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Impact of lifetime marijuana use on fasting plasma insulin levels and HOMA-IR score in obese adults with and without insulin resistance

Abstract

Aims

To explore the association of marijuana use with mean plasma fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) score in obese adults with different HOMA-IR.

Methods

The National Health and Nutrition Examination Survey (NHANES) is a survey research program designed to assess the health and nutrition status of individuals in the United States and to track changes over time. We abstracted data from NHANES 2009–2016. We estimated the minimal lifetime marijuana use (MLU) using the duration of regular exposure and the frequency of use. We assessed the association of MLU and both plasma fasting insulin and HOMA-IR score using log-linear regression models.

Results

A total of 65,209 obese individuals aged 18 to 59 years were included. In obese individuals who never used marijuana (reference), the mean value (± standard deviation) was 19.0 (± 12.8) μU/mL for plasma fasting insulin and 4.78 (± 3.49) for HOMA-IR. In individuals with HOMA-IR < 2.13 or ≥ 5.72, we found no association of marijuana use with HOMA-IR. In those with HOMA-IR < 5.72, the highest tertile of MLU (i.e., ≥ 1799 times) was associated with 12% decrease (95% confidence intervals, 4–19%) in the fasting insulin and 10% decrease in HOMA-IR (95% CI 1–19%), as compared with their counterparts who never used marijuana. In those with HOMA-IR ≥ 2.13, we found a marked impact of marijuana use only in adults who used marijuana ≥ 1799 times, with 13% decrease (95% CI 5–19%) in fasting insulin and 10% decrease (95% CI 3–18%) in HOMA-IR score.

Conclusions

Marijuana use is associated with reduced fasting insulin levels and HOMA-IR score in US obese adults with HOMA-IR ≥ 2.13, but not in those with HOMA-IR < 2.13 or ≥ 5.72. The impact of marijuana use is the greatest after long-term exposure and is independent of BMI.

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Acknowledgements

We are grateful to all the study participants and acknowledge the contributions of all their collaborators for their valuable help.

Funding

Dr. Ngueta received a postdoctoral fellowship (No. 331786) from Canadian Institutes of Health Research.

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Authors

Contributions

GN takes responsibility for the accuracy of data analysis. He conceptualized and designed the study and analyzed and interpreted the results. He also wrote the manuscript.

Corresponding author

Correspondence to Gerard Ngueta.

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The author declares that he has no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Informed consent was obtained from all patients for being included in the current study.

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Ngueta, G. Impact of lifetime marijuana use on fasting plasma insulin levels and HOMA-IR score in obese adults with and without insulin resistance. Acta Diabetol 57, 133–140 (2020). https://doi.org/10.1007/s00592-019-01390-x

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  • DOI: https://doi.org/10.1007/s00592-019-01390-x

Keywords

  • Marijuana use
  • Fasting insulin
  • HOMA-IR
  • Obesity