Metabolic syndrome in people with a psychotic illness: is cannabis protective?
Metabolic syndrome in people with a psychotic illness: is cannabis protective?
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精神病患者的代谢综合征：大麻有保护作用吗？
作者：
A. Waterreus;P. D. Prinzio;Gerald F. Watts;David Castle;Cherrie Galletly;V. Morgan
精神疾病患者中代谢综合征的发生率很高。新出现的证据表明，大麻的使用可能对一般人群的心脏代谢风险因素有积极影响，但对精神病患者的影响知之甚少。我们的目的是调查精神疾病患者代谢综合征的发生率是否与大麻使用频率有关。方法2010年澳大利亚精神病调查采用两阶段设计，随机抽取1825名具有全国代表性的成年精神病患者进行访谈和体格评估。这项研究基于1813名提供大麻使用数据的参与者。使用多元逻辑回归对大麻使用频率对代谢综合征的影响进行建模，调整了抗精神病药物使用、吸烟、饮酒和认知功能等潜在协变量。结果三分之一（33.0%）的参与者在过去一年中使用过大麻。不使用、偶尔使用和频繁使用代谢综合征的比例分别为63%、51.7%和43.5% （p < 0.001）。在未经调整的分析中，偶尔使用和频繁使用大麻与代谢综合征的几率显着降低相关。在调整后的分析中，代谢综合征与频繁使用大麻之间的相关性仍然显著[优势比= 0.56,95%可信区间（CI） 0.39-0.80]，但与偶尔使用大麻之间的相关性不显著（优势比= 0.75,95% CI 0.49-1.13）。结论：虽然大麻的使用可能对心理健康有害，但这些数据表明，它也可能具有心脏代谢保护作用。需要进一步的研究来理解这一矛盾发现背后的机制。
Background Rates of the metabolic syndrome in people with psychotic illness are high. Emerging evidence suggests that cannabis use may have a positive impact on cardiometabolic risk factors in the general population, but little is known about its impact for people with psychotic illness. Our aim was to investigate whether the rate of the metabolic syndrome in people with psychotic illness was associated with frequency of cannabis use. Method The 2010 Australian psychosis survey used a two-phase design to randomly select a nationally representative sample of 1825 adults with psychotic illness for interview and physical assessment. This study is based on 1813 participants who provided data on cannabis use. Multiple logistic regression was used to model the influence of frequency of cannabis use on the metabolic syndrome, adjusting for potential covariates including antipsychotic medication use, smoking, alcohol use and cognitive function. Results One-third (33.0%) of participants had used cannabis in the past year. The proportion of non-users, occasional users and frequent users with the metabolic syndrome was 63.0, 51.7 and 43.5%, respectively (p < 0.001). In unadjusted analyses, both occasional use and frequent cannabis use were associated with significantly lower odds of the metabolic syndrome. In the adjusted analyses, the association between the metabolic syndrome and frequent cannabis use remained significant [odds ratio = 0.56, 95% confidence interval (CI) 0.39–0.80], but not the association with occasional use (odds ratio = 0.75, 95% CI 0.49–1.13). Conclusions While cannabis use may be detrimental for mental health, these data suggest that it may also have a cardiometabolic protective effect. Further investigation is required to understand the mechanism underlying this paradoxical finding.
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