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Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C.
Gastroenterology. 2008 Feb; 134(2):432-9.G

Abstract

BACKGROUND & AIMS

Steatosis is highly prevalent in patients with chronic hepatitis C (CHC) and has been reported to increase fibrosis and reduce the rate of viral eradication. Two recent studies indicate that endocannabinoids promote experimental steatosis via activation of hepatic CB1 receptors. We therefore investigated the impact of cannabis smoking on steatosis severity during CHC.

METHODS

A total of 315 consecutive patients with untreated CHC undergoing liver biopsy were included. Detailed histories of recent cannabis, alcohol, and tobacco use were recorded. Steatosis, activity, and fibrosis stage were assessed by 2 pathologists according to METAVIR. Marked steatosis was defined as >/=30%. Patients were categorized as cannabis nonusers (63.5%), occasional cannabis smokers (12.4%), or daily cannabis smokers (24.1%).

RESULTS

Multivariate analysis identified 6 predictors of marked steatosis: daily cannabis use (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.01-4.5]), activity grade >/=A2 (OR, 2.1; 95% CI, 1.0-4.3), genotype 3 (OR, 5.4; 95% CI, 2.6-11.3), hyperglycemia or diabetes (OR, 5.1; 95% CI, 1.8-15.0), body mass index >27 kg/m(2) (OR, 2.1; 95% CI, 1.0-4.3), and serum HCV RNA load (OR, 1.7; 95% CI, 1.0-2.9). Upon adjustment of HCV genotype (3 vs non-3) or alcohol intake (<30 g/day vs >/=30 g/day), marked steatosis was more frequent in daily cannabis users compared with occasional users and nonusers (P = .03 and P = .008, respectively).

CONCLUSIONS

Our results identify daily cannabis smoking as a novel independent predictor of steatosis severity during CHC and strongly argue for a steatogenic role of the cannabinoid system. Cannabis use should be discouraged in patients with CHC.

Authors+Show Affiliations

Department of Hepatology and Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18242211

Citation

Hézode, Christophe, et al. "Daily Cannabis Use: a Novel Risk Factor of Steatosis Severity in Patients With Chronic Hepatitis C." Gastroenterology, vol. 134, no. 2, 2008, pp. 432-9.
Hézode C, Zafrani ES, Roudot-Thoraval F, et al. Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C. Gastroenterology. 2008;134(2):432-9.
Hézode, C., Zafrani, E. S., Roudot-Thoraval, F., Costentin, C., Hessami, A., Bouvier-Alias, M., Medkour, F., Pawlostky, J. M., Lotersztajn, S., & Mallat, A. (2008). Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C. Gastroenterology, 134(2), 432-9. https://doi.org/10.1053/j.gastro.2007.11.039
Hézode C, et al. Daily Cannabis Use: a Novel Risk Factor of Steatosis Severity in Patients With Chronic Hepatitis C. Gastroenterology. 2008;134(2):432-9. PubMed PMID: 18242211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C. AU - Hézode,Christophe, AU - Zafrani,Elie Serge, AU - Roudot-Thoraval,Françoise, AU - Costentin,Charlotte, AU - Hessami,Ali, AU - Bouvier-Alias,Magali, AU - Medkour,Fatiha, AU - Pawlostky,Jean-Michel, AU - Lotersztajn,Sophie, AU - Mallat,Ariane, Y1 - 2007/11/28/ PY - 2007/07/27/received PY - 2007/11/16/accepted PY - 2008/2/5/pubmed PY - 2008/2/15/medline PY - 2008/2/5/entrez SP - 432 EP - 9 JF - Gastroenterology JO - Gastroenterology VL - 134 IS - 2 N2 - BACKGROUND & AIMS: Steatosis is highly prevalent in patients with chronic hepatitis C (CHC) and has been reported to increase fibrosis and reduce the rate of viral eradication. Two recent studies indicate that endocannabinoids promote experimental steatosis via activation of hepatic CB1 receptors. We therefore investigated the impact of cannabis smoking on steatosis severity during CHC. METHODS: A total of 315 consecutive patients with untreated CHC undergoing liver biopsy were included. Detailed histories of recent cannabis, alcohol, and tobacco use were recorded. Steatosis, activity, and fibrosis stage were assessed by 2 pathologists according to METAVIR. Marked steatosis was defined as >/=30%. Patients were categorized as cannabis nonusers (63.5%), occasional cannabis smokers (12.4%), or daily cannabis smokers (24.1%). RESULTS: Multivariate analysis identified 6 predictors of marked steatosis: daily cannabis use (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.01-4.5]), activity grade >/=A2 (OR, 2.1; 95% CI, 1.0-4.3), genotype 3 (OR, 5.4; 95% CI, 2.6-11.3), hyperglycemia or diabetes (OR, 5.1; 95% CI, 1.8-15.0), body mass index >27 kg/m(2) (OR, 2.1; 95% CI, 1.0-4.3), and serum HCV RNA load (OR, 1.7; 95% CI, 1.0-2.9). Upon adjustment of HCV genotype (3 vs non-3) or alcohol intake (<30 g/day vs >/=30 g/day), marked steatosis was more frequent in daily cannabis users compared with occasional users and nonusers (P = .03 and P = .008, respectively). CONCLUSIONS: Our results identify daily cannabis smoking as a novel independent predictor of steatosis severity during CHC and strongly argue for a steatogenic role of the cannabinoid system. Cannabis use should be discouraged in patients with CHC. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/18242211/Daily_cannabis_use:_a_novel_risk_factor_of_steatosis_severity_in_patients_with_chronic_hepatitis_C_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(07)02116-6 DB - PRIME DP - Unbound Medicine ER -