Alshaarawy Omayma, Anthony James C
From the Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI.
Epidemiology. 2015 Jul;26(4):597-600. doi: 10.1097/EDE.0000000000000314.
In preclinical animal studies, evidence links cannabis with hyperphagia, obesity, and insulin resistance. Epidemiologic data, however, suggest an inverse cannabis smoking-diabetes mellitus association. Here, we offer epidemiologic estimates from eight independent replications from (1) the National Health and Nutrition Examination Surveys, and (2) the National Surveys on Drug Use and Health (2005-2012).
For each national survey participant, computer-assisted self-interviews assess cannabis smoking and physician-diagnosed diabetes mellitus; the National Health and Nutrition Examination Surveys provide additional biomarker values and a composite diabetes diagnosis. Regression analyses produce estimates of cannabis smoking-diabetes associations. Meta-analyses summarize the replication estimates.
Recently active cannabis smoking and diabetes mellitus are inversely associated. The meta-analytic summary odds ratio is 0.7 (95% confidence interval = 0.6, 0.8).
Current evidence is too weak for causal inference, but there now is a more stable evidence base for new lines of clinical translational research on a possibly protective (or spurious) cannabis smoking-diabetes mellitus association suggested in prior research.
在临床前动物研究中，有证据表明大麻与食欲亢进、肥胖和胰岛素抵抗有关。然而，流行病学数据显示大麻吸烟与糖尿病之间存在负相关。在此，我们提供了来自（1）国家健康与营养检查调查以及（2）国家药物使用和健康调查（2005 - 2012年）的八项独立重复研究的流行病学估计。
对于每项全国调查的参与者，通过计算机辅助自我访谈评估大麻吸烟情况和医生诊断的糖尿病；国家健康与营养检查调查提供额外的生物标志物值和综合糖尿病诊断。回归分析得出大麻吸烟与糖尿病关联的估计值。荟萃分析总结重复研究的估计值。
近期活跃的大麻吸烟与糖尿病呈负相关。荟萃分析汇总的优势比为0.7（95%置信区间 = 0.6, 0.8）。
目前的证据对于因果推断来说过于薄弱，但现在有了一个更稳定的证据基础，可用于开展新的临床转化研究，探讨先前研究中提出的大麻吸烟与糖尿病之间可能存在的保护性（或虚假性）关联。
