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. 2012 Feb 24;2(1):e000494.
doi: 10.1136/bmjopen-2011-000494. Print 2012.

Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III

Tripathi B Rajavashisth  1 , Magda Shaheen, Keith C Norris, Deyu Pan, Satyesh K Sinha, Juan Ortega, Theodore C Friedman
Affiliations

Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III

Tripathi B Rajavashisth et al. BMJ Open. .

Abstract

Objective: To determine the association between diabetes mellitus (DM) and marijuana use.

Design: Cross-sectional study.

Setting: Data from the National Health and Nutrition Examination Survey (NHANES III, 1988-1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

Participants: The study included participants of the NHANES III, a nationally representative sample of the US population. The total analytic sample was 10 896 adults. The study included four groups (n=10 896): non-marijuana users (61.0%), past marijuana users (30.7%), light (one to four times/month) (5.0%) and heavy (more than five times/month) current marijuana users (3.3%). DM was defined based on self-report or abnormal glycaemic parameters. We analysed data related to demographics, body mass index, smoking status, alcohol use, total serum cholesterol, high-density lipoprotein, triglyceride, serum 25-hydroxy vitamin D, plasma haemoglobin A1c, fasting plasma glucose level and the serum levels of C reactive protein and four additional inflammatory markers as related to marijuana use.

Main outcome measures: OR for DM associated with marijuana use adjusted for potential confounding variables (ie, odds of DM in marijuana users compared with non-marijuana users).

Results: Marijuana users had a lower age-adjusted prevalence of DM compared to non-marijuana users (OR 0.42, 95% CI 0.33 to 0.55; p<0.0001). The prevalence of elevated C reactive protein (>0.5 mg/dl) was significantly higher (p<0.0001) among non-marijuana users (18.9%) than among past (12.7%) or current light (15.8%) or heavy (9.2%) users. In a robust multivariate model controlling for socio-demographic factors, laboratory values and comorbidity, the lower odds of DM among marijuana users was significant (adjusted OR 0.36, 95% CI 0.24 to 0.55; p<0.0001).

Conclusions: Marijuana use was independently associated with a lower prevalence of DM. Further studies are needed to show a direct effect of marijuana on DM.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare the following: TBR is the owner of Omics Biotechnology, Inc, a company with an interest in using modifications of cannabinoids-mediated cell signalling to treat diabetes mellitus and other diseases of inflammation. TBR was not involved in the data collection or statistical analyses. MS, KCN, DP, SKS, JO and TCF have no relationships with companies that might have an interest in the submitted work in the previous 3 years. TBR, MS, KCN, DP, SKS, JO and TCF have no non-financial interests that may be relevant to the submitted work and their spouses, partners or children have no financial relationships that may be relevant to the submitted work.

Figures

Figure 1
Figure 1
The prevalence of marijuana users (past and current) among subjects according to fasting glucose levels (in milligrams per decilitre). Per cent and 95% CI are depicted. *p<0.05 compared to glucose level <94 mg/dl.
Figure 2
Figure 2
The prevalence of marijuana users (past and current) among subjects according to plasma haemoglobin A1c (HbA1c) levels. Per cent and 95% CI are depicted. *p<0.05 compared to <5.8%.
Figure 3
Figure 3
OR and 95% CI of having diabetes mellitus (DM) among past and current marijuana users relative to non-marijuana users.
See this image and copyright information in PMC

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