title: Cannabis use and bone mineral density: NHANES 2007-2010.
abstract: Cannabis use is rising in the USA. Its relationship to cannabinoid signaling in bone cells implies its use could affect bone mineral density (BMD) in the population. In a national survey of people ages 20-59, we found no association between self-reported cannabis use and BMD of the hip or spine.
  
  
  BACKGROUND
  Cannabis is the most widely used illegal drug in the USA, and its recreational use has recently been approved in several US states. Cannabinoids play a role in bone homeostasis. We aimed to determine the association between cannabis use and BMD in US adults.
  
  
  METHODS
  In the National Health and Nutrition Examination Survey 2007-2010, 4743 participants between 20 and 59 years old, history of cannabis use was categorized into never, former (previous use, but not in last 30 days), light (1-4 days of use in last 30 days), and heavy (≥5 days of use in last 30 days). Multivariable linear regression was used to test the association between cannabis use and DXA BMD of the proximal femur and lumbar spine with adjustment for age, sex, BMI, and race/ethnicity among other BMD determinants.
  
  
  RESULTS
  Sixty percent of the population reported ever using cannabis; 47% were former users, 5% were light users, and 7% were heavy users. Heavy cannabis users were more likely to be male, have a lower BMI, increased daily alcohol intake, increased tobacco pack-years, and were more likely to have used other illegal drugs (cocaine, heroin, or methamphetamines). No association between cannabis and BMD was observed for any level of use (p ≥ 0.28).
  
  
  CONCLUSIONS
  A history of cannabis use, although highly prevalent and related to other risk factors for low BMD, was not independently associated with BMD in this cross-sectional study of American men and women.
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Bourne
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.
authors.forename: Wesley
authors.initials: W
authors.lastname: Plinke
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Hooker
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA. nielsoca@ohsu.edu.
authors.forename: Carrie M
authors.initials: CM
authors.lastname: Nielson
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D002188:Cannabis / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000187:drug effects; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Bone mineral density; Cannabis; Drug use; NHANES; Osteoporosis