Inverse association of marijuana use with nonalcoholic fatty liver disease among adults in the United States
Inverse association of marijuana use with nonalcoholic fatty liver disease among adults in the United States
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DOI：
10.1371/journal.pone.0186702
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发表时间：
2017-10-19
期刊：
影响因子：
3.7
通讯作者：
Ahmed, Aijaz
中科院分区：
文献类型：
--
作者：
Kim, Donghee;Kim, Won;Ahmed, Aijaz
背景与目的大麻对非酒精性脂肪性肝病（NAFLD）的影响在很大程度上是未知的。我们利用2005-2014年国家健康和营养检查调查（NHANES）和NHANES III的横截面数据研究了大麻与NAFLD之间的关联。1988-1994年，在无其他肝病的情况下，如果血清丙氨酸氨基转移酶（ALT）男性> 30 IU/L，女性> 19 IU/L，则诊断为疑似NAFLD（2005-2014年全国家庭健康和营养状况调查）。在NHANES III队列中，NAFLD是根据超声检查定义的。结果在14，080（NHANES 2005-2014）和8，286（NHANES III）参与者中，疑似NAFLD和超声诊断NAFLD的患病率与大麻使用呈负相关（p < 0.001）。与未吸食大麻的参与者相比，大麻使用者不太可能怀疑NAFLD（既往使用者的比值比[OR]：0.90，95%置信区间[CI]：0.82-0.99;当前使用者的比值比：0.68，95% CI：0.58-0.80）和超声诊断的NAFLD（OR：0.75，95% CI：0.57-0.98，当前用户）。在多变量分析中，目前轻度或重度使用者与非使用者相比，疑似NAFLD的OR为0.76（95% CI 0.58-0.98）和0.70（95% CI 0.56-0.89）（趋势P = 0.001），超声诊断的NAFLD趋势相似（当前使用者OR：0.77，95% CI：0.59-1.00;当前轻度使用者OR：0.71，95% CI：0.51-0.97）。在胰岛素抵抗调整模型，大麻的使用仍然是一个独立的预测较低的风险怀疑NAFLD.ConclusionsIn这个全国代表性的样本，积极使用大麻提供了一个保护作用，对NAFLD独立的已知代谢危险因素。病理生理学尚不清楚，需要进一步研究。
Background & aimsThe impact of marijuana on nonalcoholic fatty liver disease (NAFLD) is largely unknown. We studied the association between marijuana and NAFLD utilizing cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2005-2014 and NHANES III (1988-1994).MethodsSuspected NAFLD was diagnosed if serum alanine aminotransferase (ALT) was > 30 IU/L for men and > 19 IU/L for women in the absence of other liver diseases (NHANES 2005-2014). In NHANES III cohort, NAFLD was defined based on ultrasonography.ResultsOf the 14,080 (NHANES 2005-2014) and 8,286 (NHANES III) participants, prevalence of suspected NAFLD and ultrasonographically-diagnosed NAFLD were inversely associated with marijuana use (p < 0.001). Compared to marijuana-naive participants, marijuana users were less likely to have suspected NAFLD (odds ratio [OR]: 0.90, 95% confidence interval [CI]: 0.82-0.99 for past user; OR: 0.68, 95% CI: 0.58-0.80 for current user) and ultrasonographically-diagnosed NAFLD (OR: 0.75, 95% CI: 0.57-0.98 for current user) in the age, gender, ethnicity-adjusted model. On multivariate analysis, the ORs for suspected NAFLD comparing current light or heavy users to non-users were 0.76 (95% CI 0.58-0.98) and 0.70 (95% CI 0.56-0.89), respectively (P for trend = 0.001) with similar trends in ultrasonographically-diagnosed NAFLD (OR: 0.77, 95% CI: 0.59-1.00 for current user; OR: 0.71, 95% CI: 0.51-0.97 for current light user). In insulin resistance-adjusted model, marijuana use remained an independent predictor of lower risk of suspected NAFLD.ConclusionsIn this nationally representative sample, active marijuana use provided a protective effect against NAFLD independent of known metabolic risk factors. The pathophysiology is unclear and warrants further investigation.