Self-reported marijuana use over 25 years and abdominal adiposity: the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Corresponding Author
Michael P. Bancks
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Correspondence to: Mike Bancks, Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA. E-mail: [email protected]Search for more papers by this authorReto Auer
Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
Search for more papers by this authorJ. Jeffrey Carr
Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN, USA
Search for more papers by this authorDavid C. Goff Jr.
National Heart, Lung, and Blood Institute, Bethesda, MD, USA
This work was completed while DC Goff was at the Colorado School of Public Health. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; National Institutes of Health; or the United States Department of Health and Human Services.Search for more papers by this authorCatarina Kiefe
University of Massachusetts Medical School, Worcester, MA, USA
Search for more papers by this authorJamal S. Rana
Kaiser Permanente Division of Cardiology, Oakland, CA, USA
Department of Medicine, University of California San Francisco, San Francisco, CA, USA
Search for more papers by this authorJared Reis
National Heart, Lung, and Blood Institute, Bethesda, MD, USA
Search for more papers by this authorStephen Sidney
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
Search for more papers by this authorJames G. Terry
Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN, USA
Search for more papers by this authorPamela J. Schreiner
University of Minnesota, School of Public Health, Minneapolis, MN, USA
Search for more papers by this authorCorresponding Author
Michael P. Bancks
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Correspondence to: Mike Bancks, Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA. E-mail: [email protected]Search for more papers by this authorReto Auer
Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
Search for more papers by this authorJ. Jeffrey Carr
Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN, USA
Search for more papers by this authorDavid C. Goff Jr.
National Heart, Lung, and Blood Institute, Bethesda, MD, USA
This work was completed while DC Goff was at the Colorado School of Public Health. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; National Institutes of Health; or the United States Department of Health and Human Services.Search for more papers by this authorCatarina Kiefe
University of Massachusetts Medical School, Worcester, MA, USA
Search for more papers by this authorJamal S. Rana
Kaiser Permanente Division of Cardiology, Oakland, CA, USA
Department of Medicine, University of California San Francisco, San Francisco, CA, USA
Search for more papers by this authorJared Reis
National Heart, Lung, and Blood Institute, Bethesda, MD, USA
Search for more papers by this authorStephen Sidney
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
Search for more papers by this authorJames G. Terry
Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN, USA
Search for more papers by this authorPamela J. Schreiner
University of Minnesota, School of Public Health, Minneapolis, MN, USA
Search for more papers by this authorAbstract
Aims
We investigated the association between cumulative lifetime and current marijuana use with total abdominal adipose tissue (AT), visceral AT, subcutaneous AT, intermuscular AT, and mean liver attenuation (LA) at mid-life.
Design
Longitudinal and cross-sectional secondary data analysis of participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.
Setting
CARDIA field centers in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA, USA.
Participants
CARDIA participants, aged 18–30 years in 1985–1986, who were present at the clinic examination in 2010–2011 (n = 2902).
Measurements
Marijuana use was assessed from responses to self-administered questionnaires at 8 CARDIA examinations over 25 years, determined as cumulative marijuana-years and current use status. Non-contrast computed tomography imaging of the abdomen was obtained in 2010–2011.
Findings
In 2010–2011, 84% of participants reported a history of marijuana use with 11% reporting use within the past 30 days. Before adjustment, we observed greater cumulative marijuana use was associated with lower total abdominal and subcutaneous AT volume and lower LA and current marijuana use was associated with lower subcutaneous AT. However, after adjustment for age, sex, race, field center, cigarette pack-years and current use, regular alcohol consumption, cumulative drink-years, and physical activity, neither cumulative marijuana use nor current use showed an association with any abdominal adipose depot. Our estimates did not differ by age, sex, or race nor after accounting for cohort attrition.
Conclusion
Neither cumulative marijuana use nor current marijuana use is associated with total abdominal, visceral, subcutaneous, or intermuscular adipose tissue, or liver attenuation in mid-life.
Supporting Information
| Filename | Description |
|---|---|
| add14097-sup-0001-supplementary material.docxWord 2007 document , 583.8 KB |
Table S1 Baseline (1985–1986) characteristics of participants in the Coronary Artery Risk Development in Young Adults Study for those included in analysis compared to those excluded from analysis. Table S2 Unadjusted estimates for abdominal adipose tissue depot according to basic demographic and behavioral characteristics for 2478 participants in the Coronary Artery Risk Development in Young Adults study (2010–2011). Figure S1 Association between cumulative lifetime marijuana use and total abdominal adipose tissue. The restricted cubic spline of total abdominal adipose tissue (mL) corresponds to the left y-axis and the histogram plots the frequency of individuals corresponding to the right y-axis. Both y-axes are plotted according to marijuana-years on the x-axis. Figure S2 Association between cumulative lifetime marijuana use and visceral adipose tissue. The restricted cubic spline of visceral adipose tissue (mL) corresponds to the left y-axis and the histogram plots the frequency of individuals corresponding to the right y-axis. Both y-axes are plotted according to marijuana-years on the x-axis. Figure S3 Association between cumulative lifetime marijuana use and subcutaneous adipose tissue. The restricted cubic spline of subcutaneous adipose tissue (mL) corresponds to the left y-axis and the histogram plots the frequency of individuals corresponding to the right y-axis. Both y-axes are plotted according to marijuana-years on the x-axis. Figure S4 Association between cumulative lifetime marijuana use and intermuscular adipose tissue. The restricted cubic spline of intermuscular adipose tissue (mL) corresponds to the left y-axis and the histogram plots the frequency of individuals corresponding to the right y-axis. Both y-axes are plotted according to marijuana-years on the x-axis. Figure S5 Association between cumulative lifetime marijuana use and liver attenuation. The restricted cubic spline of liver attenuation (Hounsfield Units) corresponds to the left y-axis and the histogram plots the frequency of individuals corresponding to the right y-axis. Both y-axes are plotted according to marijuana-years on the x-axis. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1Fant R. V., Heishman S. J., Bunker E. B., Pickworth W. B. Acute and residual effects of marijuana in humans. Pharmacol Biochem Behav 1998; 60: 777–784.
- 2Mittleman M. A., Lewis R. A., Maclure M., Sherwood J. B., Muller J. E. Triggering myocardial infarction by marijuana. Circulation 2001; 103: 2805–2809.
- 3Martinasek M. P., McGrogan J. B., Maysonet A. A systematic review of the respiratory effects of inhalational marijuana. Respir Care 2016; 61: 1543–1551.
- 4Sidney S., Quesenberry C. P. Jr., Friedman G. D., Tekawa I. S. Marijuana use and cancer incidence (California, United States). Cancer Causes Control 1997; 8: 722–728.
- 5Pletcher M. J., Vittinghoff E., Kalhan R., Richman J., Safford M., Sidney S. et al. Association between marijuana exposure and pulmonary function over 20 years. JAMA 2012; 307: 173–181.
- 6Hancox R. J., Poulton R., Ely M., Welch D., Taylor D. R., McLachlan C. R. et al. Effects of cannabis on lung function: a population-based cohort study. Eur Respir J 2010; 35: 42–47.
- 7Berthiller J., Straif K., Boniol M., Voirin N., Benhaim-Luzon V., Ayoub W. B. et al. Cannabis smoking and risk of lung cancer in men: a pooled analysis of three studies in Maghreb. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 2008; 3: 1398–1403.
- 8Hashibe M., Morgenstern H., Cui Y., Tashkin D. P., Zhang Z. F., Cozen W. et al. Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case–control study. Cancer Epidemiol Biomarkers Prev 2006; 15: 1829–1834.
- 9Zhang L. R., Morgenstern H., Greenland S., Chang S. C., Lazarus P., Teare M. D. et al. Cannabis smoking and lung cancer risk: pooled analysis in the International Lung Cancer Consortium. Int J Cancer 2015; 136: 894–903.
- 10Macleod J., Robertson R., Copeland L., McKenzie J., Elton R., Reid P. Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population. Br J Gen Pract 2015; 65: e89–e95.
- 11Tan W. C., Lo C., Jong A., Xing L., Fitzgerald M. J., Vollmer W. M. et al. Marijuana and chronic obstructive lung disease: a population-based study. CMAJ 2009; 180: 814–820.
- 12Moore B. A., Augustson E. M., Moser R. P., Budney A. J. Respiratory effects of marijuana and tobacco use in a U.S. sample. J Gen Intern Med 2005; 20: 33–37.
- 13Bancks M., Pletcher M., Kertesz S., Sidney S., Rana J., Schreiner P. Marijuana use and risk of prediabetes and diabetes by middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Diabetologia 2015; 58: 2736–2744.
- 14Sidney S., Beck J. E., Tekawa I. S., Quesenberry C. P., Friedman G. D. Marijuana use and mortality. Am J Public Health 1997; 87: 585–590.
- 15Vidot D. C., Prado G., Hlaing W. M., Florez H. J., Arheart K. L., Messiah S. E. Metabolic syndrome among marijuana users in the United States: an analysis of National Health and Nutrition Examination Survey data. Am J Med 2016; 129: 173–179.
- 16Rodondi N., Pletcher M. J., Liu K., Hulley S. B., Sidney S. Marijuana use, diet, body mass index, and cardiovascular risk factors (from the CARDIA study). Am J Cardiol 2006; 98: 478–484.
- 17Auer R., Vittinghoff E., Yaffe K., Kunzi A., Kertesz S. G., Levine D. A. et al. Association between lifetime marijuana use and cognitive function in middle age: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. JAMA Intern Med 2016; 176: 352–361.
- 18Penner E. A., Buettner H., Mittleman M. A. The impact of marijuana use on glucose, insulin, and insulin resistance among US adults. Am J Med 2013; 126: 583–589.
- 19Farhat T., Iannotti R. J., Simons-Morton B. G. Overweight, obesity, youth, and health-risk behaviors. Am J Prev Med 2010; 38: 258–267.
- 20Johansson E., Noren K., Sjovall J., Halldin M. M. Determination of delta 1-tetrahydrocannabinol in human fat biopsies from marihuana users by gas chromatography-mass spectrometry. Biomed Chromatogr 1989; 3: 35–38.
- 21Boyko E. J., Fujimoto W. Y., Leonetti D. L., Newell-Morris L. Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans. Diabetes Care 2000; 23: 465–471.
- 22Reis J. P., Auer R., Bancks M. P., Goff D. C. Jr., Lewis C. E., Pletcher M. J. et al. Cumulative lifetime marijuana use and incident cardiovascular disease in middle age: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Public Health 2017; 107: 601–606.
- 23 Center for Behavioral Health Statistics and Quality. 2016 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2017.
- 24Cerdá M., Wall M., Keyes K. M., Galea S., Hasin D. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug Alcohol Depend 2012; 120: 22–27.
- 25Wall M. M., Mauro C., Hasin D. S., Keyes K. M., Cerda M., Martins S. S. et al. Prevalence of marijuana use does not differentially increase among youth after states pass medical marijuana laws: commentary on and reanalysis of US National Survey on Drug Use in Households data 2002–2011. Int J Drug Policy 2016; 29: 9–13.
- 26Pacher P., Batkai S., Kunos G. The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacol Rev 2006; 58: 389–462.
- 27Molenaar E. A., Massaro J. M., Jacques P. F., Pou K. M., Ellison R. C., Hoffmann U. et al. Association of lifestyle factors with abdominal subcutaneous and visceral adiposity: the Framingham Heart Study. Diabetes Care 2009; 32: 505–510.
- 28Taylor D. R., Poulton R., Moffitt T. E., Ramankutty P., Sears M. R. The respiratory effects of cannabis dependence in young adults. Addiction (Abingdon, England) 2000; 95: 1669–1677.
- 29Hall W. What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction 2015; 110: 19–35.
- 30Hayatbakhsh M. R., O'Callaghan M. J., Mamun A. A., Williams G. M., Clavarino A., Najman J. M. Cannabis use and obesity and young adults. Am J Drug Alcohol Abuse 2010; 36: 350–356.
- 31Muniyappa R., Sable S., Ouwerkerk R., Mari A., Gharib A. M., Walter M. et al. Metabolic effects of chronic cannabis smoking. Diabetes Care 2013; 36: 2415–2422.
- 32Ngueta G., Bélanger R. E., Laouan-Sidi E. A., Lucas M. Cannabis use in relation to obesity and insulin resistance in the inuit population. Obesity (Silver Spring) 2015; 23: 290–295.
- 33Adejumo A. C., Alliu S., Ajayi T. O., Adejumo K. L., Adegbala O. M., Onyeakusi N. E. et al. Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: a cross-sectional study. PLoS One 2017; 12: e0176416.
- 34Vidot D. C., Bispo J. B., Hlaing W. M., Prado G., Messiah S. E. Moderate and vigorous physical activity patterns among marijuana users: results from the 2007–2014 National Health and Nutrition Examination Surveys. Drug Alcohol Depend 2017; 178: 43–48.
- 35Chalasani N., Younossi Z., Lavine J. E., Diehl A. M., Brunt E. M., Cusi K. et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012; 55: 2005–2023.
- 36Jacobs D. J., Hahn L., Haskell W., Pirie P., Sidney S. Validity and reliability of a short physical activity history: CARDIA and the Minnesota Heart Health Program. J Cardiopulm Rehabil 1989; 9: 448–459.
- 37 American College of Sports Medicine The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Position stand of the American College of Sports Medicine. Schweizerische Zeitschrift fur Sportmedizin 1993; 41: 127–137.
- 38Hasin D. S., Wall M., Keyes K. M., Cerda M., Schulenberg J., O'Malley P. M. et al. Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: results from annual, repeated cross-sectional surveys. Lancet Psychiatry 2015; 2: 601–608.
- 39Le Strat Y., Le Foll B. Obesity and cannabis use: results from 2 representative national surveys. Am J Epidemiol 2011; 174: 929–933.
- 40Davidson L. E., Kuk J. L., Church T. S., Ross R. Protocol for measurement of liver fat by computed tomography. J Appl Physiol (1985) 2006; 100: 864–868.
- 41Weuve J., Tchetgen Tchetgen E. J., Glymour M. M., Beck T. L., Aggarwal N. T., Wilson R. S. et al. Accounting for bias due to selective attrition: the example of smoking and cognitive decline. Epidemiology 2012; 23: 119–128.
- 42Pasch K. E., Velazquez C. E., Cance J. D., Moe S. G., Lytle L. A. Youth substance use and body composition: does risk in one area predict risk in the other? J Youth Adolesc 2012; 41: 14–26.
- 43Hirvonen J., Goodwin R. S., Li C. T., Terry G. E., Zoghbi S. S., Morse C. et al. Reversible and regionally selective downregulation of brain cannabinoid CB1 receptors in chronic daily cannabis smokers. Mol Psychiatry 2012; 17: 642–649.
- 44Gunasekaran N., Long L. E., Dawson B. L., Hansen G. H., Richardson D. P., Li K. M. et al. Reintoxication: the release of fat-stored delta(9)-tetrahydrocannabinol (THC) into blood is enhanced by food deprivation or ACTH exposure. Br J Pharmacol 2009; 158: 1330–1337.
- 45Wong A., Gunasekaran N., Hancock D. P., Denyer G. S., Meng L., Radford J. L. et al. The major plant-derived cannabinoid Delta(9)-tetrahydrocannabinol promotes hypertrophy and macrophage infiltration in adipose tissue. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme 2012; 44: 105–113.
- 46Kramer C. K., von Muhlen D., Gross J. L., Barrett-Connor E. A prospective study of abdominal obesity and coronary artery calcium progression in older adults. J Clin Endocrinol Metab 2009; 94: 5039–5044.
- 47Frost L., Mostofsky E., Rosenbloom J. I., Mukamal K. J., Mittleman M. A. Marijuana use and long-term mortality among survivors of acute myocardial infarction. Am Heart J 2013; 165: 170–175.
- 48Friedman G. D., Cutter G. R., Donahue R. P., Hughes G. H., Hulley S. B., Jacobs D. R. Jr. et al. CARDIA: study design, recruitment, and some characteristics of the examined subjects. J Clin Epidemiol 1988; 41: 1105–1116.
- 49 US Department of Health Human Services. Dietary guidelines for Americans 2015–2020. Skyhorse Publishing Inc.; 2017.
- 50VanWagner L. B., Ning H., Lewis C. E., Shay C. M., Wilkins J., Carr J. J. et al. Associations between nonalcoholic fatty liver disease and subclinical atherosclerosis in middle-aged adults: the Coronary Artery Risk Development in Young Adults Study. Atherosclerosis 2014; 235: 599–605.
- 51Gaoni Y., Mechoulam R. Isolation and structure of DELTA-1-tetrahydrocannabinol and other neutral cannabinoids from hashish. J Am Chem Soc 1971; 93: 217–224.
- 52Despres J. P., Ross R., Boka G., Almeras N., Lemieux I. Effect of rimonabant on the high-triglyceride/ low-HDL-cholesterol dyslipidemia, intraabdominal adiposity, and liver fat: the ADAGIO-Lipids trial. Arterioscler Thromb Vasc Biol 2009; 29: 416–423.
