North Shore Medical Center, Salem, Massachusetts.
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Alcohol Clin Exp Res. 2019 Feb;43(2):270-276. doi: 10.1111/acer.13930. Epub 2018 Dec 24.
Alcoholic gastritis, a superficial erosive disease of the stomach, is a common manifestation of risky alcohol use. In contrast, cannabis which is frequently co-used with alcohol suppresses gastric acidity and might counteract the deleterious effect of alcohol on the gastric mucosa. However, no clinical study has examined the impact of cannabis use on the development of alcoholic gastritis among risky alcohol users.
We analyzed hospital discharge records of adults (age ≥ 18 years), from 2014 of the Nationwide Inpatient Sample, with a diagnosis of risky alcohol use (n = 316,916). We used a propensity-based matching algorithm to match cannabis users to nonusers on 1:1 ratio (30,713: 30,713). We then measured the adjusted relative risk (aRR) for having alcoholic gastritis using conditional Poisson regression models with generalized estimating equations.
Our study revealed that among risky alcohol users, cannabis co-users have a lower prevalence of alcoholic gastritis compared to noncannabis users (1,289 [1,169 to 1,421] vs. 1,723 [1,583 to 1,875] per 100,000 hospitalizations for risky alcohol use), resulting in a 25% decreased probability of alcoholic gastritis (aRR: 0.75 [0.66 to 0.85]; p-value <0.0001). Furthermore, dependent cannabis usage resulted in a lower prevalence of alcoholic gastritis when compared to both nondependent cannabis users (0.72 [0.52 to 0.99]) and to noncannabis users (0.56 [0.41 to 0.76]).
We reveal that risky alcohol drinking combined with cannabis use is associated with reduced prevalence of alcohol-associated gastritis in patients. Given increased cannabis legislation globally, understanding whether and how the specific ingredients in cannabis plant extract can be used in the treatment of alcoholic gastritis is paramount. In this regard, further molecular mechanistic studies are needed to delineate the mechanisms of our novel findings not only for alcoholic gastritis but also for gastritis from other causes.
酒精性胃炎是一种胃的浅表性糜烂性疾病，是危险饮酒的常见表现。相比之下，大麻常与酒精同时使用，可抑制胃酸分泌，可能抵消酒精对胃黏膜的有害影响。然而，尚无临床研究检查大麻使用对危险饮酒者中酒精性胃炎的发展的影响。
我们分析了 2014 年全国住院患者样本中年龄≥18 岁的成年人（n=316916）的住院记录，这些患者有危险饮酒史。我们使用基于倾向评分的匹配算法，将大麻使用者与非使用者以 1:1 的比例进行匹配（30713:30713）。然后，我们使用条件泊松回归模型和广义估计方程来衡量患有酒精性胃炎的调整后相对风险（aRR）。
我们的研究表明，在危险饮酒者中，与非大麻使用者相比，大麻同时使用者的酒精性胃炎患病率较低（每 100000 例因危险饮酒而住院的患者中，1289[1169 至 1421]例与 1723[1583 至 1875]例），这意味着酒精性胃炎的可能性降低了 25%（aRR：0.75[0.66 至 0.85]；p 值<0.0001）。此外，与非大麻使用者相比，依赖大麻使用者（0.72[0.52 至 0.99]）和非大麻使用者（0.56[0.41 至 0.76]）相比，酒精性胃炎的患病率更低。
我们发现，危险饮酒加上大麻使用与患者中酒精性胃炎的发生率降低有关。鉴于全球大麻法规的增加，了解大麻植物提取物中的特定成分是否以及如何用于治疗酒精性胃炎至关重要。在这方面，需要进一步的分子机制研究来阐明我们新发现的机制，不仅对酒精性胃炎，而且对其他原因引起的胃炎也是如此。
