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Relationship between Years of Marijuana Use and the Four Main Diagnostic Criteria for Metabolic Syndrome among United States Adults

Barbara A Yankey*, Richard Rothenberg, Sheryl Strasser, Kim Ramsey-White and Ike S Okosun

Objective: Research on marijuana use suggests a protective effect on metabolic syndrome. National Cholesterol Education Program, Adult Treatment Panel III, World Health Organization, European Group for the study of Insulin Resistance and International Diabetes Federation has different criteria for metabolic syndrome. Definitions of both marijuana use and criteria for metabolic syndrome may influence the observed effects. We examine the relationship of years of marijuana use with the four common definitions of metabolic syndrome.

Method: This is a cross-sectional study of 3051 adults aged ≥ 20 years who participated in the National Health and Nutrition Examination Survey 2011-2012. Only participants who responded to the question, "Have you ever even once used marijuana or hashish?" were enrolled. Using multivariate logistic regression, we estimated odds ratios for metabolic syndrome with each year of marijuana use.

Results: Adjusted odds ratios (AOR) for having metabolic syndrome with each increase in year of marijuana use was 1.05 (95% CI: 1.02, 1.08) using National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Respective AOR using International Diabetes Federation (IDF) was 1.08 (95% CI: 1.04, 1.13) and 1.05 (95% CI: 1.04, 1.13) using World Health Organization (WHO) or European Group for the study of Insulin Resistance (EGIR) criteria. Using ATP III or IDF criteria, the adjusted odds ratio of having hypertension (AOR Hyp) for each year of marijuana use was 1.07 (95% CI: 1.03, 1.12). Using WHO criteria, AOR Hyp was 1.05 (95% CI: 1.01, 1.09) and 1.08 (95% CI: 1.03, 1.12) using EGIR. All the applicable criteria show increased odds for abdominal obesity: AOR 1.06 (95% CI: 1.00, 1.11) (ATP III), 1.09 (95% CI: 1.05, 1.14) (EGIR) or 1.07 (95% CI: 1.01, 1.13) (IDF). Adjusted odds ratio for having high oral glucose tolerance test levels was 1.12 (95% CI: 1.07, 1.18) using WHO and EGIR criteria.

Conclusion: Irrespective of the criteria for metabolic syndrome, each year of marijuana use showed increased odds of having metabolic syndrome, hypertension or high oral glucose tolerance test levels. This increased odd is in contrast to most findings in literature. The small, yet consistent increase in odds for hypertension was slightly higher than that observed with cigarette smoking. Recreational marijuana use may be detrimental to cardiovascular health. A standardized definition of marijuana use will be relevant for further investigation.