Heavy Cannabis Use Is Associated With Low Bone Mineral Density and an Increased Risk of Fractures - 18/04/17
Abstract |
Purpose |
To investigate possible associations between recreational cannabis use and bone health in humans.
Methods |
Cross-sectional study of individuals recruited from primary care in the UK between 2011 and 2013. Cases were regular smokers of cannabis divided into moderate (n = 56) and heavy user (n = 144) subgroups depending on whether they reported fewer or more than 5000 cannabis smoking episodes during their lifetime. Controls comprised 114 cigarette smokers.
Results |
Heavy cannabis users had lower total hip bone mineral density (mean ± SD Z-score: −0.20 ± 0.9 vs +0.2 ± 0.9, P < .0005), lower spine bone mineral density (−0.5 ± 1.2 vs 0.0 ± 1.2, P < .0005), and lower body mass index (BMI; 26.5 ± 6.0 vs 29.0 ± 7.0, P = .01) than controls. Fracture rate was also increased in heavy users (rate ratio = 2.17; 95% confidence interval, 1.59-2.95; P < .001). When compared with controls, serum cross-linked C-telopeptide of type 1 collagen (CTX) concentrations were raised in heavy cannabis users (0.3 ± 0.1 vs 0.2 ± 0.1 pg/mL, P = .045), as were serum N-terminal propeptide of type 1 procollagen (P1NP) concentrations (47.1 ± 19.2 vs 41.2 ± 17.8 pg/mL, P = .01). Serum total 25-hydroxyvitamin D concentrations were reduced in heavy users compared with controls (25.3 ± 16.8 vs 36.9 ± 26.7 nmol/L, P = .002). Multiple regression analysis revealed that heavy cannabis use was an independent predictor of spine bone mineral density, accounting for 5.4% of the variance (P = .035), and total hip bone mineral density, accounting for 5.8% of the variance (P = .001), but mediation analysis suggested that the effect on spine bone mineral density was indirect and mediated through low body mass index.
Conclusions |
Heavy cannabis use is associated with low bone mineral density, low BMI, high bone turnover, and an increased risk of fracture. Heavy cannabis use negatively impacts on bone health both directly and indirectly through an effect on BMI.
Le texte complet de cet article est disponible en PDF.Keywords : Bone mineral density, Cannabinoids, Cannabis, Fracture
Plan
| Funding: The study was supported by a programme grant from Arthritis Research UK (17713). |
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| Conflict of Interest: SHR is the inventor on a patent concerning the use of cannabinoid receptor ligands as treatments for osteoporosis and other bone diseases. The other authors have no conflicts of interest to declare. |
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| Authorship: All authors had access to the data and played a role in writing the manuscript. Study design and conceptualization: SHR, AS; Investigation: AS, JMK; Statistical analyses: AS, NBF; Resources and Supervision: RR, WDF; Interpretation of results: AS, NBF, SHR; Writing – Original Draft: AS, SHR; Writing – Review & Editing: all authors; Funding Acquisition: SHR. |
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| Current address for Sophocleous: Department of Life Sciences, European University Cyprus, Nicosia, Cyprus. |
Vol 130 - N° 2
P. 214-221 - février 2017 Retour au numéro
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