Cannabis use is associated with a lower risk of diabetes in chronic hepatitis C-infected patients (ANRS CO22 Hepather cohort)
Cannabis use is associated with a lower risk of diabetes in chronic hepatitis C-infected patients (ANRS CO22 Hepather cohort)
复制标题
DOI：
10.1111/jvh.13380
复制
发表时间：
2020-09-08
影响因子：
2.5
通讯作者：
Carrieri, Patrizia
中科院分区：
文献类型：
--
作者：
Barre, Tangui;Nishimwe, Marie Liberee;Carrieri, Patrizia
慢性丙型肝炎病毒（HCV）感染是胰岛素抵抗的危险因素，HCV感染患者发生糖尿病的风险很高。在一般人群中，研究表明使用大麻对预防糖尿病和相关代谢紊乱具有潜在益处。我们的目的是测试大麻使用是否与慢性HCV感染患者糖尿病风险降低相关。慢性HCV感染患者（n = 10 445）选自法国国家、多中心、观察性ANRS CO22 Hepather队列。在队列招募时收集的横断面数据用于评估患者的临床和行为特征与糖尿病风险之间的关联。以大麻使用作为主要自变量进行Logistic回归模型，显著性水平设定为5%。还运行了根据晚期肝纤维化（FIB-4 > 3.25）的存在分层的类似模型。多变量校正后，目前（AOR [95%CI]：0.49 [0.38-0.63]）和以前（0.81 [0.67-0.98]，P <0.001）使用大麻均与糖尿病发病率降低相关。相反，男性、吸烟、BMI升高、贫困、移民和晚期纤维化与糖尿病发病率增加相关。大麻使用和糖尿病之间的关联在分层分析中得到维持。在这项针对慢性HCV感染患者的大型横断面研究中，大麻使用与糖尿病风险降低相关，独立于临床和社会行为因素。需要进一步研究，以阐明潜在的因果关系，并阐明大麻化合物和这种关系所涉及的机制。
Chronic hepatitis C virus (HCV) infection is a risk factor of insulin resistance, and HCV-infected patients are at a high risk of developing diabetes. In the general population, research has shown the potential benefit of cannabis use for the prevention of diabetes and related metabolic disorders. We aimed to test whether cannabis use is associated with a lower risk of diabetes in chronic HCV-infected patients. Chronic HCV-infected patients (n = 10 445) were selected from the French national, multicenter, observational ANRS CO22 Hepather cohort. Cross-sectional data collected at cohort enrollment were used to assess the association between patients' clinical and behavioural characteristics and the risk of diabetes. Logistic regression model was performed with cannabis use as the main independent variable and a significance level set at 5%. A similar model stratified by the presence of advanced liver fibrosis (FIB-4 > 3.25) was also run. After multivariable adjustment, current (AOR [95%CI]: 0.49 [0.38-0.63]) and former (0.81 [0.67-0.98],P < .001) cannabis use were both associated with a reduced odds of diabetes. Conversely, male gender, tobacco use, elevated BMI, poverty, being a migrant and advanced fibrosis were associated with increased odds of diabetes. The association between cannabis use and diabetes was maintained in the stratified analysis. In this large cross-sectional study of chronic HCV-infected patients, cannabis use was associated with a lower risk of diabetes independently of clinical and socio-behavioural factors. Further studies are needed to elucidate a potential causal link and shed light on cannabis compounds and mechanisms involved in this relationship.