Barré Tangui, Pol Stanislas, Ramier Clémence, Di Beo Vincent, Carrat Fabrice, Bureau Morgane, Bourlière Marc, Dorival Céline, Serfaty Lawrence, Asselah Tarik, Boursier Jérôme, Marcellin Fabienne, Carrieri Patrizia, Fontaine Hélène, Protopopescu Camelia
Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
Université Paris Centre, Département d'Hépatologie, Hôpital Cochin, APHP, Paris, France.
Cannabis Cannabinoid Res. 2022 Oct;7(5):677-689. doi: 10.1089/can.2021.0094. Epub 2021 Oct 13.
Chronic hepatitis B virus (HBV) infection may evolve into cirrhosis and hepatocellular carcinoma, and this progression may be accelerated by specific risk factors, including overweight and obesity. Although evidence for a protective effect of cannabis use on elevated body weight has been found for other populations, no data are available for HBV-infected patients. We aimed to identify risk factors (including cannabis use) for overweight and obesity in patients with HBV chronic infection. Using baseline data from the French ANRS CO22 Hepather cohort, we performed two separate analyses, one using "central obesity" (based on waist circumference) and the other "overweight" and "obesity" (based on body mass index) as outcomes. Logistic and multinomial regressions were used to model central obesity and overweight/obesity, respectively. Among the 3706 patients in the study population, 50.8% had central obesity, 34.7% overweight, and 14.4% obesity. After multivariable adjustment, current cannabis use was associated with a 59% lower risk of central obesity compared with no lifetime use (adjusted odds ratio [95% CI]: 0.41 [0.24 to 0.70]). It was also associated with a 54% and 84% lower risk of overweight (adjusted relative risk ratio [95% CI]: 0.46 [0.27 to 0.76]) and obesity (0.16 [0.04 to 0.67]), respectively. Cannabis use was associated with lower risks of overweight and obesity in patients with HBV chronic infection. Future studies should test whether these potential benefits of cannabis and cannabinoid use translate into reduced liver disease progression in this high-risk population.
慢性乙型肝炎病毒（HBV）感染可能会发展为肝硬化和肝细胞癌，而超重和肥胖等特定风险因素可能会加速这一进程。虽然已发现大麻使用对其他人群体重升高有保护作用，但尚无针对HBV感染患者的数据。我们旨在确定慢性HBV感染患者超重和肥胖的风险因素（包括大麻使用）。利用法国ANRS CO22 Hepather队列的基线数据，我们进行了两项独立分析，一项以“中心性肥胖”（基于腰围）为结果，另一项以“超重”和“肥胖”（基于体重指数）为结果。分别使用逻辑回归和多项回归对中心性肥胖和超重/肥胖进行建模。在研究人群的3706名患者中，50.8%有中心性肥胖，34.7%超重，14.4%肥胖。多变量调整后，与从未使用过大麻相比，当前使用大麻与中心性肥胖风险降低59%相关（调整后的优势比[95%CI]：0.41[0.24至0.70]）。它还分别与超重风险降低54%（调整后的相对风险比[95%CI]：0.46[0.27至0.76]）和肥胖风险降低84%（0.16[0.04至0.67]）相关。在慢性HBV感染患者中，大麻使用与超重和肥胖风险降低相关。未来的研究应测试大麻和大麻素使用的这些潜在益处是否能转化为该高危人群肝病进展的减缓。
