National Public Health Institute of Quebec, 945 Avenue Wolfe, Quebec, QC, G1V 5B3, Canada.
Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, QC, Canada.
Acta Diabetol. 2020 Feb;57(2):133-140. doi: 10.1007/s00592-019-01390-x. Epub 2019 Jul 31.
To explore the association of marijuana use with mean plasma fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) score in obese adults with different HOMA-IR.
The National Health and Nutrition Examination Survey (NHANES) is a survey research program designed to assess the health and nutrition status of individuals in the United States and to track changes over time. We abstracted data from NHANES 2009-2016. We estimated the minimal lifetime marijuana use (MLU) using the duration of regular exposure and the frequency of use. We assessed the association of MLU and both plasma fasting insulin and HOMA-IR score using log-linear regression models.
A total of 65,209 obese individuals aged 18 to 59 years were included. In obese individuals who never used marijuana (reference), the mean value (± standard deviation) was 19.0 (± 12.8) μU/mL for plasma fasting insulin and 4.78 (± 3.49) for HOMA-IR. In individuals with HOMA-IR < 2.13 or ≥ 5.72, we found no association of marijuana use with HOMA-IR. In those with HOMA-IR < 5.72, the highest tertile of MLU (i.e., ≥ 1799 times) was associated with 12% decrease (95% confidence intervals, 4-19%) in the fasting insulin and 10% decrease in HOMA-IR (95% CI 1-19%), as compared with their counterparts who never used marijuana. In those with HOMA-IR ≥ 2.13, we found a marked impact of marijuana use only in adults who used marijuana ≥ 1799 times, with 13% decrease (95% CI 5-19%) in fasting insulin and 10% decrease (95% CI 3-18%) in HOMA-IR score.
Marijuana use is associated with reduced fasting insulin levels and HOMA-IR score in US obese adults with HOMA-IR ≥ 2.13, but not in those with HOMA-IR < 2.13 or ≥ 5.72. The impact of marijuana use is the greatest after long-term exposure and is independent of BMI.
探讨大麻使用与肥胖成年人不同胰岛素抵抗评估模型（HOMA-IR）评分的空腹胰岛素平均血浆水平及 HOMA-IR 评分之间的关联。
全国健康和营养调查（NHANES）是一项旨在评估美国个人健康和营养状况并跟踪随时间变化的调查研究计划。我们从 2009 年至 2016 年的 NHANES 中提取数据。我们使用定期暴露的持续时间和使用频率来估计最低终生大麻使用量（MLU）。我们使用对数线性回归模型评估 MLU 与空腹胰岛素和 HOMA-IR 评分的关系。
共纳入 65209 名年龄在 18 至 59 岁的肥胖个体。在从未使用过大麻的肥胖个体（参考组）中，空腹胰岛素的平均值（±标准差）为 19.0（±12.8）μU/mL，HOMA-IR 为 4.78（±3.49）。在 HOMA-IR<2.13 或≥5.72 的个体中，我们未发现大麻使用与 HOMA-IR 之间存在关联。在 HOMA-IR<5.72 的个体中，MLU 最高三分位（即≥1799 次）与空腹胰岛素降低 12%（95%置信区间，4-19%）和 HOMA-IR 降低 10%（95%置信区间 1-19%）相关，与从未使用过大麻的个体相比。在 HOMA-IR≥2.13 的个体中，我们仅在使用大麻≥1799 次的成年人中发现大麻使用的显著影响，空腹胰岛素降低 13%（95%置信区间，5-19%），HOMA-IR 评分降低 10%（95%置信区间，3-18%）。
在美国肥胖成年人中，大麻使用与 HOMA-IR≥2.13 的空腹胰岛素水平和 HOMA-IR 评分降低有关，但与 HOMA-IR<2.13 或≥5.72 无关。长期暴露后，大麻使用的影响最大，且与 BMI 无关。
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