Division of Urology, Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, Colorado, USA.
Kansas City Urology Care, Overland Park, Kansas, USA.
Can J Urol. 2022 Aug;29(4):11249-11254.
Despite widespread usage, research on the relationship of marijuana use to disease is sorely lacking. We sought to test the relationship of LUTS/BPH treatment and endocannabinoid agonist usage, as well as alcohol usage and depression, with treatment for LUTS/BPH in our health system.
We queried our hospital system database of nearly three million patients in a marijuana-legalized region for data from the electronic medical record between January 2011 and October 2018. Men over the age of 45 on medical therapy for LUTS (selective alpha blockade and/or finasteride) were included. Exclusions were diagnosis of bladder or prostate malignancy and men with only one visit. Alcohol and marijuana (MJ) use were found from diagnosis code and/or social history text. Medical diagnoses were based on ICD-9/10 codes. Multiple logistic regression was used to control for confounders. We considered all men over the age of 45 who had any of these features: depression, obesity or metabolic syndrome (MetS), hypertension (HTN), erectile dysfunction (ED), hypogonadism, diabetes (DM) and calculated the odds ratio of also receiving medical therapy for LUTS. Univariable and multivariable analyses were employed, multiple logistic regression was used to control for confounders.
A total of 173,469 patients were identified meeting criteria with 20,548 (11.9%) on medical treatment for LUTS. After adjusting for confounding variables, MJ and depression remained associated with an increased risk of LUTS medication, within the context of verifying previously established relationships of ED, Obesity/MetS, DM, HTN and hypogonadism.
Men with depression and MJ usage were more likely to be treated for LUTS/BPH in our system. Better understanding of the causality of this relationship and potential interaction of LUTS/BPH with the endocannabinoid system is desirable.
尽管大麻的使用非常普遍，但关于大麻使用与疾病之间关系的研究却严重不足。我们试图检验大麻使用与良性前列腺增生/下尿路症状（LUTS）治疗之间的关系，以及酒精使用和抑郁与我们的医疗系统中 LUTS/BPH 治疗之间的关系。
我们在大麻合法化地区的医院系统数据库中查询了近 300 万患者的数据，时间范围为 2011 年 1 月至 2018 年 10 月，包括年龄在 45 岁以上、正在接受 LUTS（选择性α阻断剂和/或非那雄胺）治疗的男性。排除标准为膀胱癌或前列腺癌诊断和仅有一次就诊的男性。酒精和大麻（MJ）的使用情况是通过诊断代码和/或社会史文本发现的。医学诊断基于 ICD-9/10 代码。采用多变量逻辑回归来控制混杂因素。我们考虑了所有年龄在 45 岁以上且具有以下任何特征的男性：抑郁、肥胖或代谢综合征（MetS）、高血压（HTN）、勃起功能障碍（ED）、性腺功能减退症、糖尿病（DM），并计算了同时接受 LUTS 药物治疗的可能性。采用单变量和多变量分析，多变量逻辑回归用于控制混杂因素。
共有 173469 名符合条件的患者被确定，其中 20548 名（11.9%）正在接受 LUTS 治疗。在调整混杂变量后，MJ 和抑郁与 LUTS 药物治疗的风险增加相关，同时也验证了 ED、肥胖/代谢综合征、DM、HTN 和性腺功能减退症之间的先前建立的关系。
在我们的系统中，患有抑郁和 MJ 使用的男性更有可能接受 LUTS/BPH 的治疗。更好地了解这种关系的因果关系以及 LUTS/BPH 与内源性大麻素系统之间的潜在相互作用是可取的。
