Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada.
National Public Health Institute of Quebec, Quebec, Quebec, Canada.
J Diabetes. 2020 Jan;12(1):38-47. doi: 10.1111/1753-0407.12958. Epub 2019 Jul 1.
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.
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.
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.
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.
肥胖个体更有可能表现出胰岛素抵抗（IR）。然而，针对大麻使用与 IR 标志物的有限人群研究得出的结果喜忧参半。本研究旨在探讨美国不同 BMI 状态成年人中，大麻使用与 IR 的相关性。
从 2009 年至 2016 年的国家健康和营养调查（NHANES）中提取数据。使用定期暴露的持续时间和使用频率来估计大麻的最低终生使用量。使用广义线性模型分别在瘦体重、超重和肥胖个体中确定大麻使用与空腹胰岛素（FINS）和稳态模型评估的胰岛素抵抗（HOMA-IR）之间的关联。使用访谈体重年数据来考虑抽样和无应答的不等概率。
在所有 129509 名 18 至 59 岁的成年人中，有 50.3%为女性。在当前肥胖的大麻使用者中，每月使用次数少于 4 次的人的平均 FINS 比从未使用者低 52%（95%置信区间 [CI] 19%-71%）。在过去肥胖的大麻使用者中，每月使用 8 次或更多，且停止使用大麻不到 12 个月，他们的平均 FINS 比从未使用者低 47%（95% CI 18%-66%）。在过去 12 至 119 个月和 120 个月及以上停止使用大麻的人中，平均 FINS 分别降低了 36%（95% CI 7%-57%）和 36%（95% CI 10%-54%）。
即使在每月使用次数少于 4 次的低频率下，大麻使用与肥胖但非非肥胖成年人的 FINS 和 HOMA-IR 降低有关。终生大量使用大麻的前使用者的 FINS 水平显著降低，且持续存在，与最后一次使用的时间长短无关。
