFLD development, the complex effects and impacts of plant-derived cannabinoids in the aspect of NAFLD pathophysiology are yet not fully understood, and effective medications are still in demand. In our review, we present the latest reports describing the role of ECS in NAFLD, focusing primarily on two types of cannabinoid receptors. Moreover, we sum up the recent literature on the clinical use of natural cannabinoids in NAFLD treatment. This review is useful for understanding the importance of ECS in NAFLD development, and it also provides the basis for more extensive clinical phytocannabinoids testing in patients suffering from NAFLD.
Collapse
|
4
|
Adamson M, Di Giovanni B, Delgado DH. The positive and negative cardiovascular effects of cannabis. Expert Rev Cardiovasc Ther 2020; 18:905-917. [PMID: 33054426 DOI: 10.1080/14779072.2020.1837625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The use of cannabis and its derivatives have increased steadily over the past few decades, prompting patients and clinicians to increasingly inquire about its health effects and safety profile. However, despite promising evidence suggesting therapeutic utilization, cannabis remains a controlled substance in most countries and is largely considered to have no medical or recreational benefit; thus, a lack of observational studies and randomized control trials exist to outline positive and negative health implications. Ultimately, this leaves patients, health-care professionals, and policymakers without necessary evidence required to make informed decisions on cannabis use. AREAS COVERED This review outlines cannabis in a clinical setting and delves into specific effects of cannabinoids on cardiovascular health and disease. It discusses positive and negative health implications associated with cannabis, mechanisms in cardiovascular disease, and reveals methods guiding cannabis use in the clinical setting. EXPERT OPINION Advances in research are necessary to guide decisions regarding cannabinoid use. Countries that have federally legalized cannabis have a unique opportunity to study cardiovascular implications in an unbiased and comprehensive manner. Ultimately, as cannabis use will inevitably increase, researchers, clinicians, and policymakers must work together to ensure cannabis is utilized in a way that is therapeutically beneficial.
Collapse
Affiliation(s)
- Mitchell Adamson
- Department of Medicine, Institute of Medical Sciences, University of Toronto , Toronto, ON, Canada.,Division of Cardiology, Heart Failure and Transplant Program, Toronto General Hospital, University Health Network , Toronto, ON, Canada
| | - Bennett Di Giovanni
- Division of Cardiology, Heart Failure and Transplant Program, Toronto General Hospital, University Health Network , Toronto, ON, Canada
| | - Diego H Delgado
- Division of Cardiology, Heart Failure and Transplant Program, Toronto General Hospital, University Health Network , Toronto, ON, Canada
| |
Collapse
|
5
|
Mizuno H, Kihara Y. Druggable Lipid GPCRs: Past, Present, and Prospects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1274:223-258. [PMID: 32894513 DOI: 10.1007/978-3-030-50621-6_10] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
G protein-coupled receptors (GPCRs) have seven transmembrane spanning domains and comprise the largest superfamily with ~800 receptors in humans. GPCRs are attractive targets for drug discovery because they transduce intracellular signaling in response to endogenous ligands via heterotrimeric G proteins or arrestins, resulting in a wide variety of physiological and pathophysiological responses. The endogenous ligands for GPCRs are highly chemically diverse and include ions, biogenic amines, nucleotides, peptides, and lipids. In this review, we follow the KonMari method to better understand druggable lipid GPCRs. First, we have a comprehensive tidying up of lipid GPCRs including receptors for prostanoids, leukotrienes, specialized pro-resolving mediators (SPMs), lysophospholipids, sphingosine 1-phosphate (S1P), cannabinoids, platelet-activating factor (PAF), free fatty acids (FFAs), and sterols. This tidying up consolidates 46 lipid GPCRs and declutters several perplexing lipid GPCRs. Then, we further tidy up the lipid GPCR-directed drugs from the literature and databases, which identified 24 clinical drugs targeting 16 unique lipid GPCRs available in the market and 44 drugs under evaluation in more than 100 clinical trials as of 2019. Finally, we introduce drug designs for GPCRs that spark joy, such as positive or negative allosteric modulators (PAM or NAM), biased agonism, functional antagonism like fingolimod, and monoclonal antibodies (MAbs). These strategic drug designs may increase the efficacy and specificity of drugs and reduce side effects. Technological advances will help to discover more endogenous lipid ligands from the vast number of remaining orphan GPCRs and will also lead to the development novel lipid GPCR drugs to treat various diseases.
Collapse
Affiliation(s)
| | - Yasuyuki Kihara
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
| |
Collapse
|
6
|
Gotfried J, Naftali T, Schey R. Role of Cannabis and Its Derivatives in Gastrointestinal and Hepatic Disease. Gastroenterology 2020; 159:62-80. [PMID: 32333910 DOI: 10.1053/j.gastro.2020.03.087] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/26/2020] [Accepted: 03/29/2020] [Indexed: 02/08/2023]
Abstract
Medical and recreational cannabis use has increased dramatically over the last decade, resulting from mainstream cultural acceptance and legalization in several countries worldwide. Cannabis and its derivatives affect many gastrointestinal processes via the endocannabinoid system (ECS). The ECS influences gastrointestinal homeostasis through anti-inflammatory, anti-nociceptive, and anti-secretory effects. Some gastrointestinal disorders might therefore be treated with cannabinoids. Despite numerous studies in cell lines and animals, few human studies have evaluated the therapeutic effects of cannabinoids. Cannabis' schedule 1 drug status has limited its availability in research; cannabis has been legalized only recently, in some states, for medicinal and/or recreational use. Cannabinoids can alleviate chemotherapy-induced nausea and emesis and chronic pain. Studies have demonstrated the important roles of the ECS in metabolism, obesity, and nonalcoholic fatty liver disease and the anti-inflammatory effects of cannabis have been investigated in patients with inflammatory bowel diseases. Despite its potential benefits, undesired or even detrimental effects of cannabis can limit its use. Side effects such as cannabinoid hyperemesis syndrome affect some users. We review the ECS and the effects of cannabis and its derivatives on gastrointestinal and hepatic function in health and disease.
Collapse
Affiliation(s)
- Jonathan Gotfried
- Section of Gastroenterology, Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Timna Naftali
- Division of Gastroenterology and Hepatology, Meir Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Schey
- Division of Gastroenterology/Hepatology Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida.
| |
Collapse
|