title: Marijuana use and risk of prediabetes and diabetes by middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study.
abstract: OBJECTIVE
  The impact of marijuana use on metabolic health is largely unknown. This study sought to clarify the cross-sectional and longitudinal associations between self-reported marijuana use, and prediabetes (defined as fasting glucose 5.6-6.9 mmol/l, 2 h glucose post OGTT 7.8-11.0 mmol/l or HbA1c 5.7-6.4% [39-47 mmol/mol]) and diabetes.
  
  
  METHODS
  Data from the community-based Coronary Artery Risk Development in Young Adults (CARDIA) study were used to determine marijuana use and the presence of prediabetes and diabetes among participants. The association between marijuana use and the prevalence of prediabetes and diabetes was examined in 3,034 participants at CARDIA examination year 25 (2010-2011), while the incidence of prediabetes and diabetes according to previous marijuana use was assessed in 3,151 individuals who were free from prediabetes/diabetes at year 7 (1992-1993) and who returned for at least one of the four subsequent follow-up examinations over 18 years.
  
  
  RESULTS
  The percentage of individuals who self-reported current use of marijuana declined over the course of the study's follow-up. After multivariable adjustment, higher odds of prediabetes were found for individuals who reported current use of marijuana (OR 1.65 [95% CI 1.15, 2.38]) and a lifetime use of 100 times or more (OR 1.49 [95% CI 1.06, 2.11]), compared with individuals who reported never using marijuana. There was no association between marijuana use and diabetes at CARDIA examination year 25. Over 18 years of follow-up, a greater risk of prediabetes (but not diabetes) was found for individuals who reported a lifetime use of marijuana of 100 times or more (HR 1.39 [95% CI 1.13, 1.71]), compared with individuals who had never used marijuana.
  
  
  CONCLUSIONS
  Marijuana use in young adulthood is associated with an increased risk of prediabetes by middle adulthood, but not with the development of diabetes by this age.
authors.affiliation: Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA. banck005@umn.edu.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bancks
authors.affiliation: Departments of Epidemiology and Biostatistics and Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pletcher
authors.affiliation: Birmingham VA Medical Center, Birmingham, AL, USA.|Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Kertesz
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.|Department of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA.|Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Jamal S
authors.initials: JS
authors.lastname: Rana
authors.affiliation: Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
mesh_terms: D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects / Q000453:epidemiology*; D011236:Prediabetic State / Q000453:epidemiology* / Q000209:etiology; D012306:Risk; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin
keywords: Diabetes; Incidence; Longitudinal; Marijuana use; Prediabetes