Department of Medicine, Division of Gastroenterology, New York University Langone Health.
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
J Clin Gastroenterol. 2020 Mar;54(3):242-248. doi: 10.1097/MCG.0000000000001220.
Marijuana use has been assessed in patients with chronic gastrointestinal disorders and may contribute to either symptoms or palliation. Use in those with celiac disease (CD) has not been assessed. Our aim was to evaluate patterns of marijuana use in a large population-based survey among patients with CD, people who avoid gluten (PWAG), and controls.
We analyzed data from the National Health and Nutrition Examination Survey from 2009 to 2014. χ tests and multivariable logistic regression were used to compare participants with CD and PWAG to controls regarding the use of marijuana.
Among respondents who reported ever using marijuana (overall 59.1%), routine (at-least monthly) marijuana use was reported by 46% of controls versus 6% of participants with diagnosed CD (P=0.005) and 66% undiagnosed CD as identified on serology (P=0.098) and 51% of PWAG (P=0.536). Subjects with diagnosed CD had lower odds of routine marijuana use compared with controls (odds ratio, 0.08; 95% confidence interval, 0.01-0.73), whereas participants with undiagnosed CD had increased odds of routine use (odds ratio, 2.26; 95% confidence interval, 0.83-6.13), which remained elevated even after adjusting for age, sex, race/ethnicity, health insurance status, alcohol, tobacco use, educational level, and poverty/income ratio.
In all groups, marijuana use was high. Although there were no differences among subjects with CD, PWAG, and controls who ever used marijuana, subjects with diagnosed CD appear to have decreased routine use of marijuana when compared with controls and PWAG. Those with undiagnosed CD have significantly higher rates of regular use. Future research should focus on the utilization of marijuana as it may contribute to further understanding of symptoms and treatments.
大麻的使用在慢性胃肠道疾病患者中已经得到评估，它可能导致症状加重或缓解。尚未评估乳糜泻（CD）患者的使用情况。我们的目的是评估在一项大型基于人群的 CD 患者、避免食用 gluten（PWAG）的人群和对照组的调查中，大麻的使用模式。
我们分析了 2009 年至 2014 年国家健康和营养检查调查的数据。使用 χ 检验和多变量逻辑回归比较了报告曾使用过大麻的参与者中 CD 患者和 PWAG 与对照组之间的大麻使用情况。
在报告曾使用过大麻的受访者中（总体为 59.1%），对照组中有 46%的人经常（至少每月）使用大麻，而确诊 CD 的参与者中只有 6%（P=0.005），在血清学检查中发现未确诊 CD 的参与者中有 66%（P=0.098），而 PWAG 中有 51%（P=0.536）。与对照组相比，确诊 CD 的患者常规使用大麻的可能性较低（比值比，0.08；95%置信区间，0.01-0.73），而未确诊 CD 的患者常规使用大麻的可能性增加（比值比，2.26；95%置信区间，0.83-6.13），即使在调整了年龄、性别、种族/民族、健康保险状况、酒精、烟草使用、教育水平和贫困/收入比后，这一比例仍然升高。
在所有组中，大麻的使用率都很高。尽管 CD、PWAG 和对照组的曾使用者之间没有差异，但与对照组和 PWAG 相比，确诊 CD 的患者似乎减少了常规使用大麻的频率。未确诊 CD 的患者有更高的定期使用大麻的比率。未来的研究应重点关注大麻的使用情况，因为它可能有助于进一步了解症状和治疗方法。
