title: Metabolic effects of chronic cannabis smoking.
abstract: OBJECTIVE
  We examined if chronic cannabis smoking is associated with hepatic steatosis, insulin resistance, reduced β-cell function, or dyslipidemia in healthy individuals.
  
  
  METHODS
  In a cross-sectional, case-control study, we studied cannabis smokers (n = 30; women, 12; men, 18; 27 ± 8 years) and control subjects (n = 30) matched for age, sex, ethnicity, and BMI (27 ± 6). Abdominal fat depots and intrahepatic fat content were quantified by magnetic resonance imaging and proton magnetic resonance spectroscopy, respectively. Insulin-sensitivity indices and various aspects of β-cell function were derived from oral glucose tolerance tests (OGTT).
  
  
  RESULTS
  Self-reported cannabis use was: 9.5 (2-38) years; joints/day: 6 (3-30) [median (range)]. Carbohydrate intake and percent calories from carbohydrates, but not total energy intake, were significantly higher in cannabis smokers. There were no group differences in percent total body fat, or hepatic fat, but cannabis smokers had a higher percent abdominal visceral fat (18 ± 9 vs. 12 ± 5%; P = 0.004). Cannabis smokers had lower plasma HDL cholesterol (49 ± 14 vs. 55 ± 13 mg/dL; P = 0.02), but fasting levels of glucose, insulin, total cholesterol, LDL cholesterol, triglycerides, or free fatty acids (FFA) were not different. Adipocyte insulin resistance index and percent FFA suppression during an OGTT was lower (P < 0.05) in cannabis smokers. However, oral glucose insulin sensitivity index, measures of β-cell function, or incretin concentrations did not differ between the groups.
  
  
  CONCLUSIONS
  Chronic cannabis smoking was associated with visceral adiposity and adipose tissue insulin resistance but not with hepatic steatosis, insulin insensitivity, impaired pancreatic β-cell function, or glucose intolerance.
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA.
authors.forename: Ranganath
authors.initials: R
authors.lastname: Muniyappa
authors.forename: Sara
authors.initials: S
authors.lastname: Sable
authors.forename: Ronald
authors.initials: R
authors.lastname: Ouwerkerk
authors.forename: Andrea
authors.initials: A
authors.lastname: Mari
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Gharib
authors.forename: Mary
authors.initials: M
authors.lastname: Walter
authors.forename: Amber
authors.initials: A
authors.lastname: Courville
authors.forename: Gail
authors.initials: G
authors.lastname: Hall
authors.forename: Kong Y
authors.initials: KY
authors.lastname: Chen
authors.forename: Nora D
authors.initials: ND
authors.lastname: Volkow
authors.forename: George
authors.initials: G
authors.lastname: Kunos
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
authors.forename: Monica C
authors.initials: MC
authors.lastname: Skarulis
mesh_terms: D050154:Adiposity; D000328:Adult; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*
chemical_list: D004040:Dietary Carbohydrates