Abstract

Cannabis use prevalence has increased in the United States (U.S.) and worldwide. Cannabis exerts its effects on human function primarily through activating the cannabinoid system. In recent years, the cannabinoid system has emerged as an important regulator of energy balance. Pharmacological deactivation or genetic deletion of the cannabinoid-1 receptor in animals improved various metabolic outcomes. Human epidemiological studies, however, suggests a paradox. Increased caloric intake and decreased physical activity were observed in cannabis users. Surprisingly, cannabis use was associated with attenuated weight gain and lower levels of fasting insulin. The aim of this study is to examine the association of cannabis use and glucose clearance as indicated by glucose tolerance test among adults participating in the National Health and Nutrition Examination Survey (NHANES). NHANES is designed to recruit, interview and examine a nationally representative sample of the U.S. non-institutionalized population. For this study, we used publicly available NHANES data generated through surveys conducted in 2007-2016. After a 9-hour fast, a subsample of participants were asked to drink a calibrated dose (75 grams of glucose) of TrutolTM and had a second venipuncture 2 hours after drinking. Cannabis use questions were self-administered using the Audio Computer-Assisted Self-Interview in NHANES mobile examination center. Results from generalized regression modelling indicated an inverse association between cannabis use in the 30 days prior to NHANES and 2-hr blood glucose levels (β= -5.9; 95% CI = -9.9, -1.8). Adjusting for tobacco smoking, alcohol drinking or body mass index minimally affected the estimates. The relationship between 2-hr glucose levels and cannabis use frequency was stronger for occasional users compared to heavy users. In conclusion, cannabis use is associated with improved glucose clearance. Additional studies are needed to confirm the results of this study and to investigate the underlying mechanisms. Disclosure O. Alshaarawy: None. Funding National Center for Complementary and Integrative Health (AT009156)

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