大麻使用作为丙型肝炎感染患者体重较低的一个因素：ANRS CO22 Hepather队列研究结果
Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort.
作者信息
Barré Tangui, Carrat Fabrice, Ramier Clémence, Fontaine Hélène, Di Beo Vincent, Bureau Morgane, Dorival Céline, Larrey Dominique, Delarocque-Astagneau Elisabeth, Mathurin Philippe, Marcellin Fabienne, Petrov-Sanchez Ventzislava, Cagnot Carole, Carrieri Patrizia, Pol Stanislas, Protopopescu Camelia
机构信息
Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France.
出版信息
J Cannabis Res. 2022 Jun 11;4(1):31. doi: 10.1186/s42238-022-00138-9.
BACKGROUND
Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection.
METHODS
Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models.
RESULTS
Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37-0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19-0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38-0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI.
CONCLUSIONS
We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT01953458 .
背景
慢性丙型肝炎病毒（HCV）感染患者发生代谢紊乱的风险更高。肥胖是这些疾病的主要危险因素，因此，控制体重至关重要。大麻使用在这些患者中很常见，在不同人群中，大麻使用与较低的肥胖程度相关。然而，尚未在慢性HCV感染患者中研究这种关系。
方法
利用法国ANRS CO22 Hepather队列的基线数据，我们使用二元逻辑回归模型和多项逻辑回归模型，对该队列中慢性HCV感染患者的大麻使用情况（既往/当前）与（i）中心性肥胖（即腰围较大）以及（ii）超重和肥胖（即体重指数（BMI）升高）之间的负相关关系进行检验。我们还使用线性回归模型，将大麻使用情况与腰围和BMI作为连续变量之间的关系进行检验。
结果
在研究人群的6348名参与者中，55%有中心性肥胖，13.7%根据BMI诊断为肥胖，12.4%为当前大麻使用者。经过多变量调整后，当前大麻使用与中心性肥胖风险较低（调整优势比，aOR [95%置信区间，CI]：0.45 [0.37 - 0.55]）、基于BMI的肥胖（调整相对风险比（aRRR）[95% CI]：0.27 [0.19 - 0.39]）以及超重（aRRR [95% CI]：0.47 [0.38 - 0.59]）相关。既往使用大麻的情况也是如此，但程度较轻。既往和当前大麻使用与腰围和BMI呈负相关。
结论
我们发现，在慢性HCV感染患者中，既往使用大麻以及在更大程度上当前使用大麻，始终与较小的腰围、较低的BMI以及较低的超重、肥胖和中心性肥胖风险相关。需要进行纵向研究以证实这些关系，并评估HCV治愈后大麻使用对肥胖程度和肝脏结局的影响。
试验注册
ClinicalTrials.gov标识符：NCT01953458 。
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