Tan Hua Shin, McAnally Helena M, Dummer Jack, Hancox Robert J
Dept of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Dept of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
ERJ Open Res. 2022 May 3;8(2). doi: 10.1183/23120541.00688-2021. eCollection 2022 Apr.
The long-term effects of cannabis on small airway function remain unclear. We investigated associations between cannabis use and small airway function in a general population sample.
Cannabis use was ascertained at multiple ages from age 18 to 45 years and quantified as joint-years among 895 participants in the Dunedin Multidisciplinary Health and Development Study. Small airway function at ages 38 and 45 years was measured using impulse oscillometry (IOS) before and after inhalation of salbutamol. Analyses used multiple linear regression adjusting for tobacco use, body mass index and height. Longitudinal analyses of cannabis use between 38 and 45 years also adjusted for IOS at age 38 years.
Associations between lifetime cannabis joint-years and IOS differed between men and women: in women, cannabis use was associated with pre-bronchodilator resistance at 5 Hz ( ) and 20 Hz ( ), reactance at 5 Hz, area of reactance and resonant frequency, and marginally associated with the difference between and . Cannabis use was only statistically significantly associated with pre-bronchodilator resonant frequency in men. Cannabis use between the ages of 38 and 45 years was associated with a similar pattern of changes in IOS measures. After salbutamol, cannabis use was only statistically significantly associated with and among women and none of the IOS measures among men.
Cannabis use is associated with small airway dysfunction at age 45 years, indicating an increase in peripheral airway resistance and reactance. These associations were greater and mostly only statistically significant among women. Associations were weaker and mostly nonsignificant after bronchodilator use, suggesting that cannabis-induced changes in small airways may be at least partially reversible.
大麻对小气道功能的长期影响尚不清楚。我们在一个普通人群样本中研究了大麻使用与小气道功能之间的关联。
在达尼丁多学科健康与发展研究的895名参与者中，确定了18至45岁多个年龄段的大麻使用情况，并将其量化为大麻使用年限。在38岁和45岁时，使用脉冲振荡法（IOS）在吸入沙丁胺醇前后测量小气道功能。分析采用多元线性回归，并对烟草使用、体重指数和身高进行了调整。对38岁至45岁期间大麻使用的纵向分析也对38岁时的IOS进行了调整。
终生大麻使用年限与IOS之间的关联在男性和女性中有所不同：在女性中，大麻使用与支气管扩张剂使用前5赫兹（）和20赫兹（）时的阻力、5赫兹时的电抗、电抗面积和共振频率相关，并且与和之间的差异有微弱关联。大麻使用仅在男性中与支气管扩张剂使用前的共振频率有统计学显著关联。38岁至45岁之间的大麻使用与IOS测量值的类似变化模式相关。使用沙丁胺醇后，大麻使用仅在女性中与和有统计学显著关联，而在男性中与任何IOS测量值均无关联。
大麻使用与45岁时的小气道功能障碍有关，表明外周气道阻力和电抗增加。这些关联在女性中更大，且大多仅具有统计学显著性。支气管扩张剂使用后关联较弱且大多无显著性，这表明大麻引起的小气道变化可能至少部分是可逆的。
